scholarly journals Effect of Mobile Phone Reminders and Recalls on Pentavalent Vaccines Drop-out Rate among Caregivers Accessing Childhood Immunisation Services in a Developing City, Southeast Nigeria

Author(s):  
N. C. Eze ◽  
C. N. Onwasigwe

Background: Immunisation drop-out rate measures the effectiveness of the immunisation programme. When drop-outs exceed 10 percent it indicates a problem of utilisation of services. Receipt of vaccines at the recommended ages and intervals will ensure that children are adequately protected from target diseases at all times. Immunisation reminder and recall (RR) systems are cost-effective methods of improving adherence to recommended immunisation schedules. This study, therefore, determined the effect of immunisation reminders and recalls on reducing pentavalent vaccination drop-outs in Abakaliki. Materials and Methods: This is a quasi-experimental study among caregivers of infants in rural health facilities in Abakaliki, Nigeria. Mile-Four and St. Vincent hospitals in Izzi and Ebonyi Local Government Areas (LGA) of Ebonyi State were selected purposively. Mile-Four was assigned the phone reminder/recall intervention group and St. Vincent as a control group. The sample size was determined using the formula for comparing two proportions.  Caregiver-child pair was enrolled into the two groups during the infants’ BCG or Pentavalent vaccines 1 immunisation visit and followed till the final scheduled immunisation visit for each child. Data were collected using questionnaire forms, proforma and checklist. Statistical Package for Social Science (SPSS) version 22.0 was used for analysis. Ethical approval was obtained from the Research and Ethics Committee (REC) of the Federal Teaching Hospital Abakaliki (FETHA), Nigeria.            Results: The mean age of respondents were 26.6 ±4.9 years and 27.1±4.2 years in the intervention and control groups respectively. Thirty five point seven percent (35.7%) of infants dropped out of pentavalent vaccinnation 3 in pre-intervention phase when compared with 5.5% post-intervention. This difference in their proportions was found statistically significant (p<0.01).  In the control group, 47.7% dropped out of pentavalent vaccination 3 at the beginning of the study when compared with 22.1% at the end of the study, a difference that was statistically significant (p=0.02). Out of 145 infants who received pentavalent vaccines 1 in both groups, 137 (94.5%) infants received pentavalent vaccines 3 in the intervention group while 113 (77.9%) infants received pentavalent vaccines 3 in the control group. Far distance to health facility predicted immunisation drop-out in the control group. It is 2.8 times more likely to cause immunisation drop-out than near distance to health facility. No predictor was found in the intervention group. Conclusion: Mobile phone reminders and recall has proven very effective in reducing pentavalent vaccines drop-out rate in Abakaliki. Implementation of immunisation reminders and recall systems are therefore recommended in immunisation clinics in developing countries especially in Nigeria for improved immunisation coverage in order to achieve Sustainable Developmental Goal 3 (SDG 3).

Author(s):  
Byamukama Topher ◽  
Keraka M. Margaret ◽  
Gitonga Eliphas

Background: Immunization is one of the most cost-effective public health interventions to reduce child mortality and morbidity associated with infectious diseases. The objective of this study was to determine the perceptions of caregivers on immunization in Ntungamo district.Methods: Quasi-experimental study was used with health centres assigned to intervention and control groups. Purposive sampling was used to select the two counties where the study was done. Proportional sampling was done to get study samples from each health facility, while systematic sampling was done to get study participants. A total of 787 children from twelve health facilities provided the study sample. A post intervention evaluation was conducted to determine the effect of these interventions. Association of variables was tested using Mann Whitney U-test and Chi-square.Results: On benefits, most caregivers in the intervention group (85.3%) and in the control group (54.3%) regarded immunization as very highly and moderately beneficial to their children respectively. On risks, most caregivers in the intervention group (85.5%) and control group (43.1%) regarded the risk factor associated with immunization as very low and moderate respectively. From hypothesis testing, there was a significant difference on the perceived benefits and risks of immunization between the intervention and control group.Conclusions: Most caregivers in the intervention and control group regarded immunization as very highly beneficial and moderately to their children respectively. Most of the caregivers in the intervention and control group regarded the risk factor associated with immunization as very low and moderate respectively. 


Author(s):  
N. C. Eze ◽  
B. N. Azuogu ◽  
I. L. Okoronkwo

Background: Missed immunisation (MI) may contribute to low immunisation coverage in diverse settings, especially developing countries. Receipt of vaccines at the recommended ages and intervals will ensure that children are adequately protected from target diseases at all times. Immunisation reminder and recall (RR) systems are cost-effective methods of improving adherence to recommended immunisation schedules. This study, therefore, determined the effect of immunisation reminders and recalls on reducing missed immunisations in Abakaliki. Materials and Methods: This is a quasi-experimental study conducted among caregivers of infants in rural health facilities in Abakaliki. Mile-Four and St. Vincent hospitals located in Ebonyi and Izzi Local Government Areas (LGA) respectively in Ebonyi State were selected purposively. Mile-Four was assigned intervention group and St. Vincent as control group. The sample size was determined using the formula for comparing two proportions.  Caregiver-child pair was recruited during the infants’ BCG or Pentavalent vaccines 1 immunisation visit and followed till the final scheduled immunisation visit for each child. Data was collected using a questionnaire, proforma and checklist. Statistical Package for Social Science (SPSS) version 22.0 was used for analysis. Ethical approval was obtained from the Research and Ethics Committee (REC) of the Federal Teaching Hospital Abakaliki (FETHA). Results: A greater proportion of respondents in the intervention group (8.3%) missed vaccination at the 6th and 10th weeks when compared with the 4.1% and 6.9% for the above mentioned weeks respectively in the control group. In the control group, a greater proportion (22.1%) missed vaccination than the intervention group (8.9%) at the 14th week, a difference in the proportion that was significant (p=0.04). Relative to female caregivers, male caregivers are 6.2 times more likely to miss immunisation in the intervention group. They are 2.3 times more likely to miss immunisation than the female ones in the control group. Those at older age (≥30 years) are 1.2 times more likely to miss immunisation than those of younger age group.                                                                                              Conclusion: Mobile phone reminders and recall has proven effective in reducing childhood missed immunisations and non-compliance in Abakaliki. Implementation of immunisation reminders and recall systems is therefore recommended in immunisation clinics in developing countries especially in Nigeria for immunisation timeliness and completion.


2015 ◽  
Vol 21 (9) ◽  
pp. 1184-1194 ◽  
Author(s):  
A Bogosian ◽  
P Chadwick ◽  
S Windgassen ◽  
S Norton ◽  
P McCrone ◽  
...  

Background: Mindfulness-based interventions have been shown to effectively reduce anxiety, depression and pain in patients with chronic physical illnesses. Objectives: We assessed the potential effectiveness and cost-effectiveness of a specially adapted Skype distant-delivered mindfulness intervention, designed to reduce distress for people affected by primary and secondary progressive MS. Methods Forty participants were randomly assigned to the eight-week intervention ( n = 19) or a waiting-list control group ( n = 21). Participants completed standardised questionnaires to measure mood, impact of MS and symptom severity, quality of life and service costs at baseline, post-intervention and three-month follow-up. Results: Distress scores were lower in the intervention group compared with the control group at post-intervention and follow-up ( p < 0.05), effect size −0.67 post-intervention and −0.97 at follow-up. Mean scores for pain, fatigue, anxiety, depression and impact of MS were reduced for the mindfulness group compared with control group at post-therapy and follow-up; effect sizes ranged from −0.27 to −0.99 post-intervention and −0.29 to −1.12 at follow-up. There were no differences in quality-adjusted life years, but an 87.4% probability that the intervention saves on service costs and improves outcome. Conclusions: A mindfulness intervention delivered through Skype video conferences appears accessible, feasible and potentially effective and cost-effective for people with progressive MS.


2019 ◽  
Vol 10 (2) ◽  
pp. 70
Author(s):  
Samah Nasser Abd El-Aziz El-Shora ◽  
Amina Mohamed Rashad El-Nemer

Background and aim: Hypotension during cesarean section (CS) under spinal anesthesia has been a subject of scientific study for more than 50 years and the search for the most effective strategy to achieve hemodynamic stability remains challenging. Aim: The study was carried out to apply leg wrapping technique for the prevention of spinal-induced hypotension (SIH) during CS.Methods: Randomized Controlled Trial design was utilized at cesarean delivery operating room Mansoura General Hospital in El-Mansoura City during the period from May 2018 to November 2018. A purposive sample of 88 pregnant women, assigned randomly to an intervention group (n = 44) in which their legs wrapped with elastic crepe bandage and control group (n = 44) in which no wrapping was done. Data collected for maternal, neonatal hemodynamic and signs of hypotension, the feasibility of application and cost analysis.Results: There was a statistically significant difference in the incidence of SIH and Ephedrine use among both groups (18.20% in leg wrapping group whereas 75% in control group). In addition, neonatal acidosis and NICU admission were less among leg wrapping group (11.40%, 9.10% respectively). Economically, leg wrapping technique was cost effective compared to the cost of the hospital regimen for treating SIH and admission to (NICU).Conclusion and recommendations: Leg wrapping technique was cost effective and an efficient method for decreasing SIH, neonatal acidosis and Ephedrine administration. It is recommended to apply leg wrapping technique in maternal hospitals' protocol of care for decreasing SIH during CS.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 119-120
Author(s):  
N. Østerås ◽  
E. Aas ◽  
T. Moseng ◽  
L. Van Bodegom-Vos ◽  
K. Dziedzic ◽  
...  

Background:To improve quality of care for patients with hip and knee osteoarthritis (OA), a structured model for integrated OA care was developed based on international treatment recommendations. A previous analysis of a cluster RCT (cRCT) showed that compared to usual care, the intervention group reported higher quality of care and greater satisfaction with care. Also, more patients were treated according to international guidelines and fulfilled recommendations for physical activity at the 6-month follow-up.Objectives:To assess the cost-utility of a structured model for hip or knee OA care.Methods:A cRCT with stepped-wedge cohort design was conducted in 6 Norwegian municipalities (clusters) in 2015-17. The OA care model was implemented in one cluster at the time by switching from “usual care” to the structured model. The implementation of the model was facilitated by interactive workshops for general practitioners (GPs) and physiotherapists (PTs) with an update on OA treatment recommendations. The GPs explained the OA diagnosis and treatment alternatives, provided pharmacological treatment when appropriate, and suggested referral to physiotherapy. The PT-led patient OA education programme was group-based and lasted 3 hours followed by an 8–12-week individually tailored resistance exercise programme with twice weekly 1-hour supervised group sessions (5–10 patients per PT). An optional 10-hours Healthy Eating Program was available. Participants were ≥45 years with symptomatic hip or knee OA.Costs were measured from the healthcare perspective and collected from several sources. Patients self-reported visits in primary healthcare at 3, 6, 9 and 12 months. Secondary healthcare visits and joint surgery data were extracted from the Norwegian Patient Register. The health outcome, quality-adjusted life-year (QALY), was estimated based on the EQ-5D-5L scores at baseline, 3, 6, 9 and 12 months. The result of the cost-utility analysis was reported using the incremental cost-effectiveness ratio (ICER), defined as the incremental costs relative to incremental QALYs (QALYs gained). Based on Norwegian guidelines, the threshold is €27500. Sensitivity analyses were performed using bootstrapping to assess the robustness of reported results and presented in a cost-effectiveness plane (Figure 1).Results:The 393 patients’ mean age was 63 years (SD 9.6) and 74% were women. 109 patients were recruited during control periods (control group), and 284 patients were recruited during interventions periods (intervention group). Only the intervention group had a significant increase in EQ-5D-5L utility scores from baseline to 12 months follow-up (mean change 0.03; 95% CI 0.01, 0.05) with QALYs gained: 0.02 (95% CI -0.08, 0.12). The structured OA model cost approx. €301 p.p. with an additional €50 for the Healthy Eating Program. Total 12 months healthcare cost p.p. was €1281 in the intervention and €3147 in the control group, resulting in an incremental cost of -€1866 (95% CI -3147, -584) p.p. Costs related to surgical procedures had the largest impact on total healthcare costs in both groups. During the 12-months follow-up period, 5% (n=14) in the intervention compared to 12% (n=13) in the control group underwent joint surgery; resulting in a mean surgical procedure cost of €553 p.p. in the intervention as compared to €1624 p.p. in the control group. The ICER was -€93300, indicating that the OA care model resulted in QALYs gained and cost-savings. At a threshold of €27500, it is 99% likely that the OA care model is a cost-effective alternative.Conclusion:The results of the cost-utility analysis show that implementing a structured model for OA care in primary healthcare based on international guidelines is highly likely a cost-effective alternative compared to usual care for people with hip and knee OA. More studies are needed to confirm this finding, but this study results indicate that implementing structured OA care models in primary healthcare may be beneficial for the individual as well as for the society.Disclosure of Interests:None declared


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Younes Lotfi ◽  
Mahdieh Hasanalifard ◽  
Abdollah Moossavi ◽  
Enayatollah Bakhshi ◽  
Mohammad Ajalloueyan

Abstract Background The objective of this study was to evaluate the effect of “Spatially separated speech in noise” auditory training on the ability of speech perception in noise among bimodal fitting users. The assumption was that the rehabilitation can enhance spatial hearing and hence speech in noise perception. This study was an interventional study, with a pre/post-design. Speech recognition ability was assessed with the specific tests. After performing the rehabilitation stages in the intervention group, the speech tests were again implemented, and by comparing the pre- and post-intervention data, the effect of auditory training on the speech abilities was assessed. Twenty-four children of 8–12 years who had undergone cochlear implantation and continuously used bimodal fitting were investigated in two groups of control and intervention. Results The results showed a significant difference between the groups in different speech tests after the intervention, which indicated that the intervention group have improved more than the control group. Conclusion It can be concluded that “Spatially separated speech in noise” auditory training can improve the speech perception in noise in bimodal fitting users. In general, this rehabilitation method is useful for enhancing the speech in noise perception ability.


Author(s):  
Leticia Borfe ◽  
Caroline Brand ◽  
Letícia Schneiders ◽  
Jorge Mota ◽  
Claudia Cavaglieri ◽  
...  

Physical exercise reduces the biochemical markers of obesity, but the effects of multicomponent interventions on these markers should be explored. The present study aimed to elucidate how overweight/obese adolescents respond to a multicomponent program approach on body composition, physical fitness, and inflammatory markers, using a quasi-experimental study with 33 overweight/obesity adolescents (control group (CG) = 16; intervention group (IG) = 17). The intervention consisted of 24 weeks with physical exercises and nutritional and psychological guidance. Both groups were evaluated at the pre/post-intervention moments on body mass index (BMI); body fat (%Fat); waist circumference (WC); waist/hip ratio (WHR); waist-to-height ratio (WHtR), cardiorespiratory fitness (CRF); abdominal strength, flexibility; leptin; interleukin 6; interleukin 10; and tumor necrosis factor-alpha. Mixed-analysis of variance and generalized estimation equations were used for statistical analysis. There was an interaction effect between groups and time on %Fat (p = 0.002), WC (p = 0.023), WHR (p < 0.001), WHtR (p = 0.035), CRF (p = 0.050), and leptin (p = 0.026). Adolescents were classified as 82.4% responders for %Fat, 70.6% for WC, 88.2% for WHR, and 70.6% for CRF. Further, there was an association between changes in %Fat (p = 0.033), WC (p = 0.032), and WHR (p = 0.033) between responders and non-responders with CRF in the IG. There was a positive effect on body composition, physical fitness, and leptin. In addition, reductions in body composition parameters were explained by CRF improvements.


2018 ◽  
Vol 6 (1) ◽  
pp. 89-96 ◽  
Author(s):  
Oktavina Permatasari ◽  
Retno Murwani ◽  
M. Zen Rahfiludin

Tempe is a well known fermented soybean food, inexpensive, and a good source of dietary protein and energy. To improve fresh Tempe as an attractive food to children, Tempe is processed into nugget. A study using pre and post control group design was conducted to determine the effect of the Tempe nugget provision on energy and protein intake, and body weight/age (W/A) of 24-59 months old children. Forty six subjects were selected according to inclusion criteria from local Community Health Center (Puskesmas) and grouped into intervention (provision of Tempe nugget) and control group (no provision). Data of energy and protein intake of subjects before intervention were obtained by 2x24 food recall to determine deficiency in intake for the respective age. The amount of the nugget given to each underweight child in intervention group was calculated on the basis of deficiency in energy and protein intake of each child (W/A) per day. Body weight was recorded pre and post intervention. The deep-fried nuggets contained 276.53 calories per 100 g, 8.60% protein, 28.41% carbohydrate, 13.28% lipid, and 44.28% fiber. The mean age of the subjects in intervention and control group were homogeneous i.e. 40.52±10.88 months and 42.39±12.35 months respectively. Tempe nugget provision for 30 days improved significantly energy intake (p 0.001) in intervention compared to control group. Protein intake and W/A in intervention group were higher compared to control although not significant and further study with higher amount of Tempe nugget provision is needed. This study provides evidence that deep fried Tempe nugget can be used as inexpensive and nutritious food to improve protein and energy intake for underweight underfive children.


2021 ◽  
Author(s):  
Remi Yoshikata ◽  
Khin Zay Yar Myint ◽  
Hiroaki Ohta ◽  
Yoko Ishigaki

Abstract Introduction: Equol, an isoflavone derivative whose chemical structure is similar to estrogen, is considered as a potentially effective agent for relieving climacteric symptoms, for the prevention of the lifestyle-related diseases, and for aging care in post-menopausal women. We investigated the effect of an equol-containing supplement on metabolism and aging, and climacteric symptoms, with respect to internally-produced equol in post-menopausal women.Methods: A single center, randomized controlled trial (registration number: UMIN000030975) on 57 post-menopausal Japanese women (mean age: 56±5.37 years), was conducted. Twenty-seven women received the equol supplement, while the remaining received Control. Metabolic and aging-related biomarkers were compared before and after the 3-month intervention. Climacteric symptoms were assessed every month using a validated self-administered questionnaire in Japanese post-menopausal women. Results: Three months post intervention, the treatment group showed significant improvement in climacteric symptoms, when compared to the Control group (81% vs. 53% respectively, p=0.045). We did not observe any beneficial effect on metabolic and aging-related biomarkers in the intervention group. However, in certain populations significant improvement in skin auto-fluorescence, which is a measurement of AGE skin products, and visceral fat area was observed, especially among equol producers. Conclusion: Women receiving equol supplement showed improved climacteric symptoms. This study offered a new hypothesis that there may be a synergy between supplemented equol and endogenously-produced equol to improve skin aging and visceral fat in certain populations.


2022 ◽  
Author(s):  
Forouzandeh Soleimanian-Boroujeni ◽  
Negin Badihian ◽  
Shervin Badihian ◽  
Vahid Shaygannejad ◽  
Yousef Gorji

Abstract Introduction: Psychological interventions are shown to be effective in migraine, but not utilized routinely yet. We aimed to evaluate the efficacy of transdiagnostic cognitive behavioral therapy (TCBT) on people with migraine (PwM). Method: This study was conducted on 40 PwM aged 20-50 years. We randomly assigned participants to two groups of intervention, receiving 10 sessions of TCBT, and control. Days with headache, headache severity, migraine-related disability and effects on daily life, number of pain-relivers taken for headache, depression, and anxiety were assessed pre-intervention, post-intervention (three-month follow-up), and one-month after TCBT termination (four-month follow-up).Results: Thirty-five participants suffering moderate to severe migraine completed the study (16 and 19 in TCBT and control groups, respectively). TCBT improved all measured items between study time-points (p<0.05) in the intervention group, while such an improvement was not observed in the control group. Between group comparisons revealed superiority of TCBT group compared to the control group in most measured items at three- and four-month follow-ups (p<0.05).Conclusion: Ten sessions of TCBT improved migraine severity, associated disability, anxiety, and depression in PwM, with persistent effects after one month of therapy termination. TCBT is an affordable, practical, and feasible intervention to be utilized for PwM.Protocol registration: The study protocol was registered in clinicaltrial.gov (NCT03701477) prior to enrollment.


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