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Vaccination coverage and reasons for non-vaccination in a district of Istanbul
Sebahat D Torun, Nadi Bak?rc?
BMC Public Health , 2006, DOI: 10.1186/1471-2458-6-125
Abstract: A '30 × 7' cluster sampling design was used as the sampling method. Thirty streets were selected at random from study area. Survey data were collected by a questionnaire which was applied face to face to parents of 221 children. A Chi-square test and logistic regression was used for the statistical analyses. Content analysis method was used to evaluate the open-ended questions.The complete vaccination rate for study population was 84.5% and 3.2% of all children were totally non-vaccinated. The siblings of non-vaccinated children were also non-vaccinated. Reasons for non-vaccination were as follows: being in the village and couldn't reach to health care services; having no knowledge about vaccination; the father of child didn't allow vaccination; intercurrent illness of child during vaccination time; missed opportunities like not to shave off a vial for only one child. In logistic regression analysis, paternal and maternal levels of education and immigration time of both parents to Istanbul were found to influence whether children were completely vaccinated or non-vaccinated. Measles vaccination coverage during MID was 79.3%.Efforts to increase vaccination coverage should take reasons for non-vaccination into account.High vaccination coverage is important in control and elimination of vaccine preventable diseases in a country. In Turkey the Expanded Program of Immunization (EPI) aims for 95% coverage for each antigen and complete vaccination schedules for 90% of children under 1 year of age [1]. All the vaccines included in the national vaccination schedule (Bacille Calmette Guerin (BCG), Oral Polio Vaccine, Diphtheria-Pertussis-Tetanus (DPT) vaccine, Measles and hepatitis B vaccine are provided free of charge in the primary health services all over Turkey. Although the coverage of all vaccines in our country is increased especially in the last ten years, the EPI targets has not been achieved yet [2] and there are still regional differences. In 2003, full vaccination
Determinants of vaccination coverage in rural Nigeria
Olumuyiwa O Odusanya, Ewan F Alufohai, Francois P Meurice, Vincent I Ahonkhai
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-381
Abstract: A cross-sectional survey was conducted in September 2006, which included the use of interviewer-administered questionnaire to assess knowledge of mothers of children aged 12–23 months and vaccination coverage. Survey participants were selected following the World Health Organization's (WHO) immunization coverage cluster survey design. Vaccination coverage was assessed by vaccination card and maternal history. A child was said to be fully immunized if he or she had received all of the following vaccines: a dose of Bacille Calmette Guerin (BCG), three doses of oral polio (OPV), three doses of diphtheria, pertussis and tetanus (DPT), three doses of hepatitis B (HB) and one dose of measles by the time he or she was enrolled in the survey, i.e. between the ages of 12–23 months. Knowledge of the mothers was graded as satisfactory if mothers had at least a score of 3 out of a maximum of 5 points. Logistic regression was performed to identify determinants of full immunization status.Three hundred and thirty-nine mothers and 339 children (each mother had one eligible child) were included in the survey. Most of the mothers (99.1%) had very positive attitudes to immunization and > 55% were generally knowledgeable about symptoms of vaccine preventable diseases except for difficulty in breathing (as symptom of diphtheria). Two hundred and ninety-five mothers (87.0%) had a satisfactory level of knowledge. Vaccination coverage against all the seven childhood vaccine preventable diseases was 61.9% although it was significantly higher (p = 0.002) amongst those who had a vaccination card (131/188, 69.7%) than in those assessed by maternal history (79/151, 52.3%). Multiple logistic regression showed that mothers' knowledge of immunization (p = 0.006) and vaccination at a privately funded health facility (p < 0.001) were significantly correlated with the rate of full immunization.Eight years after initiation of this privately financed vaccination project (private-public partnership), v
Pertussis outbreak in Papua New Guinea: the challenges of response in a remote geo-topographical setting  [cached]
Siddhartha Sankar Datta,Steven Toikilik,Berry Ropa,Glenys Chidlow
Western Pacific Surveillance and Response , 2012,
Abstract: Introduction: A large outbreak of pertussis was detected during March 2011 in Goilala, a remote district of the Central Province in Papua New Guinea, characterized by rugged topography with no road access from the provincial headquarters. This outbreak investigation highlights the difficulties in reporting and responding to outbreaks in these settings.Method: The suspected pertussis cases, reported by health workers from the Ononge health centre area, were investigated and confirmed for the presence of Bordetella pertussis DNA using the polymerase chain reaction (PCR) method.Results: There were 205 suspected pertussis cases, with a case-fatality rate (CFR) of 3%. All cases were unvaccinated. The Central Province conducted a response vaccination programme providing 65% of children less than five years of age with diphtheria–pertussis-tetanus-HepB-Hib vaccine at a cost of US$ 12.62 per child.Discussion: The incurred cost of vaccination in response to this outbreak was much higher than the US$ 3.80 per child for routine outreach patrol. To prevent further outbreaks of vaccine-preventable diseases in these areas, local health centres must ensure routine vaccination is strengthened through the “Reaching Every District” initiative of the National Department of Health.
Meningococcal, influenza virus, and hepatitis B virus vaccination coverage level among health care workers in Hajj
Tariq A Madani, Tawfik M Ghabrah
BMC Infectious Diseases , 2007, DOI: 10.1186/1471-2334-7-80
Abstract: A cross-sectional survey of doctors and nurses working in all Mena and Arafat hospitals and primary health care centers who attended Hajj-medicine training programs immediately before the beginning of Hajj of the lunar Islamic year 1423 (2003) using self-administered structured questionnaire which included demographic data and data on vaccination history.A total of 392 HCWs were studied including 215 (54.8%) nurses and 177 (45.2%) doctors. One hundred and sixty four (41.8%) HCWs were from Makkah and the rest were recruited from other regions in Saudi Arabia. Three hundred and twenty three (82.4%) HCWs received the quadrivalent (ACYW135) meningococcal meningitis vaccine with 271 (83.9%) HCWs receiving it at least 2 weeks before coming to Hajj, whereas the remaining 52 (16.1%) HCWs received it within < 2 weeks. Only 23 (5.9%) HCWs received the current year's influenza virus vaccine. Two hundred and sixty (66.3%) of HCWs received the three-dose hepatitis B vaccine series, 19.3% received one or two doses, and 14.3% did not receive any dose. There was no statistically significant difference in compliance with the three vaccines between doctors and nurses.The meningococcal and hepatitis B vaccination coverage level among HCWs in Hajj was suboptimal and the influenza vaccination level was notably low. Strategies to improve vaccination coverage among HCWs should be adopted by all health care facilities in Saudi Arabia.Ensuring that health care workers (HCWs) are immune to vaccine-preventable diseases is an essential part of successful employee health programs. Optimal use of vaccines can prevent transmission of vaccine-preventable diseases and eliminate unnecessary work restriction. Prevention of illness through comprehensive HCWs immunization programs is far more cost-effective than case management and outbreak control [1]. In Saudi Arabia, the national vaccination recommendations for HCWs are generally the same as those recommended by the Centers for Disease Control and P
Prevalence of HBV and HBV vaccination coverage in health care workers of tertiary hospitals of Peshawar, Pakistan
Sobia Attaullah, Sanaullah Khan, Naseemullah, Sultan Ayaz, Shahid Khan, Ijaz Ali, Naseruddin Hoti, Sami Siraj
Virology Journal , 2011, DOI: 10.1186/1743-422x-8-275
Abstract: A total of 824 health care workers were randomly selected from three major hospitals of Peshawar, Khyber Pakhtunkhwa. Blood samples were analyzed in Department of Zoology, Kohat University of Science and Technology Kohat, and relevant information was obtained by means of preset questionnaire. HCWs in the studied hospitals showed 2.18% prevalence of positive HBV. Nurses and technicians were more prone to occupational exposure and to HBV infection. There was significant difference between vaccinated and non-vaccinated HCWs as well as between the doctors and all other categories. Barriers to complete vaccination, in spite of good knowledge of subjects in this regard were work pressure (39.8%), negligence (38.8%) un-affordability (20.9%), and unavailability (0.5%).Special preventive measures (universal precaution and vaccination), which are fundamental way to protect HCW against HBV infection should be adopted.Among the blood borne pathogens, hepatitis B virus (HBV) has gained the status of global public health threat by being the 10th major deaths causing disease. HBV infects more than 2 billion peoples worldwide, of which over 350 million peoples are chronic carrier [1]. Currently HBV is the leading issue of concern in society and medicine particularly in our under-resourced health care system which lacks the safety measures necessary to avert the risks of infection [2,3]. Different country wide hospital based and population based HBV surveys (individual researchers) estimated a prevalence rate of 2-7%, which places Pakistan in intermediate HBV prevalence zone. During the past two decades this risk has become even more significant as the prevalence of HBV has increased significantly [4], and risk of contracting hepatitis B by HCWs is four fold higher as compared to general adult population [1,5,6].Worldwide annual proportion of HCWs exposed to HBV infection were about 5.9% [1,5]. In developing countries, 40-60% of HBV infection in HCWs was attributed to professional h
Pertussis Vaccination: Current Status and Recent Developments  [PDF]
Yasmeen Faiz Kazi
Journal of Medical Sciences , 2004,
Abstract: Pertussis or whooping cough is a communicable disease of early childhood but persons of all ages are susceptible. Until recently this disease was protected by use of Whole Cell Vaccines (WCV), which have been used world wide for more than 50 years. However, undesirable effects attributed to these vaccines led to the development of acellular component vaccines for pertussis. Safety data from several studies show that the acellular vaccines are better-tolerated then whole-cell vaccines and have shown to be efficacious in preventing pertussis. The adverse reaction such as seizers and convulsion are more frequent after whole-cell vaccines where as after acellular vaccines these symptoms are obvious only after 4th and 5th dose although are not harmful, do not cause long-term neurological damage or allergy and are self-limiting. Vaccine types, immunization schedules, compliance and age are not uniform in many parts of the globe. Parents and health-care workers need to be given full information regarding risks and efficacy of pertussis vaccination.
Influenza vaccination coverage of healthcare workers and residents and their determinants in nursing homes for elderly people in France: a cross-sectional survey
Sophie Vaux, Delphine No?l, Laure Fonteneau, Jean-Paul Guthmann, Daniel Lévy-Bruhl
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-159
Abstract: During the 2007-2008 influenza season, we conducted a nationwide survey to estimate influenza vaccination coverage of HCWs and residents in nursing homes for elderly people in France and to identify determinants of vaccination rates. Multivariate analysis were performed with a negative binomial regression.Influenza vaccination coverage rates were 33.6% (95% CI: 31.9-35.4) for HCWs and 91% (95% CI: 90-92) for residents. Influenza vaccination uptake of HCWs varied by occupational category. Higher vaccination coverage was found in private elderly care residences, when free vaccination was offered (RR: 1.89, 1.35-2.64), in small nursing homes (RR: 1.54, 1.31-1.81) and when training sessions and staff meetings on influenza were organized (RR: 1.20, 1.11-1.29). The analysis by occupational category showed that some determinants were shared by all categories of professionals (type of nursing homes, organization of training and staff meetings on influenza). Higher influenza vaccination coverage was found when free vaccination was offered to recreational, cleaning, administrative staff, nurses and nurse assistants, but not for physicians.This nationwide study assessed for the first time the rate of influenza vaccination among residents and HCWs in nursing homes for elderly in France. Better communication on the current recommendations regarding influenza vaccination is needed to increase compliance of HCWs. Vaccination programmes should include free vaccination and education campaigns targeting in priority nurses and nurse assistants.Influenza virus infection is a major public health problem as shown by its high morbidity [1,2] and mortality [3-5]. In nursing homes for elderly people, influenza outbreaks have often been documented. In these settings, higher rates of morbidity and mortality are observed in the elderly compared to those of their counterparts living in the open community [6].Vaccination against influenza for nursing homes residents has proved to be effective in
Risk factors for incomplete vaccination and missed opportunity for immunization in rural Mozambique
Jagrati V Jani, Caroline De Schacht, Ilesh V Jani, Gunnar Bjune
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-161
Abstract: Mothers of children under two years of age (N = 668) were interviewed in a cross-sectional study. The Road-to-Health card was utilized to check for completeness and correctness of vaccination schedule as well as for identifying the appropriate use of all available opportunities for vaccination. The chi-square test and the logistic regression were used for statistical analysis.We found that 28.2% of the children had not completed the vaccination program by two years of age, 25.7% had experienced a missed opportunity for vaccination and 14.9% were incorrectly vaccinated. Reasons for incomplete vaccination were associated with accessibility to the vaccination sites, no schooling of mothers and children born at home or outside Mozambique.Efforts to increase vaccination coverage should take into account factors that contribute to the incomplete vaccination status of children. Missed opportunities for vaccination and incorrect vaccination need to be avoided in order to increase the vaccine coverage for those clients that reach the health facility, specially in those countries where health services do not have 100% of coverage.The prevention of child mortality through immunization is one of the most cost-effective public interventions in use in resource-poor settings. The Expanded Program on Immunization (EPI) aims at delivering the primary immunization series to at least 90% of infants [1]. However, inadequate levels of immunization against childhood diseases remain a significant public health problem in resource-poor areas of the globe [2]. Nonetheless, the reasons for incomplete vaccination and non-uptake of immunization services are poorly understood.In Mozambique, the EPI targets seven diseases, namely tuberculosis, poliomyelitis, diphtheria, pertussis, tetanus, hepatitis B and measles. The reported coverage of the basic EPI vaccines in Mozambique is 80%–95%, but these figures include incomplete and incorrect vaccinations [3,4]. This may be one of the reasons why meas
Routine vaccination coverage in low- and middle-income countries: further arguments for accelerating support to child vaccination services  [PDF]
Wenjing Tao,Max Petzold,Birger C. Forsberg
Global Health Action , 2013, DOI: 10.3402/gha.v6i0.20343
Abstract: Background and objective: The Expanded Programme on Immunization was introduced by the World Health Organization (WHO) in all countries during the 1970s. Currently, this effective public health intervention is still not accessible to all. This study evaluates the change in routine vaccination coverage over time based on survey data and compares it to estimations by the WHO and United Nations Children's Fund (UNICEF). Design: Data of vaccination coverage of children less than 5 years of age was extracted from Demographic and Health Surveys (DHS) conducted in 71 low- and middle-income countries during 1986–2009. Overall trends for vaccination coverage of tuberculosis, diphtheria, tetanus, pertussis, polio and measles were analysed and compared to WHO and UNICEF estimates. Results: From 1986 to 2009, the annual average increase in vaccination coverage of the studied diseases ranged between 1.53 and 1.96% units according to DHS data. Vaccination coverage of diphtheria, tetanus, pertussis, polio and measles was all under 80% in 2009. Non-significant differences in coverage were found between DHS data and WHO and UNICEF estimates. Conclusions: The coverage of routine vaccinations in low- and middle-income countries may be lower than that previously reported. Hence, it is important to maintain and increase current vaccination levels.
Seroprevalence of Pertussis in the Netherlands: Evidence for Increased Circulation of Bordetella pertussis  [PDF]
Sabine C. de Greeff,Hester E. de Melker,Pieter G. M. van Gageldonk,Joop F. P. Schellekens,Fiona R. M. van der Klis,Liesbeth Mollema,Frits R. Mooi,Guy A. M. Berbers
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0014183
Abstract: In many countries, the reported pertussis has increased despite high vaccination coverage. However, accurate determination of the burden of disease is hampered by reporting artifacts. The infection frequency is more reliably estimated on the basis of the prevalence of high IgG concentrations against pertussis toxin (IgG-Ptx). We determined whether the increase in reported pertussis in the last decade is associated with an increase in the number of infections.
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