1
|
Cronin A, Ibrahim N. A scoping review of literature exploring factors affecting vaccine uptake within Roma communities across Europe. Expert Rev Vaccines 2022; 21:1429-1442. [PMID: 35877604 DOI: 10.1080/14760584.2022.2104715] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Vaccine hesitancy is described by the WHO as one of the top threats to global health. The trajectory of the current COVID-19 pandemic depends upon the vaccination of a global population; therefore, barriers to routine vaccination within marginalized groups considered vaccine hesitant are of critical importance. Consistently, vaccination levels within Roma communities across Europe rate very poorly in comparison with general population coverage, and a number of measles and hepatitis outbreaks over the past 10 years have included Roma communities. This study aims to identify barriers to Roma vaccination in general with a view to informing analysis of potential low levels of vaccination within Roma communities for COVID-19. AREAS COVERED The research question explores factors and barriers affecting general vaccine (non-COVID-19 vaccine) uptake within Roma communities across Europe. This scoping review was conducted using the Arksey & O'Malley framework, complying with PRISMA-SR for Scoping Review guidelines. EXPERT OPINION Using Thomson's 5A's Taxonomy, access was identified as the greatest barrier to vaccination within Roma communities. Access factors had the greatest number of references in this scoping review and were considered the most relevant in terms of increasing vaccination uptake. Important access themes identified are health system issues, socioeconomic conditions, and mobility.
Collapse
Affiliation(s)
- Anne Cronin
- School of Medicine (Public Health), University of Limerick, Limerick, Ireland
| | - Nuha Ibrahim
- School of Medicine (Public Health), University of Limerick, Limerick, Ireland
| |
Collapse
|
2
|
Hunter PR, Colón-González FJ, Brainard J, Majuru B, Pedrazzoli D, Abubakar I, Dinsa G, Suhrcke M, Stuckler D, Lim TA, Semenza JC. Can economic indicators predict infectious disease spread? A cross-country panel analysis of 13 European countries. Scand J Public Health 2019; 48:351-361. [PMID: 31291826 DOI: 10.1177/1403494819852830] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: It is unclear how economic factors impact on the epidemiology of infectious disease. We evaluated the relationship between incidence of selected infectious diseases and economic factors, including economic downturn, in 13 European countries between 1970 and 2010. Methods: Data were obtained from national communicable disease surveillance centres. Negative binomial forms of the generalised additive model (GAM) and the generalised linear model were tested to see which best reflected transmission dynamics of: diphtheria, pertussis, measles, meningococcal disease, hepatitis B, gonorrhoea, syphilis, hepatitis A and salmonella. Economic indicators were gross domestic product per capita (GDPpc), unemployment rates and (economic) downturn. Results: GAM models produced the best goodness-of-fit results. The relationship between GDPpc and disease incidence was often non-linear. Strength and directions of association between population age, tertiary education levels, GDPpc and unemployment were disease dependent. Overdispersion for almost all diseases validated the assumption of a negative binomial relationship. Downturns were not independently linked to disease incidence. Conclusions: Social and economic factors can be correlated with many infections. However, the trend is not always in the same direction, and these associations are often non-linear. Economic downturn or recessions as indicators of increased disease risk may be better replaced by GDPpc or unemployment measures.
Collapse
Affiliation(s)
| | | | | | | | - Debora Pedrazzoli
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, UK
| | | | - Girmaye Dinsa
- T.H. Chan School of Public Health, Harvard University, USA
| | - Marc Suhrcke
- Centre for Health Economics, University of York, UK
| | | | - Tek-Ang Lim
- Science and International Office, French Public Health Agency, France
| | - Jan C Semenza
- European Centre for Disease Prevention and Control (ECDC), Sweden
| |
Collapse
|
3
|
Endriyas M, Solomon T, Belayhun B, Mekonnen E. Poor quality data challenges conclusion and decision making: timely analysis of measles confirmed and suspected cases line list in Southern Nations Nationalities and People's Region, Ethiopia. BMC Infect Dis 2018; 18:77. [PMID: 29433436 PMCID: PMC5809861 DOI: 10.1186/s12879-018-2983-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 01/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available. Timely analysis of measles surveillance data is crucial for epidemic control and can show disease control program status. Therefore, this study aimed to show vaccination status and delay in seeking health care using surveillance data. METHODS A retrospective study was carried out in Southern Nations Nationalities and People's Region (SNNPR), Ethiopia. We reviewed 2132 records from measles surveillance line list data from July 2013 to January 2014. Descriptive statistics were performed using SPSS 20 for Windows. RESULTS From a total of 2132 confirmed and suspected measles cases, 1319 (61.9%), had at least one dose of measles containing vaccine; the rest 398 (18.7%) and 415 (19.5%) were unvaccinated and had unknown status respectively. About two fifth, 846 (39.7%), cases visited health facilities within 48 h of onset of clinical signs/symptoms with a median of 2.0 days, IQR (1.0, 3.0). CONCLUSION Majority of the measles cases were vaccinated with at least one dose of measles containing vaccine and vaccination data or vaccine potency at lower level was unclear. Delay in seeking healthcare was noted as only about two fifth of cases visited health facilities within 48 h of clinical manifestation. Vaccination and surveillance data quality and factors associated with delay in seeking health care should be investigated.
Collapse
Affiliation(s)
- Misganu Endriyas
- Health research and technology transfer support process, Southern nations nationalities and people's regional health bureau, Hawassa, Ethiopia.
| | - Tarekegn Solomon
- College of Medicine and Health Sciences, School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia
| | | | - Emebet Mekonnen
- Health research and technology transfer support process, Southern nations nationalities and people's regional health bureau, Hawassa, Ethiopia
| |
Collapse
|
4
|
Xeuatvongsa A, Hachiya M, Miyano S, Mizoue T, Kitamura T. Determination of factors affecting the vaccination status of children aged 12-35 months in Lao People's Democratic Republic. Heliyon 2017; 3:e00265. [PMID: 28367510 PMCID: PMC5362045 DOI: 10.1016/j.heliyon.2017.e00265] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 02/26/2017] [Accepted: 03/09/2017] [Indexed: 12/02/2022] Open
Abstract
Vaccines are one of the most important achievements in public health, and a major contributor to this success is the Expanded Programme on Immunization. The utilisation of vaccination services and completion of the recommended schedule are determined by numerous factors. In Lao People’s Democratic Republic (Lao PDR), the overall immunisation coverage has been improving. However, notwithstanding the improvement in immunisation coverage and the supplementary immunisation activities, there have been measles, diphtheria, and polio outbreaks in the country. The recent multicounty study of household health surveys revealed that the within-country economic-related inequality in the delivery of a vaccine was still high in Lao PDR. Our previous work evaluated the factors associated with vaccination status among the children aged 5–9 years old, which was older age group for this type of study. This study evaluated factors that affect vaccination status among children aged between 12 and 35 months. It is a nationwide population-based cross-sectional study that used data obtained through multistage cluster sampling. We found that the proportion of infants who were fully immunised was lower than the national target and that “maternal ethnicity” (odds ratio (OR) 0.34, 95% confidence interval [CI]: 0.20–0.60), “paternal education” (OR 1.87, 95% CI: 1.12–3.10), and “source of information about vaccination date by medical staff” (OR 1.65, 95% CI: 1.01–2.71) were significantly associated with the children’s vaccination status. Numerous factors are associated with the completion of the recommended vaccine schedule, and some factors are location-specific. Identification of these factors should lead to actions for facilitating the optimal use of vaccination services by all the children in Lao PDR.
Collapse
Affiliation(s)
- Anonh Xeuatvongsa
- Deputy Director of the Mother and Child Health Center/National Manager of the National Immunization Program, Ministry of Health, Lao People's Democratic Republic: Ban Vutnak, Sisattanak District, Vientiane, Lao People's Democratic Republic
| | - Masahiko Hachiya
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655, Japan
| | - Shinsuke Miyano
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655, Japan
| | - Tetsuya Mizoue
- Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655, Japan
| | - Tomomi Kitamura
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655, Japan
| |
Collapse
|
5
|
Semenza JC, Lindgren E, Balkanyi L, Espinosa L, Almqvist MS, Penttinen P, Rocklöv J. Determinants and Drivers of Infectious Disease Threat Events in Europe. Emerg Infect Dis 2016; 22:581-9. [PMID: 26982104 DOI: 10.3201/eid2204] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Infectious disease threat events (IDTEs) are increasing in frequency worldwide. We analyzed underlying drivers of 116 IDTEs detected in Europe during 2008-2013 by epidemic intelligence at the European Centre of Disease Prevention and Control. Seventeen drivers were identified and categorized into 3 groups: globalization and environment, sociodemographic, and public health systems. A combination of >2 drivers was responsible for most IDTEs. The driver category globalization and environment contributed to 61% of individual IDTEs, and the top 5 individual drivers of all IDTEs were travel and tourism, food and water quality, natural environment, global trade, and climate. Hierarchical cluster analysis of all drivers identified travel and tourism as a distinctly separate driver. Monitoring and modeling such disease drivers can help anticipate future IDTEs and strengthen control measures. More important, intervening directly on these underlying drivers can diminish the likelihood of the occurrence of an IDTE and reduce the associated human and economic costs.
Collapse
|
6
|
Semenza JC, Lindgren E, Balkanyi L, Espinosa L, Almqvist MS, Penttinen P, Rocklöv J. Determinants and Drivers of Infectious Disease Threat Events in Europe. Emerg Infect Dis 2016. [PMID: 26982104 PMCID: PMC4806948 DOI: 10.3201/eid2204.151073] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Globalization and environment, the most frequent underlying drivers, should be targeted for interventions to prevent such events. Infectious disease threat events (IDTEs) are increasing in frequency worldwide. We analyzed underlying drivers of 116 IDTEs detected in Europe during 2008–2013 by epidemic intelligence at the European Centre of Disease Prevention and Control. Seventeen drivers were identified and categorized into 3 groups: globalization and environment, sociodemographic, and public health systems. A combination of >2 drivers was responsible for most IDTEs. The driver category globalization and environment contributed to 61% of individual IDTEs, and the top 5 individual drivers of all IDTEs were travel and tourism, food and water quality, natural environment, global trade, and climate. Hierarchical cluster analysis of all drivers identified travel and tourism as a distinctly separate driver. Monitoring and modeling such disease drivers can help anticipate future IDTEs and strengthen control measures. More important, intervening directly on these underlying drivers can diminish the likelihood of the occurrence of an IDTE and reduce the associated human and economic costs.
Collapse
|
7
|
Semenza JC, Rocklöv J, Penttinen P, Lindgren E. Observed and projected drivers of emerging infectious diseases in Europe. Ann N Y Acad Sci 2016; 1382:73-83. [PMID: 27434370 PMCID: PMC7167773 DOI: 10.1111/nyas.13132] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 12/12/2022]
Abstract
Emerging infectious diseases are of international concern because of the potential for, and impact of, pandemics; however, they are difficult to predict. To identify the drivers of disease emergence, we analyzed infectious disease threat events (IDTEs) detected through epidemic intelligence collected at the European Centre for Disease Prevention and Control (ECDC) between 2008 and 2013, and compared the observed results with a 2008 ECDC foresight study of projected drivers of future IDTEs in Europe. Among 10 categories of IDTEs, foodborne and waterborne IDTEs were the most common, vaccine-preventable IDTEs caused the highest number of cases, and airborne IDTEs caused the most deaths. Observed drivers for each IDTE were sorted into three main groups: globalization and environmental drivers contributed to 61% of all IDTEs, public health system drivers contributed to 21%, and social and demographic drivers to 18%. A multiple logistic regression analysis showed that four of the top five drivers for observed IDTEs were in the globalization and environment group. In the observational study, the globalization and environment group was related to all IDTE categories, but only to five of eight categories in the foresight study. Directly targeting these drivers with public health interventions may diminish the chances of IDTE occurrence from the outset.
Collapse
Affiliation(s)
- Jan C. Semenza
- European Centre for Disease Prevention and ControlStockholmSweden
| | | | - Pasi Penttinen
- European Centre for Disease Prevention and ControlStockholmSweden
| | | |
Collapse
|
8
|
Muscat M, Marinova L, Mankertz A, Gatcheva N, Mihneva Z, Santibanez S, Kunchev A, Filipova R, Kojouharova M. The measles outbreak in Bulgaria, 2009-2011: An epidemiological assessment and lessons learnt. ACTA ACUST UNITED AC 2016; 21:30152. [PMID: 26967661 DOI: 10.2807/1560-7917.es.2016.21.9.30152] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 06/12/2015] [Indexed: 11/20/2022]
Abstract
Measles re-emerged in a nationwide outbreak in Bulgaria from 2009 to 2011 despite reported high vaccination coverage at national level. This followed an eight-year period since the last indigenous cases of measles were detected. The Bulgarian National Centre of Infectious and Parasitic Diseases collated measles surveillance data for 2009-2011. We analysed data for age group, sex, ethnicity, diagnosis confirmation, vaccination, hospitalisation, disease complications, and death and describe the outbreak control measures taken. The outbreak started in April 2009 following an importation of measles virus and affected 24,364 persons, predominantly Roma. Most cases (73%) were among children < 15 years old. Vaccination status was available for 52% (n = 12,630) of cases. Of children 1-14 years old, 22% (n = 1,769) were unvaccinated and 70% (n = 5,518) had received one dose of a measles-containing vaccine. Twenty-four measles-related deaths were reported. The Roma ethnic group was particularly susceptible to measles. The magnitude of the outbreak resulted primarily from the accumulation of susceptible children over time. This outbreak serves as a reminder that both high vaccination coverage and closing of immunity gaps across all sections of the population are crucial to reach the goal of measles elimination.
Collapse
Affiliation(s)
- Mark Muscat
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Maltezou HC, Lionis C. The financial crisis and the expected effects on vaccinations in Europe: a literature review. Infect Dis (Lond) 2015; 47:437-46. [PMID: 25739315 DOI: 10.3109/23744235.2015.1018315] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Starting in 2008 several European countries experienced a financial crisis. Historically, diseases whose prevention and treatment depend highly on the continuity of healthcare re-emerge during political and financial crises. Evidence suggests that the current financial crisis has had an impact on the health and welfare of Europeans and that population health status and morbidity as well as mortality patterns may change in the coming years. At the same time decisions about expenditure for health services may impact the ability of public health providers to respond. It is expected that the current crisis will further exacerbate socioeconomic and health inequalities and novel vulnerable groups will emerge in addition to existing ones. We review the available evidence and discuss how the current crisis may have an impact on vaccine-preventable diseases and influence vaccination coverage rates in Europe.
Collapse
Affiliation(s)
- Helena C Maltezou
- From the 1 Department for Interventions in Health Care Facilities, Hellenic Center for Disease Control and Prevention , Athens
| | | |
Collapse
|
10
|
Santibanez S, Hübschen JM, Muller CP, Freymuth F, Mosquera MM, Mamou MB, Mulders MN, Brown KE, Myers R, Mankertz A. Long-term transmission of measles virus in Central and continental Western Europe. Virus Genes 2015; 50:2-11. [DOI: 10.1007/s11262-015-1173-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 01/16/2015] [Indexed: 12/18/2022]
|
11
|
Considerations on the current universal vaccination policy against hepatitis A in Greece after recent outbreaks. PLoS One 2015; 10:e0116939. [PMID: 25590132 PMCID: PMC4295885 DOI: 10.1371/journal.pone.0116939] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 12/17/2014] [Indexed: 12/16/2022] Open
Abstract
Greece is the only European Union member state that in 2008 included hepatitis A (HAV) vaccine in the routine national childhood immunization program (NCIP). Given that the resources allocated to public health have dramatically decreased since 2008 and that Greece is a low endemicity country for the disease, the benefit from universal vaccination has been questioned. The aim of this paper is to summarize the available epidemiological data of the disease for 1982-2013, and discuss the effects of universal vaccination on disease morbidity. Descriptive analysis, ARIMA modeling and time series intervention analysis were conducted using surveillance data of acute HAV. A decreasing trend of HAV notification rate over the years was identified (p<0.001). However, universal vaccination (~ 80% vaccine coverage of children) had no significant effect on the annual number of reported cases (p = 0.261) and has resulted to a progressive increase of the average age of infection in the general population. The mean age of cases before the inclusion of the vaccine to NCIP (24.1 years, SD = 1.5) was significantly lower than the mean age of cases after 2008 (31.7 years, SD = 2.1) (p<0.001). In the last decade, one third of all reported cases were Roma (a population accounting for 1.5% of the country’s total population) and in 2013 three outbreaks with 16, 9 and 25 Roma cases respectively, were recorded, indicating the decreased effectiveness of the current immunization strategy in this group. Data suggest that universal vaccination may need to be re-considered. Probably a more cost effective approach would be to implement a program that will include: a) vaccination of high risk groups, b) universal vaccination of Roma children and improving conditions at Roma camps, c) education of the population and travel advice, and d) enhancement of the control measures to increase safety of shellfish and other foods.
Collapse
|
12
|
Suk JE, Van Cangh T, Beauté J, Bartels C, Tsolova S, Pharris A, Ciotti M, Semenza JC. The interconnected and cross-border nature of risks posed by infectious diseases. Glob Health Action 2014; 7:25287. [PMID: 25308818 PMCID: PMC4195207 DOI: 10.3402/gha.v7.25287] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/16/2014] [Accepted: 09/16/2014] [Indexed: 01/01/2023] Open
Abstract
Infectious diseases can constitute public health emergencies of international concern when a pathogen arises, acquires new characteristics, or is deliberately released, leading to the potential for loss of human lives as well as societal disruption. A wide range of risk drivers are now known to lead to and/or exacerbate the emergence and spread of infectious disease, including global trade and travel, the overuse of antibiotics, intensive agriculture, climate change, high population densities, and inadequate infrastructures, such as water treatment facilities. Where multiple risk drivers interact, the potential impact of a disease outbreak is amplified. The varying temporal and geographic frequency with which infectious disease events occur adds yet another layer of complexity to the issue. Mitigating the emergence and spread of infectious disease necessitates mapping and prioritising the interdependencies between public health and other sectors. Conversely, during an international public health emergency, significant disruption occurs not only to healthcare systems but also to a potentially wide range of sectors, including trade, tourism, energy, civil protection, transport, agriculture, and so on. At the same time, dealing with a disease outbreak may require a range of critical sectors for support. There is a need to move beyond narrow models of risk to better account for the interdependencies between health and other sectors so as to be able to better mitigate and respond to the risks posed by emerging infectious disease.
Collapse
Affiliation(s)
- Jonathan E Suk
- European Centre for Disease Prevention and Control, Stockholm, Sweden; Global Public Health Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK;
| | - Thomas Van Cangh
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Julien Beauté
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Cornelius Bartels
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Svetla Tsolova
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Anastasia Pharris
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Massimo Ciotti
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Jan C Semenza
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| |
Collapse
|