Immunisation-related knowledge, attitudes and practices of mothers in Kinshasa, Democratic Republic of the Congo
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Background: In the Democratic Republic of Congo, it was reported in 1995 that the routine coverage for BCG was as low as 47%, and that it was 27% for DPT3, 28% for OPV3 and 39% for measles vaccine. The trend also was declining unevenly. This study aimed to determine the reasons for such low coverage, examining the socio-demographic characteristics of mothers and health system factors such as health services barriers. It further sought to assess the knowledge, attitudes and practices of mothers associated with routine immunisation.Methods: In 1999, a cross-sectional household survey applied a systematic sampling technique in a sample of eight out of the 22 health zones that then served the population of Kinshasa. These were dichotomised into low- and high-coverage health zones, based on BCG immunisation coverage. Mothers of children aged from zero to four years were the respondents to a standardised questionnaire.Results: A total of 1 613 children aged zero to four years participated in the study. Awareness of immunisation and its importance in protecting a child against diseases was universal, although most mothers could not tell exactly against which diseases. Mothers had positive attitudes towards immunisation (98%). Coverage based on the immunisation card, however, was as low as 37%, indicating a discrepancy between the high level of knowledge and positive attitudes, with the observed low immunisation coverage. The father's education and the mother's experience of an EPI-targeted disease in the family emerged as significant predictors of complete immunisation of the child. The father's involvement and the mother's ability to cite signs of severity of EPI diseases were associated with the child's vaccination status in the high-coverage health zone. The mother's vaccine-related knowledge was a predictor of immunisation status only in the low-coverage zone.Conclusion: Different factors determine the complete vaccination status, depending on whether the child lives in a zone with low or high routine EPI coverage. For example, the father's involvement is associated with the child's vaccination status in the high-coverage zone, but not in the low-coverage zone. Programmes and policy makers should take these factors into account when designing strategies to increase immunisation coverage.Keywords:
Systematic sampling
Objective This study was conducted to find out the epidemiological characteristics of measles and evaluate the measles for its control and prevention.Methods Statistical analysis was conducted on the data of measles incidence in Huizhou City from 2004 to 2010.ELISA was adopted to detect IgM antibody in serum.Results A total of 2 842 cases were reported during the seven-year period,the annually average morbidity was 11.69/100 000.A sporadic epidemic pattern was evident with widely distributed affected cases and significant seasonality.Measles mainly occurred during May to July,the incidence of measles between 0~14 years old groups was higher than that of the other age groups.Unimmunized cases or cases with unknown immunization history accounted for 90.04% of the overall cases.Conclusions Routine immunization of measles should be reinforced and boost vaccination should be carried out in proper time to prevent and control measles,at the same time the measles campaign should be implemented to adult.In addition,perfecting measles surveillance system must be taken.
Routine immunization
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Clinical profile of children presenting with measles in a Nigerian secondary health-care institution
The prognosis of measles is determined largely by host factors. The objective of this study is to document the clinical profile (host factors) of children presenting with measles in a Nigerian secondary health-care institution. In this case-series study, 77 children with measles (diagnosed clinically), admitted into St Philomena Catholic Hospital, Benin City were recruited over a 4-year period. The age, sex, presenting symptoms/ signs, immunization status, duration of symptoms before presentation, complications and outcome were recorded for each patient according to the month and year of presentation. The relevant paediatric admission registers were examined. Measles accounted for 3.1% of all paediatric admissions. Majority (47.8%) of the cases were presented between the ages of 13 and 24 months. Fourteen of 77 (18.1%) of children with measles were less than nine months old. Seventeen (22.1%) of all cases of measles had been previously vaccinated against measles while the remaining 60 (77.9%) were not. Significantly more cases of measles occurred in the dry season (80.5%) compared to the wet season (19.5%) p< 0.001. Measles occurred most frequently in the month of March. The two main reasons given by mothers for failing to immunize their children against measles were that the child was ill (35.0%) and the child was less than 9 months old (23.3%). Bronchopneumonia (55.1%) and diarrhoea with dehydration (13.0%) were the two leading complications. Disease-specific burden of measles remains high in our communities due to non-immunization status, occurrence of measles in both immunized children and in those less than 9 months old.
Key words: Age, childhood measles, seasonal variation, vaccination.
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Objective To investigate effective prevention of measles of children.Methods The investigator analyzed retrospectively the data of 108 measle patients hospitalized from January 1999 to December 2003.Results The incidence of measles showed increasing trend,for example,the incidence of measles in 2003 was 2.7 times that in 2002.The incidence of measles of infants(under 8 months) was 22.2%,the incidence of measles of floating population was 11.11%.It was found that the incidence of measles among the patients with measles vaccination was 45.37%,meanwhile the incidence of measles among the patients without measles vaccination was 44.44%.10.19% of the patients were not sure whether they had measles vaccination or not.87.04% of the cases had not contacted measles patients.Some cases were atypical.Conclusion The in creasing trend of child measles merits attention.
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This paper was to study the measles epidemiological characteristics in 1999 in Hebei Province and to monitor the running status of measles surveillance system. In 1999, a total of 540 suspected measles cases were reported in the province, of which 280 were clinically diagnosed, 124 were laboratory identified and 136 were excluded by ELISA test, so the measles cases were 404. These cases distributed in 60 counties of 11 cities of the province, accounting for 34.9% of the total counties of the province. The 10 counties that reported ten more measles cases, accounted for 16.7% of the counties giving case report, 244 measles cases were reported by 10 counties and 1 county had a highest reporting of 49 cases. These data showed measles case distribution was not only scattered but also centralized. 276 measles cases concentrated in March to May, accounting for 68.3% of the total cases. Male patients were more than the females. 70.8% of the measles cases were children under 15 years old among whom preschool and primary school children were predominant. 50.2% cases definitely had measles immune history. The clinical symtoms were mild, 82.3% of the children under 15 years old were complicated with pneumonia. According to the regional distribution of measles cases, we suggested that, in 2000, a catch-up mass immunization campaign should be implemented in children under 15years old in Cangzhou and Baoding cities. Analyzing the immune history of measles cases by age, there appeared problems in the routine immunization, suggestions about timeliness and quality of measles vaccination were given. Because of the high sensitivity and low specificity in the clinical diagnostic standard of measles cases, we suggest to put more effort to serological diagnosis. In addition, aimed to the failed reporting and delayed reporting of measles cases made by the surveillance system, a solution of strict management and professional training was proposed.
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Since 1990, the decrease of measles morbidity rates and the increase of the areas with limited measles transmission are observed in Poland. In 1997, 338 measles cases was reported, the lowest number of measles cases ever reported. This represents 47% decrease from the number of measles cases (639) reported in 1996. The increase of the number of measles incidence during last two month of 1997 may forecast epidemic 1998 year. The laboratory confirmation of suspected measles, especially sporadic cases should be implemented in all voivodeships in Poland.
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Objective To know the situation and epidemiological features of measles and rubella serology in Changde from 2007 to 2009,to provide a scientific basis for achieving the goal of elimination of measles on schedule and promoting the development of expanded program on immunization(EPI).Methods The epidemiological features and laboratory test results of suspected measles cases in Changde during the period of 2007～2009 were analyzed.Results Totally 1,057 samples of suspected measles cases were detected during the period of 2007～2009,of which 360 were positive for measles IgM,with the positive rate of 34.1%.The suspected measles cases were inspected in different districts(counties and cities).The peak time of measles was from March to June.Measles occurred mainly in children aged 1 to 5 years.Conclusions Non-vaccination and non-full-course vaccination are the main reasons for measles onset.The key to control of measles is the implementation of immunization against measles,the enhancement of disease surveillance,the improvement of laboratory diagnosis,and timely control of local outbreaks of measles.
Routine immunization
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Objective This study is to analyze the epidemiology of measles in Heze in 2005,and to revise the strategy for measles control as well as its vaccination.Methods The data comes from routine report system for infectious disease and annual statistics.Results 479 suspected measles cases were reported in 2005,416 measles cases were confirmed.Of the epidemiological modes,sporadic cases and outbreak cases coexisted.The measles in some districts had affected the measles morbidity of the whole city.Measles cases mainly happened among preschool children and adults.In confirmed measles cases,19.23% had measles vaccine immunization history,36.30% were non-vaccined and 44.47% were uncertain.Conclusion The age distribution and vaccination status of measles cases remind that the routine immunization service should be strengthended.At the same time the measles campaign should be implemented to adult.In addition,perfecting measles surveillance system must be taken.
Routine immunization
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In order to know the status of measles epidemic and achieve the goal for measles control,we analyzed the data of measles cases from Jan.2000 to Dec.2002 in Shaanxi Province.The results showed that the average measles incidence in 2000-2002 increased 65.7%,as compared with that of 1997-1999.Both the sporadic and epidemic measles in some districts existed at the same time and the reported measles cases extensively distributed in all districts of Shaanxi Province.The outbreaks of measles in some districts had affected the measles morbidity of the whole province.The prevalent season was from March to June,the incidence of measles between 0～2 year old and betweew 6～8 year old age groups were higher than that in the other age groups. We concluded that 25% of the total measles cases were not immunized and 24% without vaccination records through analyzing the measles cases vaccination history.The age distribution and vaccination status of measles cases remind that the routine immunization service and the second dose service should be strengthened,at the same time the measles campaign should be implemented to a certain age group of children.In addition,readjusting the old vaccination schedule and perfecting measles surveillance system must be taken.
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Objective The data of measles reported by the measles surveillance system in Zhejiang Province. Methods From January,2001 to December,2003,the data of measles were analyzed to direct the measles control in the futrue. Results The results showed that the average measles incidence rate in 2001-2003 was higher than that of 1998-2000.Both the sporadic and epidemic measles in some districts existed at the same time and the reported measles cases extensively distributed in all districts of Zhejiang Province. The measles in some districts had affected the measles morbidity of the whole Province. The prevalent season was from March to June,the incidence of measles between 0-2 years old and between 6-8 years old groups were higher than that of the other age groups. Conclusion We concluded that 30% of the total measles cases were not immunized and 30% without vaccination records through analyzing the measles cases vaccination history.The age distribution and vaccination status of measles cases remind that the routine immunization service should be strengthened,at the same time the measles campaign should be implemented to adult. In addition,prefecting measles surveillance system must be taken.
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[Objective] To analyze the changing of age characteristic of measles cases in Baoding City from 1999-2007 in order to provide reference to the strategy adjustments for measles surveillance and immunization to eliminate measles. [Meth-ods] Age characteristics of measles cases from 1999 to 2007 were analyzed with epidemiological analysis. [Results] Measles cases of 1-14 years old accounted for 75.90% in 1999-2002, 45.95% in 2003-2007, which descended gradually. Measles cas-es of under 1 year old accounted for 0.92% in 1999-2002, 22.33% in 2003-2007, which was a increasing tendency. Measles cases of over 15 years old accounted for 14.86% in 1999-2002, 30.72% in 2003-2007, which was a increasing tendency. [Conclusion] Though accelerated measles control, measles mainly takes place in people aged under 1 and over 15 years ole and age distribution of measles cases is remarkably different in different areas in Baoding. We should pay attention to the tran-sient population on measles immunization and surveillance.
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