Your search found 2912 Results

  1. 1
    396615

    Assessment of mother's perception and children's routine vaccination coverage in District Faisalabad, Pakistan.

    Asim M; Nawaz Y; Batool Z; Ahmad S

    Rawal Medical Journal. 2018 Oct-Dec; 43(4):757-760.

    Objective: To access the routine vaccination coverage of children age 6-23 months and to evaluate mothers' knowledge and perception about the child vaccination. Methodology: This descriptive study was conducted in district Faisalabad, Pakistan from March 20 to April 15, 2015. The sample size comprised of 492 respondents. The data were collected from four randomly selected Tehsils in the district Faisalabad. Interview schedule was employed with a questionnaire using 30 household cluster for Expanded Program on Immunization (EPI). The mothers who had a child with age 6 to 23 month were interviewed and assessment was based on both mother's recall and EPI cards. Results: It was found that 81. 7% mothers had EPI cards of their children. The BCG and Pentavalent 3rd dose coverage was found in 90.6% and 85%, respectively. The coverage of 2"d dose of measles was found only 64.3%. 79.67% children were immunized up to date and 9.35% were found unvaccinated. Education of mothers (P>0.000), education of fathers (p>0.000) and income of household (p>0.01) were significantly associated with age appropriate child vaccination coverage Conclusion: We found that almost one child out of ten is still unvaccinated in the study area. The 64 percent of 2"d dose of the measles coverage exposed the discontinuity and gaps in adoption of the child vaccination among higher age group children.
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  2. 2
    379680
    Peer Reviewed

    Cost of a human papillomavirus vaccination project, Zimbabwe.

    Hidle A; Gwati G; Abimbola T; Pallas SW; Hyde T; Petu A; McFarland D; Manangazire P

    Bulletin of the World Health Organization. 2018 Dec; 96(12):834-842.

    Objective: To determine the cost of Zimbabwe’s human papillomavirus (HPV) vaccination demonstration project. Methods: The government of Zimbabwe conducted the project from 2014-2015, delivering two doses of HPV vaccine to 10-year-old girls in two districts. School delivery was the primary vaccination strategy, with health facilities and outreach as secondary strategies. A retrospective cost analysis was conducted from the provider perspective. Financial costs (government expenditure) and economic costs (financial plus the value of existing or donated resources including vaccines) were calculated by activity, per dose and per fully immunized girl. Results: The project delivered 11 599 vaccine doses, resulting in 5724 fully immunized girls (5540 at schools, 168 at health facilities and 16 at outreach points). The financial cost for service delivery per fully immunized girl was United States dollars (US$) 5.34 in schools, US$ 34.90 at health facilities and US$ 288.63 at outreach; the economic costs were US$ 17.39, US$ 41.25 and US$ 635.84, respectively. The mean financial cost per dose was US$ 19.76 and per fully immunized girl was US$ 40.03 (economic costs were US$ 45.00 and US$ 91.19, respectively). The largest number of doses delivered (5788) occurred during the second vaccination round (the second group’s first dose concurrently delivered with the first group’s second dose), resulting in the lowest financial and economic service delivery costs per dose: US$ 1.97 and US$ 6.79, respectively. Conclusion: The mean service delivery cost was lower in schools (primary strategy) and when more girls were vaccinated in each round, demonstrating scale efficiency.
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  3. 3
    378416
    Peer Reviewed

    HPV vaccine knowledge and coverage among female students in a medical college, Kerala.

    Das N; Francis PT

    International Journal of Community Medicine and Public Health. 2018 Dec; 5(12):5133-5138.

    Background: Cervical cancer is the second most common cancer among women in developing countries including India. Human papilloma virus (HPV) infection of the cervix is the most common risk factor for cervical cancer. HPV infection is widespread and occurs soon after becoming sexually active. Lack of hygiene and multiple sexual partners increases the risk of chronic HPV infection. HPV vaccine offers protection against cervical cancer. However the knowledge about HPV and vaccine is very limited among the general public. Knowledge among doctors is essential to provide timely advice to the target population. This study aims to measure the awareness among female medical students in a medical college in Kerala. Methods: 1st to 4th year female medical students of Amrita School of Medicine were administered an anonymous, validated self-administered pretested questionnaire. Only students who had volunteered and given consent were included in the study. 165 students participated in the study. Results: The overall knowledge about cervical cancer its causation and prevention was good only in about 40%. However 83% had a positive attitude towards HPV vaccine and were willing to take the vaccine. Only 6% had been vaccinated against HPV. Conclusions: There is a need to emphasize the aetiology and preventive measures of cervical cancer in the curriculum of MBBS students. In-depth knowledge among future doctors is essential for dissemination of knowledge to general public and timely preventive intervention.
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  4. 4
    377961
    Peer Reviewed

    Measles vaccination coverage among children aged (12-23) months in Marawi locality - Northern state, Sudan - 1026.

    Osman WM

    International Journal of Community Medicine and Public Health. 2018 Jun; 5(6):2195-2198.

    Background: Worldwide measles remains the fifth cause of mortality among children under 5 years. Immunization coverage is the proportion of individuals in the target population who are vaccinated. It is a key measure of immunization system performance. Coverage for measles in Eastern Mediterranean region in 2015 for MCV1 was 85%, and MCV2 was 61%. Methods: A total sample size of 462 mothers was determined according to WHO guidelines regarding coverage survey in (February - July 2016). Data were collected using a prepared and pretested questionnaire, reviewing cards of children, and interview with EPI personnel. Data were analyzed using SPSS version 20, p=0.05 was considered significant. Results: The majority of the children (96.1%) were vaccinated against MCV1, and (77.4%) were vaccinated against MCV2. Small group of mothers (5.7%) had a negative attitude towards immunization. Most mothers (94.3%) were satisfied with measles immunization services. More than half of mothers (55.7%) wait for <15 minutes to immunize their children. Most of the mothers (62.3%) went to the immunization centers by public transports. The main factors affecting vaccination coverage were: weakness of incentives, lack of means of transport for staff, poor working environment like: shortage of water, furniture and technological materials. Conclusions: The coverage with MCV1 was reaching the WHO elimination standards while the coverage of MCV2 was not; due to many factors that affected the vaccination coverage. The study recommends health education covering all aspects of immunization, improvement of the working environment, and availing outreach centers.
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  5. 5
    377744
    Peer Reviewed

    Knowledge and practice of polio vaccination among mothers of infants attending community health centre of northern Kerala.

    Kaithery NN; Kumaran JA

    International Journal of Community Medicine and Public Health. 2018 Jul; 5(7):2911-2915.

    Background: Poliomyelitis is a highly infectious disease caused by polio virus which invades the nervous system causing irreversible total paralysis. The aim of the study is to assess the knowledge and practice of mothers regarding polio vaccination. Methods: It s a descriptive type of study conducted in mothers of Infants who had attended Community health centre of Kannur district during a study period of 2 weeks (June 1 to June 14, 2017). Written consent was obtained from the mothers. Data was collected using a semi structured questionnaire with 3 sections -demographic details, knowledge and practice. Data was analyzed and the results are expressed in terms of frequency and percentage. Results: A total of 220 women were studied. Out of 220 mothers, 93.6% had satisfactory knowledge and 90.45% mothers had their child immunized up to age according to National Immunization Schedule. All of them were taking their children to government hospital for vaccination and their main source of knowledge were health workers. Conclusions: In the present study, majority of the mothers had attended immunization class and had satisfactory knowledge. In order to achieve 100% vaccination coverage, we have to emphasize more on awareness campaigns.
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  6. 6
    377706
    Peer Reviewed

    Factors associated with utilization of antenatal care services among rural women, Telangana, India.

    Das BN; Kanakamedala S; Mummadi MK

    International Journal of Community Medicine and Public Health. 2018 Jul; 5(7):2807-2813.

    Background: Antenatal care is the essential health care extended to pregnant women. Complete antenatal health care includes four antenatal visits, 2 TT injections, and consumption of 100 Iron and Folic acid tablets. In Telangana state the proportion of mothers received full ante natal care in rural area is only 37.3%. Hence, the present study conducted with an objective to assess the factors associated with utilization of antenatal care services among rural women in Telangana state. Methods: The study is a community based cross sectional study. It was conducted in villages of Moinabad Mandal of Telangana state. Sample size was calculated to 373.Out of 26 villages 20 villages were chosen randomly and from each village 20 houses were selected by stratified random method. Married women delivered at least one child during last five years were included. Pretested questionnaire was administered. The data were tabulated in MS Excel and analyzed by SPSS. Results: Among 373 participants, 89.3% mothers registered during 1st trimester, 92.8% confirmed their pregnancy in the Government sector, 81.3% mothers had four or more antenatal visits, nearly 87.7% mothers received two doses of TT and 77.2% had taken more than 100 Iron tablets. The factors identified to be having statistically significant (p< 0.05) association with better utilization of antenatal care were age at child birth >25 years, education10th class and above, Working mothers, first child birth, Socioeconomic class I- IV and early registration. On application of simple logistic regression predictors were found to be age, education, occupation, birth order, SES and early registration. Conclusions: Awareness should be made by the ASHA workers, ANMs and Anganwadi workers through better education and motivation of the target groups such as young mothers, homemakers, low socio-economic status groups and late registered mothers for better utilization.
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  7. 7
    396511

    The association between women’s empowerment and uptake of child health services: a demographic and health survey-based synthesis.

    Ndaimani A; Mhlanga M; Dube-Mawerewere V

    Rockville, Maryland, ICF, DHS Program, 2018 Jun. 34 p. (DHS Working Papers No. 139)

    Globally 1.5 million children die from illnesses that could be prevented through vaccination. Since 2010 there has been stagnation in global coverage of child vaccination, despite many public health efforts. Women, who are caregivers for sick children in most societies, may not have the capacity to make decisions such as seeking health care. This study examines the association between mothers’ empowerment and uptake of child vaccination and diarrhea treatment, through a secondary analysis of data from the 2016 Zimbabwe Demographic and Health Survey. The results show that only 22% of mothers had high levels of decision-making, while 12% had full ownership of assets. For uptake of child health services, 76% of children age 12-23 months received basic vaccinations, and 42% of children under age 5 were treated for diarrhea. The unadjusted analysis showed a significant association between mother’s empowerment and child vaccination. However, no statistically significant association was found between mother’s empowerment and child health outcomes, after controlling for other sociodemographic factors. The regression analysis showed some statistically significant predictors of child health outcomes, however. Predictors that favored completion of basic vaccines included being in the middle wealth quintile compared with the poorest wealth quintile, having visited a health facility in the past 12 months, and having health insurance. Mothers who visited a health facility in the past 12 months had 50% higher odds of receiving treatment for diarrhea for their children under age 5 compared with mothers who did not visit a facility. Internet use by the mother also favored receiving treatment for children’s diarrhea. Universal health insurance may improve child health outcomes. Advising mothers on websites to access child health messages, particularly where the household heads are 15-24 years old, may improve uptake of health messages.
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  8. 8
    377483
    Peer Reviewed

    A study on evaluation of utilization of antenatal care services in a rural area of North Kerala, India.

    Satheesh BC; Rajeev KH

    International Journal of Community Medicine and Public Health. 2018 Oct; 5(10):4415-4418.

    Background: Antenatal care is the care of the woman during her pregnancy. The primary aim of antenatal care is to achieve at the end of a pregnancy a healthy mother and a healthy baby National Health Mission mainly aims at reduction in maternal, neonatal, infant mortality and increasing institutional deliveries. This study was conducted to evaluate the antenatal care services utilization in a rural area of North Kerala among the women who delivered in the past six months. The objective of the study was to evaluate the antenatal care services utilization among the women who delivered in the past six months in a rural area of North Kerala. Methods: A cross sectional study was conducted in the rural field practice area of Kannur Medical College, Kannur among women who delivered in the past 6 months by using convenient sampling method. A total of 150 mothers were interviewed using pre-validated, semi structured questionnaire. Descriptive statistics were used to analyze the data. Results: The mean age of the participants was 27.2±3.4 years. About 98% (147) mothers had at least four ANC visits, all mothers had two doses or one booster dose of TT injections and 90% (135) consumed minimum hundred IFA tablets during pregnancy. Around 96% (144) of the mothers have received the full antenatal care during pregnancy. Conclusions: Our study showed that, the full antenatal care services utilization by the mothers is better compared to National and State averages. But there is slightly increased level of delivery by caesarean which is a matter of concern.
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  9. 9
    374922
    Peer Reviewed

    Measles & rubella vaccination campaign in India: why, how, when and where.

    Chaudhary P; Saxena S

    Indian Journal of Community Health. 2018 Apr-Jun; 30(2):111-114.

    Globally, in 2015, measles killed an estimated 1,34,200 children - mostly under-5 years of age and an estimated 49,200 deaths occurred due to measles in India. Most of these children were the ones who have not received two doses of measles vaccine. This is despite the fact that the Government of India is providing vaccines free of cost under the Universal Immunization Programme. Even today some of the children in the country are not protected against the deadly life-threatening diseases. Some of these children are left unvaccinated because their parents are hesitant to immunise, believes that vaccines are dangerous. (excerpt)
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  10. 10
    395002
    Peer Reviewed

    Child motherhood: the incapability remains.

    Bas EK; Bulbul A; Uslu S; Bas V; Zubarioglu U

    World Journal of Pediatrics. 2017 Jun; 13(3):283.

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  11. 11
    394182
    Peer Reviewed

    Community perception regarding childhood vaccinations and its implications for effectiveness: a qualitative study in rural Burkina Faso.

    Kagone M; Ye M; Nebie E; Sie A; Muller O; Beiersmann C

    BMC Public Health. 2018 Mar 6; 18(1):324.

    BACKGROUND: Vaccination has contributed to major reductions in global morbidity and mortality, but there remain significant coverage gaps. Better knowledge on the interplay between population and health systems regarding provision of vaccination information and regarding health staff organization during the immunization sessions appears to be important for improvements of vaccination effectiveness. METHODS: The study was conducted in the Nouna Health and Demographic Surveillance System (HDSS) area, rural Burkina Faso, from March to April 2014. We employed a combination of in-depth interviews (n = 29) and focus group discussions (n = 4) including children's mothers, health workers, godmothers, community health workers and traditional healers. A thematic analysis was performed. All material was transcribed, translated and analyzed using the software ATLAS.ti4.2. RESULTS: There was better social mobilization in the rural areas as compared to the urban area. Most mothers know the Expanded Program of Immunization (EPI) target diseases, and the importance to immunize their children. However, the great majority of informants reported that mothers don't know the vaccination schedule. There is awareness that some children are incompletely vaccinated. Mentioned reasons for that were migration, mothers being busy with their work, the practice of not opening vaccine vials unless a critical number of children are present, poor interaction between women and health workers during immunization sessions, potential adverse events associated with vaccination, geographic inaccessibility during rainy season, and lack of information. CONCLUSIONS: Well organized vaccination programs are a key factor to improve child health and there is a clear need to consider community perceptions on program performance. In Burkina Faso, a number of factors have been identified which need attention by the EPI managers for further improvement of program effectiveness.
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  12. 12
    394043
    Peer Reviewed

    Analysis of the association between millennium development goals 4 & 5 and the physician workforce across international economic strata.

    Morley CP; Wang D; Mader EM; Plante KP; Kingston LN; Rabiei A

    BMC International Health and Human Rights. 2017 Jul 18; 17(1):18.

    BACKGROUND: The Millennium Development Goals (MDGs) are 8 international development goals voluntarily adopted by 189 nations. The goals included health related aims to reduce the under-five child mortality rate by two-thirds (MDG4), and to reduce the maternal mortality ratio by three-quarters (MDG5). To assess the relationship between the healthcare workforce and MDGs 4-5, we examined the physician workforces of countries around the globe, in terms of the Physician Density Level (PDL, or number of physicians per 1000 population), and compared this rate across a number of years to several indicator variables specified as markers of progress towards MDG4 and MDG5. METHODS: Data for each variable of interest were obtained from the World Bank's Millennium Development Goals and World Development Indicators databases for 208 countries and territories from 2004 to 2014, representing a ten-year period for which the most information is available. We analyzed the relationships between MDG outcomes and PDL, controlling for national income levels and other covariates, using linear mixed model regression. Dependent variables were logarithmically transformed to meet assumptions necessary for multivariate analysis. RESULTS: In unadjusted models, an increase of every one physician per 1000 population (one unit change in PDL) lowered the risk of not being vaccinated for measles-mumps-rubella (MMR) to 29.3% (p < 0.001, 95% CI: 22.2%-38.7%) and for not receiving diphtheria-tetanus-pertussis (DTaP) vaccination rate decreased to 38.5% (p < 0.001, 95% CI: 28.7% - 51.7%). Maternal mortality rate decreased to 76.6% (p < 0.001, 95% CI: 74.3% - 79.0%), neonatal mortality decreased to 58.8% (p < 0.001, 95% CI: 54.8% - 63.2%) and under-5 mortality rate decreased to 52.1% (p < 0.001, 95% CI: 48.0% - 56.4%), with every one-unit change in PDL. Adjusted models tended to reflect unadjusted risk assessments. CONCLUSION: The maintenance and improvement of the health workforce is a vital consideration when assessing how to achieve global development goals related to health outcomes.
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  13. 13
    374844

    Caregivers’ knowledge of pneumonia and uptake of vaccination in under-five children in Kaduna State, Nigeria.

    Yahaya AK; Ekpenyong BN; Obegu P

    Journal of Medical and Biomedical Sciences. 2018; 7(1):40-48.

    Pneumonia, though very much a preventable disease, still remains a tangible threat to the lives of under-5 children. Caregivers’ knowledge of pneumonia is important in effective management. The study determined the reported proportion of childhood pneumonia in Kaduna State and assessed caregivers’ knowledge of pneumonia and uptake of pneumococcal vaccine among under-5 children. The mixed method research ap-proach used 500 caregivers of under-five children in urban and rural communities in Kaduna state. Ethical approval and informed consent of participants was obtained before data collection using a pre-tested semi-structured questionnaire and a focus group discussion guide. Chi-square statistical test was used to test for association between variables, while data from the focus group discussion was analyzed using thematic cod-ing process. Most respondents were aware of pneumonia, they had local names for it but majority 340 (68%) had poor knowledge of pneumonia. The overall occurrence of pneumonia as reported by respond-ents among under-five children was 33 (6.6%). The rate of child pneumococcal vaccine uptake as reported by respondents was 105 (21%), the uptake was significantly more among the urban dwellers (p<0.01). The knowledge of pneumonia and uptake of pneumococcal vaccination was poor. Routine and constant health education of the community members on pneumonia is very necessary to preserve lives of under-5 children in our communities.
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  14. 14
    374841

    Missed opportunities for immunization among children attending a Paediatric Outpatient Clinic at Juba Teaching Hospital.

    Malual AC; Jowi Y; Irimu G; Admani B

    South Sudan Medical Journal. 2018 May; 11(2):36-39.

    Background: Immunization prevents child morbidity and mortality through the universal access to routinely recommended childhood vaccines. Objectives: To determine the prevalence and factors associated with missed opportunities for immunization (MOI). Method: An out-patient paediatric clinic-based study conducted in May - June 2012 using the standard World Health Organization (WHO), Expanded Programme on Immunization (EPI) protocol for assessing MOI. The study involved client exit interviews with caregivers of children aged less than 2 years, reviews of immunization cards and parental recall of immunization history, and interviews with health workers. Results: Data were collected on 448 children aged 0-23 months and from 18 health workers. The prevalence of MOI was most common among children older than 12 months. As the age of administration of the vaccine increased so did the number of MOI. MOI were more common for DPT3 (22.1%) OPV3 (24.4%), and measles (31.2%) compared to other vaccines. Factors associated with MOI included home births, inadequate antenatal care, lack of information, and, among health workers, poor knowledge of immunization schedules and contraindications. Conclusion: The high prevalence of MOI could be reduced by defaulter tracing, encouraging antenatal visits and hospital deliveries, and education of caregivers and health workers.
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  15. 15
    393910

    Reproductive, maternal, neonatal and child health in conflict: a case study on Syria using Countdown indicators.

    DeJong J; Ghattas H; Bashour H; Mourtada R; Akik C; Reese-Masterson A

    BMJ Global Health. 2017; 2(3):e000302.

    Introduction: Women and children account for a disproportionate morbidity burden among conflict-affected populations, and yet they are not included in global accountability frameworks for women's and children's health. We use Countdown to 2015 (Millennium Development Goals) health indicators to provide an up-to-date review and analysis of the best available data on Syrian refugees in Jordan, Lebanon and Turkey and internally displaced within Syria and explore data challenges in this conflict setting. Methods: We searched Medline, PubMed, Scopus, Popline and Index Medicus for WHO Eastern Mediterranean Region Office and relevant development/humanitarian databases in all languages from January 2011 until December 2015. We met in person or emailed relevant key stakeholders in Lebanon, Jordan, Syria and Turkey to obtain any unpublished or missing data. We convened a meeting of experts working with these populations to discuss the results. Results: The following trends were found based on available data for these populations as compared with preconflict Syria. Birth registration in Syria and in host neighbouring countries decreased and was very low in Lebanon. In Syria, the infant mortality rate and under-five mortality rate increased, and coverage of antenatal care (one visit with a skilled attendant), skilled birth attendance and vaccination (except for DTP3 vaccine) declined. The number of Syrian refugee women attending more than four antenatal care visits was low in Lebanon and in non-camp settings in Jordan. Few data were available on these indicators among the internally displaced. In conflict settings such as that of Syria, coverage rates of interventions are often unknown or difficult to ascertain because of measurement challenges in accessing conflict-affected populations or to the inability to determine relevant denominators in this dynamic setting. Conclusion: Research, monitoring and evaluation in humanitarian settings could better inform public health interventions if findings were more widely shared, methodologies were more explicit and globally agreed definitions and indicators were used consistently.
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  16. 16
    393289
    Peer Reviewed

    Knowledge, Perception, and Acceptance of HPV Vaccination and Screening for Cervical Cancer among Women in Yogyakarta Province, Indonesia

    Endarti D; Satibi S; Kristina SA; Farida MA; Rahmawanti Y; Andriani T

    Asian Pacific Journal of Cancer Prevention. 2018 Apr 27; 19(4):1105-1111.

    Objective: To determine knowledge, perception, and acceptance related to cervical cancer, HPV vaccination and screening for cervical cancer among Indonesian women, particularly in Yogyakarta province. Methods: A convenience sample of 392 women consists of 192 young women, 100 mothers of girls aged 12 - 15 years, and 100 adult women in Yogyakarta province, Indonesia was participated in this study. A self-administered paper-based questionnaire was used to determine demographics characteristics of respondents, as well as their knowledge - perception - acceptance related to cervical cancer, HPV vaccination, and screening for cervical cancer. Data collection were conducted during December 2013 to March 2014. Descriptive statistics was used to analyze description of demographics characteristics, knowledge, perception, and acceptance; while crosstab analysis using Chi-Square was used to analyze the relationship between demographics characteristics versus knowledge, perception, and acceptance. Results: This study found that knowledge and perception regarding cervical cancer, HPV vaccination, and screening for cervical cancer among women in Indonesia, particularly in Yogyakarta Province were still insufficient, however the acceptance was good. Among female young women, 64% had good knowledge, 62% had positive perception of cervical cancer and HPV vaccination, and 92% tended to accept HPV vaccination. Among mothers of girls aged 12 - 15 years, 44% had good knowledge, 46% had positive perception of cervical cancer and HPV vaccination, and 91% tended to accept HPV vaccination for their daughters. Among adult women, 68% had good knowledge, 57% had positive perception of cervical cancer and screening for cervical cancer, and 90% tended to accept cervical cancer screening. In general, demographics characteristics of having experience and exposure to information had significant relationship with knowledge, perception, and acceptance of HPV vaccination and screening for cervical cancer. Conclusions: Either knowledge or perception of cervical cancer and strategies toward it among Indonesian women particularly in Yogyakarta province were still unsatisfied. Efforts should be improved for supporting cervical cancer prevention and control in Indonesia through such as education on cervical cancer disease and strategies toward it. Creative Commons Attribution License
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  17. 17
    393274
    Peer Reviewed

    Coverage of childhood vaccination among children aged 12-23 months, Tamil Nadu, 2015, India.

    Murhekar MV; Kamaraj P; Kanagasabai K; Elavarasu G; Rajasekar TD; Boopathi K; Mehendale S

    Indian Journal of Medical Research. 2017 Mar; 145(3):377-386.

    BACKGROUND & OBJECTIVES: District-Level Household Survey-4 (DLHS-4) indicated that during 2012-2013, only 56 per cent of children aged 12-23 months in Tamil Nadu were fully vaccinated, which were lesser than those reported in earlier national surveys. We, therefore, conducted cluster surveys to estimate coverage of childhood vaccination in the State, and also to identify the factors associated with low coverage. METHODS: Cross-sectional surveys were conducted in 15 strata [municipal corporation non-slum (n=1), municipal corporation slum (n=1), hilly (n=1), rural (n=6) and urban (n=6)]. From each stratum, 30 clusters were selected using probability proportional to the population size linear systematic sampling; seven children aged 12-23 months were selected from each cluster and their mothers/care-takers were interviewed to collect information about vaccination status of the child. A child was considered fully vaccinated if he/she received bacillus Calmette-Guerin (BCG), three doses of pentavalent, three doses of oral polio vaccine and one dose of measles vaccine, and appropriately vaccinated if all vaccine doses were given at right age and with right interval. Further, coverage of fully vaccinated children (FVC) as per vaccination cards or mothers' recall, validated coverage of FVC (V-FVC) among those having cards, and coverage of appropriately vaccinated children (AVC) were estimated using survey data analysis module with appropriate sampling weights. RESULTS: A total of 3150 children were surveyed, of them 2528 (80.3%) had vaccination card. The weighted coverage of FVC, V-FVC and AVC in the State was 79.9 per cent [95% confidence interval (CI): 78.2-81.5], 78.8 per cent (95% CI: 76.9-80.5) and 69.7 per cent (95% CI: 67.7-71.7), respectively. The coverage of individual vaccine ranged between 84 per cent (measles) and 99.8 per cent (BCG). About 12 per cent V-FVC were not vaccinated as per the vaccination schedule. INTERPRETATION & CONCLUSIONS: The coverage of FVC in Tamil Nadu was high, with about 80 per cent children completing primary vaccination. Efforts to increase vaccination coverage in the State need to focus on educating vaccinators about the need to adhere to the national vaccination schedule and strengthening supervision to ensure that children are vaccinated appropriately.
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  18. 18
    393269
    Peer Reviewed

    Determinants of effective vaccine coverage in low and middle-income countries: a systematic review and interpretive synthesis.

    Phillips DE; Dieleman JL; Lim SS; Shearer J

    BMC Health Services Research. 2017 Sep 26; 17(1):681.

    BACKGROUND: Many children in low and middle-income countries remain unvaccinated, and vaccines do not always produce immunity. Extensive research has sought to understand why, but most studies have been limited in breadth and depth. This study documents existing evidence on determinants of vaccination and immunization and presents a conceptual framework of determinants. METHODS: We used systematic review, content analysis, thematic analysis and interpretive synthesis to document and analyze the existing evidence on determinants of childhood vaccination and immunization. RESULTS: We documented 1609 articles, including content analysis of 78 articles. Three major thematic models were described in the context of one another. Interpretive synthesis identified similarities and differences between studies, resulting in a conceptual framework with three principal vaccine utilization determinants: 1) Intent to Vaccinate, 2) Community Access and 3) Health Facility Readiness. CONCLUSION: This study presents the most comprehensive systematic review of vaccine determinants to date. The conceptual framework represents a synthesis of multiple existing frameworks, is applicable in low and middle-income countries, and is quantitatively testable. Future researchers can use these results to develop competing conceptual frameworks, or to analyze data in a theoretically-grounded way. This review enables better research in the future, further understanding of immunization determinants, and greater progress against vaccine preventable diseases around the world.
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  19. 19
    393265
    Peer Reviewed

    Use of electronic immunization registry in the surveillance of adverse events following immunization.

    Sato APS; Ferreira VLR; Tauil MC; Rodrigues LC; Barros MB; Martineli E; Costa AA; Inenami M; Waldman EA

    Revista De Saude Publica. 2018 Feb 5; 52:4.

    OBJECTIVE: To describe adverse events following vaccination (AEFV) of children under two years old and analyze trend of this events from 2000 to 2013, in the city of Araraquara (SP), Brazil. METHODS: This is a descriptive study conducted with data of the passive surveillance system of AEFV that is available in the electronic immunization registry (EIR) of the computerized medical record of the municipal health service (Juarez System). The study variables were: age, gender, vaccine, dose, clinical manifestations and hospitalization. We estimated rates using AEFV as numerator and administered doses of vaccines as denominator. The surveillance sensitivity was estimated by applying the method proposed by the Centers for Disease Control and Prevention. We used Prais-Winsten regression with a significance level of 5.0%. RESULTS: The average annual rate of AEFV was 11.3/10,000 administered doses, however without a trend in the study period (p=0.491). Most cases occurred after the first dose (41.7%) and among children under one year of age (72.6%). Vaccines with pertussis component, yellow fever and measles-mumps-rubella were the most reactogenic. We highlighted the rates of hypotonic-hyporesponsive episodes and convulsion that were 4.1/10,000 and 1.5/10,000 doses of vaccines with pertussis component, respectively, most frequently in the first dose; 60,0% of cases presented symptoms in the first 24 hours after vaccination, however, 18.6% showed after 96 hours. The sensitivity of surveillance was 71.9% and 78.9% for hypotonic-hyporesponsive episodes and convulsion, respectively. CONCLUSIONS: The EIR-based AEFV surveillance system proved to be useful and highly sensitive to describe the safety profile of vaccines in a medium-sized city. It was also shown that the significant increase of the vaccines included in the basic vaccination schedule in childhood in the last decade did not alter the high safety standard of the National Immunization Program.
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  20. 20
    393156

    A success story of Pakistan: The country at the verge of winning the battle against polio.

    Mushtaq A; Mehmood S; Hyder MZ

    Travel Medicine and Infectious Disease. 2017 Jul - Aug; 18:81-82.

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  21. 21
    393118

    Low rate of human papillomavirus vaccination among schoolgirls in Lebanon: barriers to vaccination with a focus on mothers' knowledge about available vaccines.

    Abou El-Ola MJ; Rajab MA; Abdallah DI; Fawaz IA; Awad LS; Tamim HM; Ibrahim AO; Mugharbil AM; Moghnieh RA

    therapeutics and Clinical Risk Management. 2018; 14:617-626.

    Background: Human papillomavirus (HPV) infection is an established predisposing factor of cervical cancer. In this study, we assessed the awareness about genital warts, cervical cancer, and HPV vaccine among mothers having girls who are at the age of primary HPV vaccination attending a group of schools in Lebanon. We also assessed the rate of HPV vaccination among these girls and the barriers to vaccination in this community. Subjects and methods: This is a cross-sectional, school-based survey. A 23-item, self-administered, anonymous, pretested, structured questionnaire with closed-ended questions was used to obtain data. The questionnaire was sent to the mothers through their student girls, and they were asked to return it within a week. Data were analyzed using the Statistical Package for Social Sciences version 21.0. Bivariate analysis was performed using the chi-square test to compare categorical variables, whereas continuous variables were compared using the Student's t-test. Fisher's exact test was used when chi-square test could not be employed. Results: The response rate in our survey was 39.4%. Among the responders, the rate of awareness about HPV infection was 34%, where 72% of the mothers had heard about cervical cancer, and 34% knew that a vaccine is available to prevent cervical cancer. HPV vaccination uptake rate was 2.5%. This lack of vaccination was primarily attributed to the low rate of mothers' awareness about the vaccine (34%). Factors significantly affecting awareness about the vaccine were the mothers' marital age, nationality, level of education, employment, and family income. Barriers to HPV vaccination, other than awareness, were uncertainty about safety or efficacy of the vaccine, conservative ideas of mothers regarding their girls' future sexual life, and relatively high price of the vaccine. Conclusion: Vaccine uptake is low among eligible girls attending this group of schools. The barriers to vaccination are multiple; the most important one is the mothers' lack of knowledge about HPV, cervical cancer, and the modes of prevention. Awareness campaigns along with a multimodal strategy that targets the identified barriers would be recommended to achieve higher rates of HPV vaccination.
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  22. 22
    393117

    Knowledge, perceptions and practice of cervical cancer prevention among female public secondary school teachers in Mushin local government area of Lagos State, Nigeria.

    Toye MA; Okunade KS; Roberts AA; Salako O; Oridota ES; Onajole AT

    Pan African Medical Journal. 2017; 28:221.

    Introduction: Cervical cancer is the most common gynecological cancer and a leading cause of cancer death in women in Nigeria. This study was aimed to assess the knowledge, perception, and practice of cervical cancer prevention among female public secondary school teachers in Mushin, Lagos. Methods: This was a cross-sectional study carried out among female secondary school teachers in Mushin, Lagos. The participants were selected by a two-stage random sampling method and relevant data were collected with the use a self-administered questionnaire. Data entry and analysis were done using Epi-info version 7.2 statistical software and descriptive statistics were computed for all data. Results: The knowledge of cervical cancer and its prevention was 100.0% among the respondents. The most commonly known method of cervical cancer screening identified by the respondents was Papanicolaou smear (91.4%). More than half of the women (67.0%) have had at least one cervical cancer screening done previously. Only 2.2% of the respondents have had HPV vaccine given to their female teenage children in the past despite the acceptance rate for HPV vaccination being 76.2%. Conclusion: This study, unlike most previous studies in other regions of Nigeria and most part of sub-Saharan Africa, has demonstrated a relatively high level of awareness about cervical cancer, its cause, risk factors and prevention. However, conversely, the absence of a national health programme means that screening and vaccination centers are not available, accessible or affordable.
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  23. 23
    393111
    Peer Reviewed

    HPV Screening and Vaccination Strategies in an Unscreened Population: A Mathematical Modeling Study.

    Milwid RM; Frascoli F; Steben M; Heffernan JM

    Bulletin of Mathematical Biology. 2018 Apr 12;

    Human papillomavirus (HPV), a sexually transmitted infection, is the necessary cause of cervical cancer, the third most common cancer affecting women worldwide. Prevention and control strategies include vaccination, screening, and treatment. While HPV prevention and control efforts are important worldwide, they are especially important in low-income areas with a high infection rate or high rate of cervical cancer. This study uses mathematical modeling to explore various vaccination and treatment strategies to control for HPV and cervical cancer while using Nepal as a case study. Two sets of deterministic models were created with the goal of understanding the impact of various prevention and control strategies. The first set of models examines the relative importance of screening and vaccination in an unscreened population, while the second set examines various screening scenarios. Partial rank correlation coefficients confirm the importance of screening and treatment in the reduction of HPV infections and cancer cases even when vaccination uptake is high. Results also indicate that less expensive screening technologies can achieve the same overall goal as more expensive screening technologies.
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  24. 24
    326636

    Perception, acceptance and uptake of Human papillomavirus vaccine among female adolescents in selected secondary schools in Ibadan, Nigeria.

    Ndikom CM; Oboh PI

    African Journal of Biomedical Research. 2017 Sep; 20(3):237-244.

    Infection with Human papillomavirus (HPV) contributes to malignant changes in the cervix leading to cancer mortality among women. HPV vaccine is now available for its prevention, yet the level of uptake is low. The study aimed at determining Perception, Acceptance and Uptake of Human papillomavirus Vaccine among female adolescents in selected secondary schools in Ibadan, Nigeria. This cross-sectional study was conducted among 296 female adolescent senior secondary school students in Ibadan, Nigeria. Respondents were selected using purposive sampling method and data were collected using self-administered questionnaire. The data were analysed using the Statistical Package for Social Sciences version 20.0. Variables were presented as frequency tables and hypotheses were tested using chi-square and Fisher’s exact test at P= 0.05. Most 142(48.0%) of the respondents were between ages 15-17. The respondents’ perception and knowledge about HPV vaccine, HPV infection and cervical cancer was generally poor. Furthermore, only 12(4.1%) of the respondents have received the HPV vaccine before the study. There is a significant association between adolescent’s perception and uptake of HPV vaccine p=0.000 as well as Perception and readiness for the use of HPV vaccine (p=0.007). Parental approval and readiness for HPV vaccine uptake were found to be significantly associated (p =0.000). Since knowledge about Human Papilloma Virus Vaccination is quite low, there is need to increase awareness about the Vaccination among female adolescents and their mothers. Also, peer educators in schools can be trained to improve awareness in schools so as to reduce the incidence of cervical cancer.
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  25. 25
    392844
    Peer Reviewed

    Effect of Nursing Intervention on Mothers' Knowledge of Cervical Cancer and Acceptance of Human Papillomavirus Vaccination for their Adolescent Daughters in Abuja - Nigeria.

    Odunyemi FT; Ndikom CM; Oluwatosin OA

    Asia - Pacific Journal of Oncology Nursing. 2018 Apr-Jun; 5(2):223-230.

    Objective: The aim of this study is to evaluate the effect of nursing intervention on mothers' knowledge of cervical cancer and acceptance of human papillomavirus (HPV) vaccination for their adolescent daughters in Abuja, Nigeria. Methods: This was a quasi-experimental study that utilized two groups pre and post-test design. The study was carried out among civil servant mothers in Bwari (experimental group [EG]) and Kwali (control group[CG]) Area Councils of Abuja, Nigeria. One hundred and forty-six women who met the inclusion criteria were purposively selected for this study. EG consists of 69 women while 77 are from CG. The intervention consisted of two days workshop on cervical cancer and HPV vaccination. Descriptive and inferential analyses of the data were performed using SPSS software 20 version. Results: The mean age of the respondents was 35 years +/- 6.6 in the EG and 41 years +/- 8.2 in the CG. The mean knowledge score of cervical cancer was low at baseline in both EG (9.58 +/- 7.1) and CG (11.61 +/- 6.5). However, there was a significant increase to 21.45 +/- 6.2 after the intervention in EG (P < 0.0001). The baseline acceptance of HPV vaccination was high in EG after intervention from 74% to 99%. Exposure to nursing intervention and acceptance of HPV vaccination was statistically significant after intervention (P < 0.0001). Conclusions: The nursing intervention has been found to increase mothers' knowledge of cervical cancer and acceptance of HPV vaccination. It is therefore recommended that nurses should use every available opportunity in mothers' clinic to educate on cervical cancer and HPV vaccination.
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