scholarly journals New Vaccine Introduction and Childhood Vaccination Timeliness in Two Urban, Informal Settlements in Nairobi, Kenya

2021 ◽  
Author(s):  
Cara Bess Janusz ◽  
Martin K. Mutua ◽  
Abram L. Wagner ◽  
Matthew L. Boulton
Keyword(s):  
Urban Areas ◽  
Prevalence Ratio ◽  
Childhood Vaccination ◽  
Routine Immunization ◽  
Immunization Schedule ◽  
Childhood Immunization ◽  
African Countries ◽  
Vaccine Introduction ◽  
Routine Childhood ◽  
The Impact

New vaccine introduction accompanied by social mobilization activities could contribute to improved routine immunization timeliness. This study assesses the impact of Kenya’s introduction of pneumococcal conjugate vaccine (PCV) on the timeliness of routine childhood vaccination in two informal, urban settlements in Nairobi. Data collected from 2007 to 2015 as part of a demographic surveillance system were used to estimate annual vaccination delays of ≥ 4 weeks among children aged 12–23 months in the period before and after the introduction of PCV in Kenya. Binomial segmented regression models using generalized estimating equations examined the association between vaccine introduction and timeliness of routine immunization. Over half of all children vaccinated in the two urban areas received one or more doses ≥ 4 weeks after the recommended age. The timeliness of routine immunization showed slight improvements or nonsignificant changes during the years following PCV introduction compared with the preceding years (adjusted prevalence ratio [aPR]: 0.67, 95% CI: 0.45–0.99 for Bacille Calmette-Guerin receipt; aPR: 0.59, 95% CI: 0.41–0.83 for third dose Pentavalent receipt; aPR: 1.19, 95% CI: 0.99–1.42 for measles). However, as of 2015, delayed vaccination remained prevalent in children, particularly among the poorest residing in the settlements. Many sub-Saharan African countries have introduced new life-saving vaccines into their routine childhood immunization schedule. Additional evidence regarding the positive or neutral influence of new vaccine introduction on the performance of delivery systems provides further justification to sustain the inclusion of these more costly vaccines in the immunization schedule.

scholarly journals Effectiveness of Mandatory and Incentive-Based Routine Childhood Immunization Programs in Europe: A Systematic Review of the Literature

Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1173
Author(s):  
Lidia Kuznetsova ◽  
Giorgio Cortassa ◽  
Antoni Trilla
Keyword(s):  
Vaccine Coverage ◽  
Childhood Vaccination ◽  
World Health ◽  
Childhood Immunization ◽  
Vaccination Programs ◽  
Vaccine Preventable Diseases ◽  
Routine Childhood ◽  
Vaccine Mandates ◽  
Health Organization ◽  
The Impact

There is a lack of comprehensive and systematic data and evidence regarding the effectiveness of mandatory and incentive-based vaccination schemes. The results of such programs in some countries have not been adequately studied. A number of countries have recently introduced tightening vaccination measures, and it is important to analyze and assess the results of these programs. The unprecedented situation due to the COVID-19 pandemic and mass vaccination made the topic of the effectiveness of vaccination policies and mandates even more relevant. The aim of the study is to assess childhood vaccination programs implemented in selected countries. The study focuses on initiatives implemented in the European Region of the World Health Organization (WHO). A total of 466 full-text articles were assessed for eligibility, and 26 articles on seven countries were included in the synthesis. Additionally, we obtained and performed an analysis of data on the impact of COVID-19 on vaccine coverage and incidence of vaccine-preventable diseases, and the implementation of vaccine mandates in the selected countries. The evidence collected and analyzed in this review allowed us to conclude that the introduction of children routine vaccination mandates increases vaccine coverage and reduces the incidence of vaccine-preventable diseases when compared to the situation before the introduction of the mandates.

scholarly journals Acceptability of mobile-phone reminders for routine childhood vaccination appointments in Nigeria – a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paul Eze ◽  
Sergius Alex Agu ◽  
Ujunwa Justina Agu ◽  
Yubraj Acharya
Keyword(s):  
Systematic Review ◽  
Mobile Phone ◽  
Meta Analysis ◽  
Childhood Vaccination ◽  
Routine Immunization ◽  
Current Evidence ◽  
Long Term Effects ◽  
Childhood Immunization ◽  
Routine Childhood ◽  
To Receive

Abstract Background Mobile-phone reminders have gained traction among policymakers as a way to improve childhood vaccination coverage and timeliness. However, there is limited evidence on the acceptability of mobile-phone reminders among patients and caregivers. This systematic review and meta-analysis aimed to evaluate the ownership of mobile-phone device and the willingness to receive mobile-phone reminders among mothers/caregivers utilizing routine childhood immunization services in Nigeria. Method MEDLINE, Scopus, CINAHL, CNKI, AJOL (African Journal Online), and Web of Science were systematically searched for studies on the acceptability of mobile-phone reminders for routine immunization appointments among mothers/caregivers in Nigeria. Studies were assessed for methodological quality using the Newcastle Ottawa Scale and JBI critical appraisal checklists. Meta-analysis was conducted using random-effects model to generate pooled estimates (proportion) of mothers who owned at least one mobile phone and proportion of mothers willing to receive mobile-phone reminders. Results Sixteen studies (13 cross-sectional and three interventional) involving a total of 9923 mothers across 15 states and the Federal Capital Territory Abuja met inclusion criteria. Pooled estimates showed that the proportion of mothers who owned at least one mobile phone was 96.4% (95% CI = 94.1–98.2%; I2 = 96.3%) while the proportion of mothers willing to receive mobile-phone reminders was 86.0% (95% CI = 79.8–91.3%, I2 = 98.4%). Most mothers preferred to receive text message reminders at least 24 h before the routine immunization appointment day, and in the morning hours. Approximately 52.8% of the mothers preferred to receive reminders in English, the country’s official language. Conclusion Current evidence suggests a high acceptability for mobile-phone reminder interventions to improve routine childhood immunization coverage and timeliness. Further studies, however, are needed to better understand unique regional preferences and assess the operational costs, long-term effects, and risks of this intervention. Systematic review protocol registration PROSPERO CRD42021234183.

scholarly journals Effectiveness of Haemophilus influenzae Type b Conjugate Vaccine Introduction Into Routine Childhood Immunization in Kenya

JAMA ◽  
2006 ◽  
Vol 296 (6) ◽  
pp. 671 ◽  
Author(s):  
Karen D. Cowgill ◽  
Moses Ndiritu ◽  
Joyce Nyiro ◽  
Mary P. E. Slack ◽  
Salome Chiphatsi ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Conjugate Vaccine ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Childhood Immunization ◽  
Vaccine Introduction ◽  
Routine Childhood

scholarly journals Determinants of Parental Compliance with Routine Childhood Immunization Schedule in Nassarawa State, Nigeria

2017 ◽  
Vol 1 (3) ◽  
pp. 1-7
Author(s):  
Umar Yunusa ◽  
Omolola Irinoye ◽  
Umar Lawal Bello ◽  
Golfa Timothy
Keyword(s):  
Immunization Schedule ◽  
Childhood Immunization ◽  
Parental Compliance ◽  
Routine Childhood

scholarly journals Noninvasive Pneumococcal Clones Associated with Antimicrobial Nonsusceptibility Isolated from Children in the Era of Conjugate Vaccines

2015 ◽  
Vol 59 (9) ◽  
pp. 5761-5767 ◽  
Author(s):  
Martha McElligott ◽  
Imelda Vickers ◽  
Mary Meehan ◽  
Mary Cafferkey ◽  
Robert Cunney ◽  
...  
Keyword(s):  
Conjugate Vaccine ◽  
Clonal Complex ◽  
Treatment Strategies ◽  
Significant Decline ◽  
High Rate ◽  
Immunization Schedule ◽  
Childhood Immunization ◽  
Conjugate Vaccines ◽  
Vaccine Introduction ◽  
Single Locus Variant

ABSTRACTCarriage and noninvasive pneumococcal isolates frequently have a higher prevalence of antimicrobial nonsusceptibility than invasive isolates. From 2009 to 2014, we determined the associated clones in 169 pediatric noninvasive nonsusceptible pneumococci from a total of 506 isolates collected after 7- and 13-valent conjugate vaccine introduction (PCV7/13) to the Irish childhood immunization schedule in 2008 and 2010, respectively. We compared our results to those from 25 noninvasive pediatric pneumococcal isolates collected in 2007, the year before introduction of conjugate vaccines. In 2007, England14-9 and Spain9V-3 accounted for 12% and 32% of nonsusceptible clones, respectively, but in 2009 to 2014, their prevalence fell to 0% and 2.4%. Furthermore, there was a significant decline in Spain6B-2 and its variants from 2009 to 2014 (P= 0.0024). Fluctuations occurred in clonal complex 320 associated with serotype 19A. The prevalence of Sweden15A-25 and its variants and ST558 (a single-locus variant of Utah35B-24) associated with nonvaccine serotypes (NVT) 15A and 35B increased from 0% and 8% in 2007 to 19% and 16% in 2013 to 2014, respectively. Pilus locus 1 (PI-1) is associated with the spread of some nonsusceptible pneumococcal clones. PI-1 was more frequently associated with PCV7/13 serotypes than NVT (P= 0.0020). Our data highlight the value of surveillance of noninvasive pneumococci following conjugate vaccine introduction. Importantly, emerging clones associated with NVT may limit the effectiveness of PCV7/13 in reducing the high rate of nonsusceptibility among pediatric noninvasive pneumococci, with implications for empirical treatment strategies.

scholarly journals Impact of the COVID-19 Pandemic Lockdown on Routine Childhood Immunization: A Saudi Nationwide Cross-Sectional Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Leena R. Baghdadi ◽  
Afnan Younis ◽  
Hessah I. Al Suwaidan ◽  
Marwah M. Hassounah ◽  
Reem Al Khalifah
Keyword(s):  
Saudi Arabia ◽  
Young Children ◽  
Access To Health Care ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Childhood Vaccination ◽  
Sectional Study ◽  
Childhood Immunization ◽  
Cross Sectional ◽  
Routine Childhood

Background: Routine childhood immunization is the most cost-effective method to prevent infection and decrease childhood morbidity and mortality. The COVID-19 pandemic has affected access to health care in Saudi Arabia, including mandatory vaccinations for young children. We aimed to assess the prevalence of intentionally delayed vaccinations in children aged ≤ 2 years during the COVID-19 pandemic curfew in Saudi Arabia, its relation to the caregivers' fear of infection, and identifying factors affecting the caregivers' decision.Methods: We conducted a cross-sectional study using a self-administered survey that targeted primary caregivers of children aged ≤ 2 years residing in Saudi Arabia during the COVID-19 pandemic curfew (March 4–July 6, 2020).Results: We received responses from 577 caregivers, of whom 90.8% were mothers. The prevalence of intentional vaccination delay was 37%. Upon adjusting the potential confounders, the odds of delaying scheduled childhood vaccination because of COVID-19 pandemic fears were greater among caregivers with higher levels of fear (OR 1.10, 95% CI 1.02–1.11). Common reasons for delaying vaccinations were COVID-19 infection and prevention of exposure to COVID-19 cases.Conclusion: Intentional vaccination delay leaves young children vulnerable to preventable infectious diseases. Identifying these children and offering catch-up vaccinations reduces this risk. Campaigns to increase awareness about the dangers of delaying vaccine-preventable diseases must be promoted to caregivers in addition to the promotion of home vaccination services. In preparation for future pandemics, we recommend countries consider interventions to control the level of fear and anxiety provoked by the pandemics and media, and interventions for improved access to vaccinations.

scholarly journals Effects of an urban sanitation intervention on childhood enteric infection and diarrhoea in Mozambique

2020 ◽  
Author(s):  
Jackie Knee ◽  
Trent Sumner ◽  
Zaida Adriano ◽  
Claire Anderson ◽  
Farran Bush ◽  
...  
Keyword(s):  
Low Income ◽  
Urban Areas ◽  
Critical Infrastructure ◽  
Controlled Trial ◽  
Prevalence Ratio ◽  
Low Income Countries ◽  
Enteric Infection ◽  
Urban Sanitation ◽  
Protozoan Infection ◽  
The Impact

Background. Onsite sanitation serves more than 740 million people in urban areas, primarily in low-income countries. Although this critical infrastructure may play an important role in controlling enteric infections in high-burden settings, its health impacts have never been evaluated in a controlled trial. Methods. We conducted a controlled before and after trial to evaluate the impact an onsite urban sanitation intervention on the prevalence of bacterial and protozoan infection (primary outcome), soil transmitted helminth (STH) re-infection, and seven-day period prevalence of diarrhoea among children living in informal neighborhoods of Maputo, Mozambique. A non-governmental organization replaced existing shared latrines in poor condition with engineered pour-flush toilets with septic tanks serving household clusters. We enrolled children aged 1-48 months at baseline and measured outcomes before the intervention and at 12 and 24 months following intervention. We measured outcomes concurrently among children served by the sanitation improvements and those in a comparable control arm served by existing poor sanitation. The trial was registered at ClinicalTrials.gov, number NCT02362932. Findings. At baseline, we enrolled 454 children from 208 intervention clusters and 533 children from 287 control clusters. We enrolled or re-visited 462 intervention and 477 control children 12 months 60 after intervention and 502 intervention and 499 control children 24 months after intervention. Despite nearly exclusive use of the intervention, we found no evidence that engineered onsite sanitation affected the overall prevalence of any measured bacterial or protozoan infection (12-month adjusted prevalence ratio 1.05, 95% CI [0.95-1.16]; 24-month adjusted prevalence ratio 0.99, 95% CI [0.91-1.09]), any STH re-infection (1.11 [0.89-1.38]; 0.95 [0.77-1.17]), or diarrhoea (1.69 [0.89-3.21]; 0.84 [0.47-1.51]) after 12 or 24 months of exposure. Among children born into study sites after the intervention and measured at the 24-month visit, we observed a reduced prevalence of any STH re-infection of 49% (adjusted prevalence ratio 0.51 [95% confidence interval 0.27 - 0.95]), Trichuris of 76% (0.24 [0.10 - 0.60]), and Shigella infection by 51% (0.49 [0.28-0.85]) relative to the same age group at baseline. Interpretation. The intervention did not reduce the overall prevalence of enteric infection and diarrhoea among all enrolled children but may have substantially reduced the prevalence of STHs and Shigella among children born into clusters with sanitary improvements.

scholarly journals Rotavirus disease burden pre-vaccine introduction in young children in Rural Southern Mozambique, an area of high HIV prevalence

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249714
Author(s):  
Sozinho Acácio ◽  
Tacilta Nhampossa ◽  
Llorenç Quintò ◽  
Delfino Vubil ◽  
Marcelino Garrine ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Burden ◽  
Conditional Logistic Regression ◽  
Epidemiological Data ◽  
Daily Basis ◽  
African Countries ◽  
Severe Diarrhea ◽  
Vaccine Introduction ◽  
Rotavirus Vaccines ◽  
The Impact

Background Rotavirus vaccines have been adopted in African countries since 2009, including Mozambique (2015). Disease burden data are needed to evaluate the impact of rotavirus vaccine. We report the burden of rotavirus-associated diarrhea in Mozambique from the Global Enteric Multicenter Study (GEMS) before vaccine introduction. Methods A case-control study (GEMS), was conducted in Manhiça district, recruiting children aged 0–59 months with moderate-to-severe diarrhea (MSD) and less-severe-diarrhea (LSD) between December 2007 and November 2012; including 1–3 matched (age, sex and neighborhood) healthy community controls. Clinical and epidemiological data and stool samples (for laboratory investigation) were collected. Association of rotavirus with MSD or LSD was determined by conditional logistic regression and adjusted attributable fractions (AF) calculated, and risk factors for rotavirus diarrhea assessed. Results Overall 915 cases and 1,977 controls for MSD, and 431 cases and 430 controls for LSD were enrolled. Rotavirus positivity was 44% (217/495) for cases and 15% (160/1046) of controls, with AF = 34.9% (95% CI: 32.85–37.06) and adjusted Odds Ratio (aOR) of 6.4 p< 0.0001 in infants with MSD compared to 30% (46/155) in cases and 14% (22/154) in controls yielding AF = 18.7%, (95% CI: 12.02–25.39) and aOR = 2.8, p = 0.0011 in infants with LSD. The proportion of children with rotavirus was 32% (21/66) among HIV-positive children and 23% (128/566) among HIV-negative ones for MSD. Presence of animals in the compound (OR = 1.9; p = 0.0151) and giving stored water to the child (OR = 2.0, p = 0.0483) were risk factors for MSD; while animals in the compound (OR = 2.37, p = 0.007); not having routine access to water on a daily basis (OR = 1.53, p = 0.015) and washing hands before cooking (OR = 1.76, p = 0.0197) were risk factors for LSD. Conclusion The implementation of vaccination against rotavirus may likely result in a significant reduction of rotavirus-associated diarrhea, suggesting the need for monitoring of vaccine impact.

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