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      Characteristics of persons refusing oral polio vaccine during the immunization plus days – Sokoto, Nigeria 2011


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          Nigeria, the only African country endemic for wild poliovirus, adopted Immunization Plus Days (IPD) to eradicate polio. Refusal of oral polio vaccine (OPV) by heads of households is a significant challenge. In Sokoto state, we determined characteristics of heads of households refusing OPV during IPD in 2011.


          To evaluate reasons for refusals, we conducted a case control study among heads ofhouseholds accepting or refusing OPV vaccine. Noncompliant households were defined as households refusing OPV vaccination in last three rounds of IPDs while compliant households were those accepting vaccination. Interviewers administered a questionnaire to the heads of households to obtain information on socio-demographics, media habits, and knowledge of IPD.


          Of the 121 (60 cases and 61 controls) interviews, 88 (73%) were from Sokoto north. Noncompliant heads of households were more likely to lack tertiary education (OR = 3.7, 95% CI, 1.6 - 9.2), believe that OPV is not safe (OR = 22, 95% CI, 7.1 - 76), lack access to functional radio (OR = 4.4, 95% CI, 1.4 - 15) and television (OR = 9.4, 95% CI, (1.9 - 63) andget information about IPD from town announcers (OR = 3.9, 95% CI, 1.3 - 12).


          We conclude that noncompliant heads of households compared to compliant heads of households had low level of education, lacked knowledge of immunization, and had negative attitude towards OPV. They get information about OPV from town announcers and lacked access to functional radio and television. We recommended training of town announcers in polio communication and use of key communication messages preceding every round of IPD.

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          Risk factors for incomplete vaccination and missed opportunity for immunization in rural Mozambique

          Background Inadequate levels of immunization against childhood diseases remain a significant public health problem in resource-poor areas of the globe. Nonetheless, the reasons for incomplete vaccination and non-uptake of immunization services are poorly understood. This study aimed at finding out the reasons for non-vaccination and the magnitude of missed opportunities for vaccination in children less than two years of age in a rural area in southern Mozambique. Methods 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. Results 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. Conclusion 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.
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            Implications of a 2005 measles outbreak in Indiana for sustained elimination of measles in the United States.

            Measles was declared eliminated from the United States in 2000 but remains endemic worldwide. In 2005, a 17-year-old unvaccinated girl who was incubating measles returned from Romania, creating the largest documented outbreak of measles in the United States since 1996. We conducted a case-series investigation, molecular typing of viral isolates, surveys of rates of vaccination coverage, interviews regarding attitudes toward vaccination, and cost surveys. Approximately 500 persons attended a gathering with the index patient one day after her return home. Approximately 50 lacked evidence of measles immunity, of whom 16 (32 percent) acquired measles at the gathering. During the six weeks after the gathering, a total of 34 cases of measles were confirmed. Of the patients with confirmed measles, 94 percent were unvaccinated, 88 percent were less than 20 years of age, and 9 percent were hospitalized. Of the 28 patients who were 5 to 19 years of age, 71 percent were home-schooled. Vaccine failure occurred in two persons. The virus strain was genotype D4, which is endemic in Romania. Although containment measures began after 20 persons were already infectious, measles remained confined mostly to children whose parents had refused to have them vaccinated, primarily out of concern for adverse events from the vaccine. Seventy-one percent of patients were from four households. Levels of measles-vaccination coverage in Indiana were 92 percent for preschoolers and 98 percent for sixth graders. Estimated costs of containing the disease were at least 167,685 dollars, including 113,647 dollars at a hospital with an infected employee. This outbreak was caused by the importation of measles into a population of children whose parents had refused to have them vaccinated because of safety concerns about the vaccine. High vaccination levels in the surrounding community and low rates of vaccine failure averted an epidemic. Maintenance of high rates of vaccination coverage, including improved strategies of communication with persons who refuse vaccination, is necessary to prevent future outbreaks and sustain the elimination of measles in the United States. Copyright 2006 Massachusetts Medical Society.
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              Sterilizing vaccines or the politics of the womb: retrospective study of a rumor in Cameroon.

              In 1990 a rumor that public health workers were administering a vaccine to sterilize girls and women spread throughout Cameroon. Schoolgirls leapt from windows to escape the vaccination teams, and the vaccination campaign (part of the Year of Universal Child Immunization) was aborted. This article traces the origin and development of this rumor. Theories of rumor and ambiguous cultural response to new technologies shed some light on its genesis and spread, but explain neither its timing nor its content. For this task we need to examine the historical context of Cameroonian experience with colonial vaccination campaigns and the contemporary contexts of the turmoil of democratization movements and economic crisis, concurrent changes in contraceptive policy, and regional mistrust of the state and its "hegemonic project." Drawing on Bayart's politique du ventre and White's thoughts on gossip, we explore this rumor as diagnostic of local response to global and national projects. This response, expressed in this case through the idiom of threats to local reproductive capacity, reveals a feminine side to local-global relations, a politics of the womb.

                Author and article information

                Pan Afr Med J
                Pan Afr Med J
                The Pan African Medical Journal
                The African Field Epidemiology Network
                21 July 2014
                : 18
                : Suppl 1
                : 10
                [1 ]Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
                [2 ]Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
                [3 ]National Primary Health Care Development Agency, Abuja, Nigeria
                Author notes
                [& ] Corresponding author: Mohammed Abdulaziz, Nigerian Field Epidemiology and Laboratory Training Program Asokoro, Abuja, Nigeria
                © Abdulaziz Mohammed et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 15 March 2014
                : 19 April 2014

                immunization,opv,vaccine refusal,wpv,poliomyelitis,knowledge,attitude,noncompliance
                immunization, opv, vaccine refusal, wpv, poliomyelitis, knowledge, attitude, noncompliance


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