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Savas LS, Shegog R, Frost EL, Healy CM, Mantey DS, Coan SP, Shay LA, Teague TA, Ferreris JJ, Preston SM, Vernon SW. Effect of an HPV Vaccination Multi-Level, Multi-Component Program on HPV Vaccination Initiation and Completion in a Pediatric Clinic Network. Vaccines (Basel) 2024; 12:510. [PMID: 38793761 PMCID: PMC11126005 DOI: 10.3390/vaccines12050510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/13/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024] Open
Abstract
Despite clear evidence of the public health benefits of the human papillomavirus (HPV) vaccine in preventing HPV-related cancers and genital warts, underutilization of HPV vaccination in the United States persists. Interventions targeting multi-level determinants of vaccination behavior are crucial for improving HPV vaccination rates. The study's purpose was to implement and evaluate the adapted Adolescent Vaccination Program (AVP), a clinic-based, multi-level, multi-component intervention aimed at increasing HPV vaccine initiation and completion rates in a five-clinic pediatric network in Bexar County, Texas. The adaptation process was guided by established frameworks and involved formative work with clinic stakeholders. The study utilized a quasi-experimental single group pre- and post- study design, with an external comparison data using the National Immunization Survey-Teen (NIS-Teen) datasets for the same time period to examine the AVP's effect on HPV vaccination initiation and completion. A series of interrupted time series analyses (ITSA) compared the clinic system patient outcomes (HPV vaccination initiation and completion rates) in the post-intervention to the general adolescent population (NIS-Teen). Of the 6438 patients (11-17 years) with clinic visits during the 3-year study period, HPV vaccination initiation rates increased from 64.7% to 80.2% (p < 0.05) and completion rates increased from 43.2% to 60.2% (p < 0.05). The AVP was effective across various demographic and economic subgroups, demonstrating its generalizability. ITSA findings indicated the AVP improved HPV vaccination initiation and completion rates in clinic settings and that AVP strategies facilitated resilience during the pandemic. The minimal adaptation required for implementation in a new clinic system underscores its feasibility and potential for widespread adoption.
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Affiliation(s)
- Lara S. Savas
- Center for Health Promotion and Prevention Research, UTHealth Houston School of Public Health, Houston, TX 77030, USA; (R.S.); (E.L.F.); (S.P.C.); (T.A.T.); (S.W.V.)
| | - Ross Shegog
- Center for Health Promotion and Prevention Research, UTHealth Houston School of Public Health, Houston, TX 77030, USA; (R.S.); (E.L.F.); (S.P.C.); (T.A.T.); (S.W.V.)
| | - Erica L. Frost
- Center for Health Promotion and Prevention Research, UTHealth Houston School of Public Health, Houston, TX 77030, USA; (R.S.); (E.L.F.); (S.P.C.); (T.A.T.); (S.W.V.)
| | - C. Mary Healy
- Department of Pediatrics, Infectious Diseases Section, Baylor College of Medicine, Houston, TX 77030, USA;
| | - Dale S. Mantey
- Michael & Susan Dell Center for Healthy Living, UTHealth Houston School of Public Health in Austin, Austin, TX 78701, USA;
| | - Sharon P. Coan
- Center for Health Promotion and Prevention Research, UTHealth Houston School of Public Health, Houston, TX 77030, USA; (R.S.); (E.L.F.); (S.P.C.); (T.A.T.); (S.W.V.)
| | - L. Aubree Shay
- Center for Health Promotion and Prevention Research, UTHealth Houston School of Public Health in San Antonio, San Antonio, TX 78229, USA;
| | - Travis A. Teague
- Center for Health Promotion and Prevention Research, UTHealth Houston School of Public Health, Houston, TX 77030, USA; (R.S.); (E.L.F.); (S.P.C.); (T.A.T.); (S.W.V.)
| | - Juan J. Ferreris
- Christus Health, Children’s General Pediatric Clinic, San Antonio, TX 78257, USA;
| | - Sharice M. Preston
- Center for Health Promotion and Prevention Research, UTHealth Houston School of Public Health, Houston, TX 77030, USA; (R.S.); (E.L.F.); (S.P.C.); (T.A.T.); (S.W.V.)
| | - Sally W. Vernon
- Center for Health Promotion and Prevention Research, UTHealth Houston School of Public Health, Houston, TX 77030, USA; (R.S.); (E.L.F.); (S.P.C.); (T.A.T.); (S.W.V.)
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Hu Y, Yan R, Yin X, Gong E, Xin X, Gao A, Shi X, Wang J, Xue H, Feng L, Zhang J. Effectiveness of Multifaceted Strategies to Increase Influenza Vaccination Uptake: A Cluster Randomized Trial. JAMA Netw Open 2024; 7:e243098. [PMID: 38526493 PMCID: PMC10964116 DOI: 10.1001/jamanetworkopen.2024.3098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/26/2024] [Indexed: 03/26/2024] Open
Abstract
Importance Influenza vaccination rates remain low among primary school students and vary by school in Beijing, China. Theory-informed, multifaceted strategies are needed to improve influenza vaccination uptake. Objective To evaluate the effectiveness of multifaceted strategies in improving influenza vaccination uptake among primary school students. Design, Setting, and Participants This cluster randomized trial was conducted from September 2022 to May 2023 across primary schools in Beijing, China. Schools were allocated randomly in a 1:1 ratio to multifaceted strategies or usual practice. Schools were deemed eligible if the vaccination rates in the 2019 to 2020 season fell at or below the district-wide average for primary schools. Eligible participants included students in grades 2 and 3 with no medical contraindications for influenza vaccination. Intervention The multifaceted strategies intervention involved system-level planning and coordination (eg, developing an implementation blueprint, building social norms, and enhancing supervision), school-level training and educating school implementers (eg, conducting a 1-hour training and developing educational materials), and individual-level educating and reminding students and parents (eg, conducting educational activities and sending 4 reminders about vaccination). Main Outcomes and Measures The primary outcomes were influenza vaccination uptake at school reported by school clinicians as well as overall vaccine uptake either at school or outside of school as reported by parents at 3 months. Generalized linear mixed models were used for analysis. Results A total of 20 schools were randomized. One intervention school and 2 control schools did not administer vaccination on school grounds due to COVID-19, resulting in a total of 17 schools (9 intervention and 8 control). There was a total of 1691 students aged 7 to 8 years (890 male [52.6%]; 801 female [47.4%]) including 915 in the intervention group and 776 in the control group. Of all participants, 848 (50.1%) were in grade 2, and 1209 (71.5%) were vaccinated in the 2021 to 2022 season. Participants in the intervention and control groups shared similar characteristics. At follow-up, of the 915 students in the intervention group, 679 (74.5%) received a vaccination at school, and of the 776 students in the control group, 556 (71.7%) received a vaccination at school. The overall vaccination rates were 76.0% (695 of 915 students) for the intervention group and 71.3% (553 of 776 students) for the control group. Compared with the control group, there was significant improvement of vaccination uptake at school (odds ratio, 1.40; 95% CI, 1.06-1.85; P = .02) and overall uptake (odds ratio, 1.49; 95% CI, 1.12-1.99; P = .01) for the intervention group. Conclusions and Relevance In this study, multifaceted strategies showed modest effectiveness in improving influenza vaccination uptake among primary school students, which provides a basis for the implementation of school-located vaccination programs of other vaccines in China, and in other countries with comparable programs. Trial registration Chinese Clinical Trial Registry: ChiCTR2200062449.
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Affiliation(s)
- Yiluan Hu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ruijie Yan
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xuejun Yin
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia
| | - Enying Gong
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xin Xin
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Aiyu Gao
- Dongcheng Primary and Secondary School Health Care Center, Beijing, China
| | - Xiaoyan Shi
- Dongcheng Primary and Secondary School Health Care Center, Beijing, China
| | - Jing Wang
- Department of Infectious Disease, Dongcheng Center for Disease Control and Prevention, Beijing, China
| | - Hao Xue
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, California
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Juan Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
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Saidu Y, Gu J, Ngenge BM, Nchinjoh SC, Adidja A, Nnang NE, Muteh NJ, Zambou VM, Mbanga CM, Agbor VN, Ousmane D, Njoh AA, Flegere J, Diack D, Wiwa O, Montomoli E, Clemens SAC, Clemens R. The faces behind vaccination: unpacking the attitudes, knowledge, and practices of staff of Cameroon's Expanded program on Immunization. HUMAN RESOURCES FOR HEALTH 2023; 21:88. [PMID: 37957695 PMCID: PMC10644616 DOI: 10.1186/s12960-023-00869-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/03/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Immunization is regarded as one of the most cost-effective public health interventions in global health. However, its cost-effectiveness depends greatly on the knowledge and skills of vaccinators. With the growing complexity of immunization programs, the need for a well-trained vaccination workforce cannot be overemphasized. In this study, we assessed the knowledge, attitudes, and practices among vaccination staff in Cameroon. METHODS Through a descriptive cross-sectional design, we used structured questionnaires and observation guides to collect data from vaccination staff in health facilities that were selected by a multistage sampling method. Data were analyzed using STATA 13 software. RESULTS Overall, we collected data from Expanded Program on Immunization focal staff in 265 health facilities across 68 health districts. Over half (53%) of the surveyed facilities were found in rural areas. Nearly two-thirds of health facilities had immunization focal staff with knowledge gaps for each of the four basic immunization indicators assessed. In other words, only 37% of staff knew how to estimate coverages, 36% knew how to inteprete the EPI monitoring curve, 35% knew how to prepare vaccine orders, and 37% knew how to estimate vaccine wastage. In terms of practices, staff waited for more than ten children to be present before opening a 20-dose vaccine vial in 63% of health facilities, and more than five children to be present before opening a 10-dose vaccine vial in 80% of surveyed facilities. Provision of vaccine-specific information (informing caregiver about vaccine received, explanation of benefits and potential side effects) during immunization sessions was suboptimal for the most part. CONCLUSION This study suggests marked deficits in immunization knowledge among vaccination staff and exposes common attitudes and practices that could contribute to missed opportunities for vaccination and hinder vaccination coverage and equity in Cameroon. Our findings highlight the urgent need to invest in comprehensive capacity building of vaccination staff in Cameroon, especially now that the immunization program is becoming increasingly complex.
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Affiliation(s)
- Yauba Saidu
- Clinton Health Access Initiative Inc., PO Box 2664, Yaounde, Cameroon.
- Institute for Global Health, University of Siena, 53100, Siena, Italy.
| | - Jessica Gu
- Global Vaccine Delivery, Clinton Health Access Initiative Inc, Boston, MA, 02127, United States of America
| | | | | | - Amani Adidja
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | | | | | - Valirie Ndip Agbor
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Diaby Ousmane
- Department of Projects, Ministry of Public Health, Yaounde, Cameroon
| | - Andreas Ateke Njoh
- Expanded Program on Immunization, Cameroon Ministry of Public Health, PO Box 2084, Yaoundé, Cameroon
- School of Global Health and Bioethics, Euclid University, PO Box 157, Bangui, Central African Republic
| | - Junie Flegere
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Demba Diack
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Owens Wiwa
- Clinton Health Access Iniative Inc., Abuja, Nigeria
| | - Emanuele Montomoli
- Institute for Global Health, University of Siena, 53100, Siena, Italy
- Department Molecular Medicine, University of Siena, Via Aldo Moro 3, 53100, Siena, Italy
- VisMederi Srl, Via Ferrini 53, 53035, Siena, Italy
| | - Sue Ann Costa Clemens
- Institute for Global Health, University of Siena, 53100, Siena, Italy
- Department of Pediatrics, University of Oxford, Oxford, United Kingdom
| | - Ralf Clemens
- Institute for Global Health, University of Siena, 53100, Siena, Italy
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Dionne M, Sauvageau C, Kiely M, Rathwell M, Bandara T, Neudorf C, Dubé È. "The problem is not lack of information": A qualitative study of parents and school nurses' perceptions of barriers and potential solutions for HPV vaccination in schools. Vaccine 2023; 41:6654-6660. [PMID: 37777452 DOI: 10.1016/j.vaccine.2023.09.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/07/2023] [Accepted: 09/24/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND HPV vaccination has been offered in school programs for over a decade in Quebec, Canada, but the vaccine coverages are not reaching the target coverage in several regions. This qualitative study aimed to describe barriers and enabling conditions of HPV vaccination as perceived by parents and school nurses and identify potential solutions to improve HPV vaccine uptake rates and acceptance in school-based programs. METHODS Three focus group discussions were conducted with parents of children in Grades 2 or 3 who were unsure or unwilling to vaccinate. Individual interviews were conducted with 24 school nurses. A thematic content analysis was performed using N'Vivo. RESULTS The main parental questions and concerns regarding the HPV vaccination were the children's young age, the possible side effects, the rationale behind boys' vaccination and the possible interaction with COVID-19 vaccination. Except for interaction with COVID-19 vaccination, these concerns remain similar to those identified before the pandemic. Interviews highlighted that the information on HPV vaccination provided by the public was not well understood by parents. Parents suggested different tools to access information tailored to their concerns and situation. From the nurses' perspective, HPV vaccination promotion tools such as decision-aids and social media communication campaigns were needed and could reduce their work. CONCLUSION COVID-19 may have disrupted the acceptance of the vaccines. While strategies to catch up on missed doses and reduce access barriers to vaccines are urgently needed, our findings highlight that a shift in attitudes toward routine vaccines may pose further challenges even if HPV vaccine coverage appears to have returned to pre-pandemic levels.
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Affiliation(s)
- Maude Dionne
- Institut national de santé publique du Québec, Québec, Canada
| | - Chantal Sauvageau
- Institut national de santé publique du Québec, Québec, Canada; Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Université Laval, Québec, Canada
| | - Marilou Kiely
- Institut national de santé publique du Québec, Québec, Canada; Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Mika Rathwell
- University of Saskatchewan, Saskatoon, Canada; Urban Public Health Network, Saskatoon, Canada
| | - Thilina Bandara
- University of Saskatchewan, Saskatoon, Canada; Urban Public Health Network, Saskatoon, Canada
| | - Cory Neudorf
- University of Saskatchewan, Saskatoon, Canada; Urban Public Health Network, Saskatoon, Canada
| | - Ève Dubé
- Institut national de santé publique du Québec, Québec, Canada; Centre de recherche du CHU de Québec-Université Laval, Québec, Canada.
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Dadari I, Belt RV, Iyengar A, Ray A, Hossain I, Ali D, Danielsson N, Sodha SV. Achieving the IA2030 Coverage and Equity Goals through a Renewed Focus on Urban Immunization. Vaccines (Basel) 2023; 11:809. [PMID: 37112721 PMCID: PMC10147013 DOI: 10.3390/vaccines11040809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
The 2021 WHO and UNICEF Estimates of National Immunization Coverage (WUENIC) reported approximately 25 million under-vaccinated children in 2021, out of which 18 million were zero-dose children who did not receive even the first dose of a diphtheria-tetanus-pertussis-(DPT) containing vaccine. The number of zero-dose children increased by six million between 2019, the pre-pandemic year, and 2021. A total of 20 countries with the highest number of zero-dose children and home to over 75% of these children in 2021 were prioritized for this review. Several of these countries have substantial urbanization with accompanying challenges. This review paper summarizes routine immunization backsliding following the COVID-19 pandemic and predictors of coverage and identifies pro-equity strategies in urban and peri-urban settings through a systematic search of the published literature. Two databases, PubMed and Web of Science, were exhaustively searched using search terms and synonyms, resulting in 608 identified peer-reviewed papers. Based on the inclusion criteria, 15 papers were included in the final review. The inclusion criteria included papers published between March 2020 and January 2023 and references to urban settings and COVID-19 in the papers. Several studies clearly documented a backsliding of coverage in urban and peri-urban settings, with some predictors or challenges to optimum coverage as well as some pro-equity strategies deployed or recommended in these studies. This emphasizes the need to focus on context-specific routine immunization catch-up and recovery strategies to suit the peculiarities of urban areas to get countries back on track toward achieving the targets of the IA2030. While more evidence is needed around the impact of the pandemic in urban areas, utilizing tools and platforms created to support advancing the equity agenda is pivotal. We posit that a renewed focus on urban immunization is critical if we are to achieve the IA2030 targets.
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Affiliation(s)
- Ibrahim Dadari
- Coverage & Equity Unit, Immunization Section, PG-Health, UNICEF Headquarters, 3 UN Plaza, New York, NY 10017, USA
- College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Rachel V. Belt
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, 75 George Street, Oxford OX1 2JD, UK
| | - Ananya Iyengar
- Coverage & Equity Unit, Immunization Section, PG-Health, UNICEF Headquarters, 3 UN Plaza, New York, NY 10017, USA
- Johns Hopkins Bloomberg School of Public Health, International Vaccine Access Center (IVAC), Baltimore, MD 21231, USA
| | - Arindam Ray
- New Vaccines and Immunization Systems, Bill and Melinda Gates Foundation, New Delhi 110067, India
| | - Iqbal Hossain
- John Snow, Inc., 2733 Crystal Drive, Arlington, VA 22202, USA
| | - Daniel Ali
- Johns Hopkins Bloomberg School of Public Health, International Vaccine Access Center (IVAC), Baltimore, MD 21231, USA
| | - Niklas Danielsson
- Coverage & Equity Unit, Immunization Section, PG-Health, UNICEF Headquarters, 3 UN Plaza, New York, NY 10017, USA
| | - Samir V. Sodha
- Department of Immunization Vaccines and Biologicals, WHO Headquarters, Avenue Appia 20, 1211 Geneva, Switzerland
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Sulaiman SK, Musa MS, Tsiga-Ahmed FI, Dayyab FM, Sulaiman AK, Bako AT. A systematic review and meta-analysis of the prevalence of caregiver acceptance of malaria vaccine for under-five children in low-income and middle-income countries (LMICs). PLoS One 2022; 17:e0278224. [PMID: 36455209 PMCID: PMC9715017 DOI: 10.1371/journal.pone.0278224] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/13/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Malaria is the second leading cause of death in children after diarrheal disease, with low- and middle-income countries (LMICs) accounting for over 9 in 10 incidence and deaths. Widespread acceptance and uptake of the RTS,S vaccine, recently approved by the world health organization (WHO), is projected to significantly reduce malaria incidence and deaths. Therefore, we conducted this systematic review and meta-analysis with the aim to determine the malaria vaccine acceptance rate and the factors associated with acceptance. METHODS We searched six databases including Google Scholar, PubMed, Cochrane, African Index Medicus, The Regional Office for Africa Library, and WHO Institutional Repository for Information Sharing (IRIS) to identify studies evaluating the malaria vaccine acceptance rate. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Studies were included if they were original articles published in the English language in peer-reviewed journals and assessed the prevalence of willingness to accept a free malaria vaccine, and not qualitative. The risk of publication bias was checked using both Beggar's funnel plot and Egger's test, while the I2 statistic was used to assess the heterogeneity of the included studies. Study quality was determined using the Newcastle-Ottawa scale. A meta-analysis was performed using a random effects model to evaluate the pooled prevalence of malaria vaccine acceptance. The protocol for this article was registered prospectively on the International Prospective Register for Systematic Reviews (PROSPERO), with ID number CRD42022334282). RESULTS Our analysis included 11 studies with a total sample size of 14, 666 participants. The aggregate malaria vaccine acceptance rate was 95.3% (95% CI:93.0%-97.2%). Among the general population, the acceptance rate was 96.3% (95% CI:92.0%-99.0%) and among mothers, it was 94.4% (95% CI:90.8%-97.2%). By country, Nigeria had the highest acceptance rate (97.6%, 95% CI:96.0%-98.8%), followed by Ghana (94.6%, 95% CI:93.8%-95.3%) and Tanzania (92.5%, 95% CI:84.4%-97.8%). Sociodemographic determinants of vaccine acceptance included place of residence, tribe, age, sex, occupation, and religion. Reasons for low acceptance included safety concerns, efficacy profile, vaccine's requirement for multiple injections, and poor level of awareness. CONCLUSION Future efforts should be focused on identifying factors that may improve the actual uptake of the RTS,S vaccine in malaria-endemic communities.
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Affiliation(s)
- Sahabi Kabir Sulaiman
- Department of Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria
- * E-mail:
| | - Muhammad Sale Musa
- Department of Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | - Fatimah Ismail Tsiga-Ahmed
- Department of Community Medicine, Bayero University Kano, Kano, Nigeria
- Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Farouq Muhammad Dayyab
- Infectious Diseases Hospital, Kano, Nigeria
- Department of Medicine, Kwanar Dawaki Isolation Center Kano, Kano, Kano State, Nigeria
- Department of Medicine, King Hamad University Hospital, Muharraq, Bahrain
| | - Abdulwahab Kabir Sulaiman
- Department of Medicine, Kwanar Dawaki Isolation Center Kano, Kano, Kano State, Nigeria
- Murtala Muhammad Specialist Hospital, Kano, Nigeria
| | - Abdulaziz Tijjani Bako
- Center for Outcomes Research, Houston Methodist, Houston, Texas, United States of America
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Vaivada T, Sharma N, Das JK, Salam RA, Lassi ZS, Bhutta ZA. Interventions for Health and Well-Being in School-Aged Children and Adolescents: A Way Forward. Pediatrics 2022; 149:186939. [PMID: 35503328 DOI: 10.1542/peds.2021-053852m] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/24/2022] Open
Abstract
The health and well-being of school-aged children has received little attention compared with younger children aged < 5 years and adolescents. In this final article in a supplement of reviews that have assessed the effectiveness of interventions for school-aged children across a variety of health-related domains (including infectious diseases, noncommunicable diseases, healthy lifestyle, mental health, unintentional injuries, and sexual and reproductive health), we summarize the main findings and offer a way forward for future research, policy, and implementation. We complement this evidence base on interventions with a summary of the literature related to enabling policies and intersectoral actions supporting school-aged child health. The school represents an important platform for both the delivery of preventive interventions and the collection of data related to child health and academic achievement, and several frameworks exist that help to facilitate the creation of a health-promoting environment at school.
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Affiliation(s)
- Tyler Vaivada
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Canada
| | - Naeha Sharma
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Canada
| | - Jai K Das
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Rehana A Salam
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Zohra S Lassi
- Robinson Research Institute and.,Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Canada.,Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan.,Department of Nutritional Sciences, University of Toronto, Toronto, Canada
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Vaivada T, Oh C, Carducci B, Bhutta ZA. Rationale and Approach to Evaluating Interventions to Promote Child Health in LMICs. Pediatrics 2022; 149:186942. [PMID: 35503331 DOI: 10.1542/peds.2021-053852b] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 01/08/2023] Open
Affiliation(s)
- Tyler Vaivada
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Christina Oh
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Bianca Carducci
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
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