Soil-transmitted helminthiasis in Uganda: epidemiology and cost of control.

A country-wide description of the distribution of soil-transmitted helminths in Uganda is reported, based on data for 20-185 school-children from 271 schools. The overall prevalence of Ascaris lumbricoides, Trichuris trichiura and hookworm was 6.3%, 5.0% and 43.5%, respectively. The prevalence of A. lumbricoides and T. trichiura was unevenly distributed in the country with prevalence greatest in south-western Uganda whereas hookworm was generally more homogeneously distributed. Based on preliminary cost analysis of an ongoing school-based control programme, the financial delivery cost per school-child treated with albendazole is estimated to be between US dollar 0.04 and 0.08 in different districts.

Causes of low attendance at national immunization days for polio eradication in Bushenyi district, Uganda.

The purpose of this study was to investigate the factors influencing attendance for polio National Immunization Days (NIDs) using the Attitudes-Social-influence-self-Efficacy (ASE) model as a guiding theoretical framework. The data was collected in Bushenyi district of south-western Uganda in 6 focus group discussions about outcomes of attendance at NIDs, about who decides on attendance, and about attendance barriers and supports. The purpose of NIDs - eradicating polio - was not known to the informants. The main reason mentioned for attending NIDs and other immunization was to weaken childhood diseases or to strengthen the children's capability in fighting diseases, whether they are immunizable or not. However, it was strongly believed that the previous NIDs had caused a severe malaria epidemic with a very high mortality, and this led to most parents not attending the next. Sources of social influence were mostly opinion and local leaders in communities, health workers, friends and relatives. Opinion leaders who did not immunize their children were said to hinder attendance at NIDs by other lay people. NIDs cards, on the other hand, were regarded as valuable means of support for attendance. Thus to improve immunization coverage, there is need for issuing NIDs cards, for using health education to change the belief that NIDs cause malaria, and to encourage local leaders to attend NIDs.

A low-cost, community-based measles outbreak investigation with follow-up action.

An outbreak of measles in Kampala, Uganda, in 1990 raised concern about the effectiveness of the measles vaccine that was used. The Uganda EPI programme and the medical office of the Kampala City Council therefore conducted a community-based investigation, with door-to-door interviews in two selected communities. They revealed 68 measles cases ranging in age from 5 months to 12 years; the highest age-specific attack rate (32%) was found in children aged 12 to 23 months. BCG immunization coverage was high (85%), but measles immunization coverage was moderate (48%). One community, served by a mobile clinic, presented a vaccine efficacy of only 55%. Responses by mothers revealed that many had failed to have their children completely immunized because of a lack of information, and not because of difficulties in access to the service. In a follow-up, community leaders initiated monthly checking of immunization cards of both children and mothers. The low vaccine efficacy found in one of the communities resulted in a thorough assessment of the city's cold chain. This community-based approach proved to be cost-effective and practical for identifying the obstacles to effective immunization delivery.

PIP: An outbreak of measles in Kampala, Uganda in 1990 raised concern about the effectiveness of the measles vaccine that was used. The uganda Expanded Program on Immunization and the medical office of the Kampala City Council therefore conducted a community-based investigation, with door-to-door interviews in 2 selected communities. They revealed 68 measles cases ranging in age from 5 months to 12 years; the highest age- specific attack rate (32%) was found in children aged 12-23 months. BCG immunization coverage was high (85%), but measles immunization coverage was moderate (48%). 1 community, served by a mobile clinic, presented a vaccine efficacy of only 55%. Responses by mothers revealed that many had failed to have their children completely immunized because of the lack of information, and not because of difficulties in access to the service. In a followup, community leaders initiated monthly checking of immunization cards of both children and mothers. The low vaccine efficacy found in 1 of the communities resulted in a thorough assessment of the city's cold chain. This community-based approach proved to be cost-effective and practical for identifying the obstacles to effective immunization delivery. (author's)

A low-cost; community-based measles outbreak investigation with follow-up action

An outbreak of measles in Kampala; Uganda; in 1990 raised concern about the effectiveness of the measles vaccine that was used. The Uganda EPI Programme and the medical office of the Kampala City council therefore conducted a community-based investigation; with door-to-door interviews in two selected communities. They revealed 68 measles cases ranging in age from 5 months to 12 years; the highest age-specific attack rate (32) was found in children aged 12 to 23 months. BCG immunization coverage was high (85); but measles immunization coverage was moderate (48). One community; served by a mobile clinic; presented a vaccine efficacy of only 55. Responses by mothers revealed that many had failed to have their children completely immunized because of a lack of information; and because of difficulties in access to the services. In a follow -up; community leaders initiated monthly checking of immunization cards of both children and mothers. The low vaccine efficacy found in one of the communities resulted in a thorough assessment of the city's cold chain. This community-based approach proved to be cost-effective and practical for identifying the obstacles to effective immunization delivery

A low-cost; community-based measles outbreak investigation with follow-up action

An outbreak of measles in Kampala; Uganda; in 1990 raised concern about the effectiveness of the measles vaccine that was used. The Uganda EPI programme and the medical office of the Kampala City Council therefore conducted a community-based investigation; with door-to-door interviews in two selected communities. They revealed 68 measles cases ranging in age from 5 months to 12 years; the highest age-specific attack rate (32pc) was found in children aged 12 to 23 months. BCG immunization coverage was high (85pc); but measles immunization coverage was moderate (48pc). One community; served by a mobile clinic; presented a vaccine efficacy of only 55pc. Responses by mothers revealed that many had failed to have their children completely immunized because of a lack of information; and not because of difficulties in access to the service. In a follow-up; community leaders initiated monthly checking of immunization cards of both children and mothers. The low vaccine efficacy found in one of the communities resulted in a thorough assessment of the city's cold chain. This community-based approach proved to be cost-effective and practical for identifying the obstacles to effective immunization delivery