1
|
Paiva BL, Lima IB, Nogueira LMV, Rodrigues ILA, Caldas SP, Andrade ML, Pedroza ADSC, Rodrigues AR. Use of an application on the measles vaccine for Warao indigenous refugees in Brazil. Rev Bras Enferm 2024; 77Suppl 3:e20230253. [PMID: 38477815 DOI: 10.1590/0034-7167-2023-0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/17/2023] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVE To evaluate the need to develop an application with information about the measles vaccine for Warao indigenous people. METHODS This was a quantitative study conducted at the Espaço de Acolhimento Tapanã refugee shelter in the city of Belém, Pará, Brazil. The study sample was selected for convenience. Data were analyzed descriptively using Bioestat 5.0 software. RESULTS Twenty-one Warao indigenous individuals were interviewed. It was identified that 91% (n=20) had lost their vaccination card; 91% (n=20) stated they had lost their vaccination card more than three times, and 91% expressed interest in an application to store their vaccination information. CONCLUSIONS The research provided important information for the development of a health application named WaraoMedI (Warao Measles Diversity Indigenous), as well as offered nursing professionals evidence about the challenges Warao indigenous refugees face in self-managing their vaccination information.
Collapse
|
2
|
Moonpanane K, Thepsaw J, Pitchalard K, Purkey E. Parental perceptions, attitudes, and beliefs regarding vaccination of children aged 0-5 years: A qualitative study of hill-tribe communities, Thailand. Hum Vaccin Immunother 2023; 19:2233398. [PMID: 37460107 PMCID: PMC10353339 DOI: 10.1080/21645515.2023.2233398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/19/2023] [Accepted: 07/02/2023] [Indexed: 07/20/2023] Open
Abstract
The widespread availability and use of vaccines have tremendously reduced morbidity and deaths related to infectious diseases globally. However, in hill-tribe communities in Northern Thailand, vaccination rates remain low, and there is limited literature on parental perceptions, attitudes, and beliefs about vaccination for children under five years of age. We conducted a qualitative study employing semi-structured interviews to understand parents' perceptions, attitudes, and beliefs about vaccinations. A purposive sample was used to recruit participants. Data were analyzed using thematic analysis. 74 hill-tribe parents (14 Akha, 11 Hmong, 12 Lahu, 13 Lisu, 12 Karen, and 12 Yao) were interviewed. Four themes emerged from the interviews: 1) traditional beliefs, and practices 2) traumatic experiences, 3) lack of information and effective communication, and 4) trust and support from the community. Findings highlight that it is crucial to build trust by providing knowledge, appropriate information, and advice about vaccinations in order to improve vaccine coverage in children under five years of age in the hill-tribe context.
Collapse
Affiliation(s)
| | - Jintana Thepsaw
- School of Nursing, Mae Fah Luang University, Chiang Rai, Thailand
| | | | - Eva Purkey
- Department of Family Medicine, Queen's University, Kingston, ON, Canada
| |
Collapse
|
3
|
Skinner NA, Sanders K, Lopez E, Sotz Mux MS, Abascal Miguel L, Vosburg KB, Johnston J, Diamond-Smith N, Kraemer Diaz A. Barriers to COVID-19 vaccine acceptance to improve messages for vaccine uptake in indigenous populations in the central highlands of Guatemala: a participatory qualitative study. BMJ Open 2023; 13:e067210. [PMID: 36707110 PMCID: PMC9884572 DOI: 10.1136/bmjopen-2022-067210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION As of July 2022, a little over one-third of Guatemalans were fully vaccinated. While COVID-19 vaccination rates are not officially reported nationally by racial/ethnic groups, non-governmental organisations and reporters have observed that COVID-19 vaccination rates are especially low among high-risk Indigenous populations. We conducted one of the first studies on COVID-19 vaccine acceptance in Indigenous populations in the Central Highlands of Guatemala, which aimed to better understand the barriers to COVID-19 vaccine uptake and how to improve vaccine promotional campaigns. METHODS In November 2021, we conducted eight focus group discussions (FGDs) with 42 Indigenous men and women and 16 in-depth interviews (IDIs) with community health workers, nurses and physicians in Chimaltenango and Sololá. Using a participatory design approach, our qualitative analysis used constant comparative methods to understand the inductive and deductive themes from the FGD and IDI transcripts. RESULTS We found three major overarching barriers to vaccination within the sampled population: (1) a lack of available easily understandable, linguistically appropriate and culturally sensitive COVID-19 vaccine information; (2) vaccine access and supply issues that prevented people from being vaccinated efficiently and quickly; and (3) widespread misinformation and disinformation that prey on people's fears of the unknown and mistrust of the medical establishment and government. CONCLUSION When developing COVID-19 vaccine messages, content should be culturally relevant, appropriate for low-literacy populations and in the languages that people prefer to speak. Promotional materials should be in multiple modalities (print, radio and social media) and also have specific Maya cultural references (dress, food and concepts of disease) to ensure messaging connects with intended targets. This study supports the need for more robust research into best practices for communicating about COVID-19 vaccines to marginalised communities globally and suggests that policy makers should invest in targeted local solutions to increase vaccine uptake.
Collapse
Affiliation(s)
- Nadine Ann Skinner
- Stanford Center for Health Education, Stanford University School of Medicine, Stanford, California, USA
| | - Kelly Sanders
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
| | - Emily Lopez
- Maya Health Alliance Wuqu' Kawoq, Tecpan, Guatemala
| | | | - Lucía Abascal Miguel
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
| | - Kathryn B Vosburg
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
| | - Jamie Johnston
- Stanford Center for Health Education, Stanford University School of Medicine, Stanford, California, USA
| | - Nadia Diamond-Smith
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
- Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | | |
Collapse
|
4
|
Sharif Nia H, Allen KA, Arslan G, Kaur H, She L, Khoshnavay Fomani F, Gorgulu O, Sivarajan Froelicher E. The predictive role of parental attitudes toward COVID-19 vaccines and child vulnerability: A multi-country study on the relationship between parental vaccine hesitancy and financial well-being. Front Public Health 2023; 11:1085197. [PMID: 36875362 PMCID: PMC9980903 DOI: 10.3389/fpubh.2023.1085197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/03/2023] [Indexed: 02/18/2023] Open
Abstract
Background and purpose Recent new mutations and increases in transmission of COVID-19 among adolescents and children highlight the importance of identifying which factors influence parental decisions regarding vaccinating their children. The current study aims to explore whether child vulnerability and parents' attitudes toward vaccines mediate the association between perceived financial well-being and vaccine hesitancy among parents. Method A predictive, cross-sectional, multi-country online questionnaire was administered with a convenience sample of 6,073 parents (Australia, 2,734; Iran, 2,447; China, 523; Turkey, 369). Participants completed the Parent Attitude About Child Vaccines (PACV), the Child Vulnerability Scale (CVS), a Financial Well-being (FWB) measure, and Parental Vaccine Hesitancy (PVH) questionnaire. Results The current study revealed that perceived financial well-being had significant and negative associations with parents' attitudes toward COVID-19 vaccines and child vulnerability among the Australian sample. Contrary to the Australian findings, results from Chinese participants indicated that financial well-being had significant and positive predictive effects on parent attitudes toward vaccines, child vulnerability, and parental vaccine hesitancy. The results of the Iranian sample revealed that parents' attitudes toward vaccines and child vulnerability significantly and negatively predicted parental vaccine hesitancy. Conclusion The current study revealed that a parents' perceived financial well-being had a significant and negative relationship with parental attitudes about vaccines and child vulnerability; however, it did not significantly predict parental vaccine hesitancy among Turkish parents as it did for parents in Australia, Iran, and China. Findings of the study have policy implications for how certain countries may tailor their vaccine-related health messages to parents with low financial wellbeing and parents with vulnerable children.
Collapse
Affiliation(s)
- Hamid Sharif Nia
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Kelly-Ann Allen
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Melbourne, VIC, Australia
| | - Gökmen Arslan
- Department of Psychological Counselling and Guidance, Mehmet Akif Ersoy University, Burdur, Türkiye.,Centre for Wellbeing Science, University of Melbourne, Melbourne, VIC, Australia
| | - Harpaljit Kaur
- School of Management and Marketing, Faculty of Business and Law, Taylor's University, Subang Jaya, Malaysia
| | - Long She
- Faculty of Business, Design and Arts, Swinburne University of Technology, Kuching, Sarawak, Malaysia
| | | | - Ozkan Gorgulu
- Department of Biostatistics and Medical Informatics, Kirşehir Ahi Evran University Faculty of Medicine, Kırşehir, Türkiye
| | - Erika Sivarajan Froelicher
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, San Francisco, CA, United States.,Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| |
Collapse
|
5
|
Evran M, Bekis Bozkurt H. Parents' views and information status on childhood vaccines: which myths play a role. Cent Eur J Public Health 2022; 30:219-224. [PMID: 36718923 DOI: 10.21101/cejph.a6946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/19/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The participation of families in childhood vaccination decreases slightly every year around the world. Parents arrive at a decision that vaccines are not safe for their children due to many sources of misinformation. The aim of this study was to investigate the relationship between vaccine hesitancy, vaccine knowledge status and socio-demographic characteristics of the children's parents. METHODS In this cross-sectional study, 361 parents of children aged 5 years and under, who were admitted to our paediatric outpatient clinic, were included. The parents received scores between 0-20 points according to the correct answers they gave to the questions asked. RESULTS Although all parents had a positive attitude towards vaccination, some myths, e.g. that vaccination could weaken the child's immune system because it contains heavy metals which could cause infertility and that complementary and alternative medicine could replace vaccination, are thought to be real by 1.7% to 34.6% of the parents. CONCLUSIONS Since the presence of misinformation may lead to vaccine hesitancy and incomplete vaccination, healthcare personnel have important duties and responsibilities for this group.
Collapse
Affiliation(s)
| | - Hayrunnisa Bekis Bozkurt
- Department of Paediatric Allergy and Immunology, Goztepe Training and Research Hospital, Faculty of Medicine, Medeniyet University, Istanbul, Turkey
| |
Collapse
|
6
|
Cooper S, Schmidt BM, Sambala EZ, Swartz A, Colvin CJ, Leon N, Wiysonge CS. Factors that influence parents' and informal caregivers' views and practices regarding routine childhood vaccination: a qualitative evidence synthesis. Cochrane Database Syst Rev 2021; 10:CD013265. [PMID: 34706066 PMCID: PMC8550333 DOI: 10.1002/14651858.cd013265.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Childhood vaccination is one of the most effective ways to prevent serious illnesses and deaths in children. However, worldwide, many children do not receive all recommended vaccinations, for several potential reasons. Vaccines might be unavailable, or parents may experience difficulties in accessing vaccination services; for instance, because of poor quality health services, distance from a health facility, or lack of money. Some parents may not accept available vaccines and vaccination services. Our understanding of what influences parents' views and practices around childhood vaccination, and why some parents may not accept vaccines for their children, is still limited. This synthesis links to Cochrane Reviews of the effectiveness of interventions to improve coverage or uptake of childhood vaccination. OBJECTIVES - Explore parents' and informal caregivers' views and practices regarding routine childhood vaccination, and the factors influencing acceptance, hesitancy, or nonacceptance of routine childhood vaccination. - Develop a conceptual understanding of what and how different factors reduce parental acceptance of routine childhood vaccination. - Explore how the findings of this review can enhance our understanding of the related Cochrane Reviews of intervention effectiveness. SEARCH METHODS We searched MEDLINE, Embase, CINAHL, and three other databases for eligible studies from 1974 to June 2020. SELECTION CRITERIA We included studies that: utilised qualitative methods for data collection and analysis; focused on parents' or caregivers' views, practices, acceptance, hesitancy, or refusal of routine vaccination for children aged up to six years; and were from any setting globally where childhood vaccination is provided. DATA COLLECTION AND ANALYSIS We used a pre-specified sampling frame to sample from eligible studies, aiming to capture studies that were conceptually rich, relevant to the review's phenomenon of interest, from diverse geographical settings, and from a range of income-level settings. We extracted contextual and methodological data from each sampled study. We used a meta-ethnographic approach to analyse and synthesise the evidence. We assessed methodological limitations using a list of criteria used in previous Cochrane Reviews and originally based on the Critical Appraisal Skills Programme quality assessment tool for qualitative studies. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in each finding. We integrated the findings of this review with those from relevant Cochrane Reviews of intervention effectiveness. We did this by mapping whether the underlying theories or components of trial interventions included in those reviews related to or targeted the overarching factors influencing parental views and practices regarding routine childhood vaccination identified by this review. MAIN RESULTS We included 145 studies in the review and sampled 27 of these for our analysis. Six studies were conducted in Africa, seven in the Americas, four in South-East Asia, nine in Europe, and one in the Western Pacific. Studies included urban and rural settings, and high-, middle-, and low-income settings. Many complex factors were found to influence parents' vaccination views and practices, which we divided into four themes. Firstly, parents' vaccination ideas and practices may be influenced by their broader ideas and practices surrounding health and illness generally, and specifically with regards to their children, and their perceptions of the role of vaccination within this context. Secondly, many parents' vaccination ideas and practices were influenced by the vaccination ideas and practices of the people they mix with socially. At the same time, shared vaccination ideas and practices helped some parents establish social relationships, which in turn strengthened their views and practices around vaccination. Thirdly, parents' vaccination ideas and practices may be influenced by wider political issues and concerns, and particularly their trust (or distrust) in those associated with vaccination programmes. Finally, parents' vaccination ideas and practices may be influenced by their access to and experiences of vaccination services and their frontline healthcare workers. We developed two concepts for understanding possible pathways to reduced acceptance of childhood vaccination. The first concept, 'neoliberal logic', suggests that many parents, particularly from high-income countries, understood health and healthcare decisions as matters of individual risk, choice, and responsibility. Some parents experienced this understanding as in conflict with vaccination programmes, which emphasise generalised risk and population health. This perceived conflict led some parents to be less accepting of vaccination for their children. The second concept, 'social exclusion', suggests that some parents, particularly from low- and middle-income countries, were less accepting of childhood vaccination due to their experiences of social exclusion. Social exclusion may damage trustful relationships between government and the public, generate feelings of isolation and resentment, and give rise to demotivation in the face of public services that are poor quality and difficult to access. These factors in turn led some parents who were socially excluded to distrust vaccination, to refuse vaccination as a form of resistance or a way to bring about change, or to avoid vaccination due to the time, costs, and distress it creates. Many of the overarching factors our review identified as influencing parents' vaccination views and practices were underrepresented in the interventions tested in the four related Cochrane Reviews of intervention effectiveness. AUTHORS' CONCLUSIONS Our review has revealed that parents' views and practices regarding childhood vaccination are complex and dynamic social processes that reflect multiple webs of influence, meaning, and logic. We have provided a theorised understanding of the social processes contributing to vaccination acceptance (or not), thereby complementing but also extending more individualistic models of vaccination acceptance. Successful development of interventions to promote acceptance and uptake of childhood vaccination will require an understanding of, and then tailoring to, the specific factors influencing vaccination views and practices of the group(s) in the target setting. The themes and concepts developed through our review could serve as a basis for gaining this understanding, and subsequent development of interventions that are potentially more aligned with the norms, expectations, and concerns of target users.
Collapse
Affiliation(s)
- Sara Cooper
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Bey-Marrié Schmidt
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Evanson Z Sambala
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- School of Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Alison Swartz
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Christopher J Colvin
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Natalie Leon
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
7
|
Sumengen AA, Ozcevik D, Kursun HY, Ocakci AF. Vaccine-hesitant parents' reasons for choosing alternative protection methods in Turkey. J Res Nurs 2021; 26:540-553. [DOI: 10.1177/1744987120970635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Parents use alternative protective methods instead of having their children vaccinated because of their various concerns. Aims The aim of this study is to examine the processes by which the parents preferred alternative methods rather than the vaccines to strengthen their child's immune system. Methods Semi-structured, qualitative interviews were conducted with 22 parents who had vaccine hesitancy. The study sample consisted of parents whose children were between the ages of 0 and 18 years and who experienced vaccine hesitancy and lived in Turkey. The interviews with individuals were conducted online and aimed to be representative of the population of Turkey. Results The factors that caused parental vaccine hesitancy were various, such as vaccine contents, distrust of healthcare workers and false information about vaccines. Because of these factors, parents resorted to natural nutrition, vitamin support and some other precautions, such as avoiding takeaway food or preparing homemade food, rather than having their children vaccinated. Conclusions In recent years, it is thought that parents need education about vaccination; outbreaks may be caused by immigrant children who cannot be registered, and therefore cannot be vaccinated, in Turkey, which has received immigration at a high rate.
Collapse
Affiliation(s)
- Aylin Akca Sumengen
- Assistant Professor, Department of Nursing, Faculty of Health Sciences, Bahçeşehir University, İstanbul, Turkey
| | - Damla Ozcevik
- PhD student, Graduate School of Health Sciences, Koç University, İstanbul, Turkey
| | - Hulya Yaren Kursun
- School Nurse, Nursing, Graduate School of Health Sciences, Koc University, Istanbul, Turkey
| | - Ayse Ferda Ocakci
- Faculty Member, Nursing, School of Nursing, Child Health and Diseases Nursing, Koc University, Istanbul, Turkey
| |
Collapse
|
8
|
YILDIZ M, YILDIRIM MS, TANİMOWO A, KHADKA RB, GOHAİN A, RHİNO A, RUDİN NA, GHATAK D, AYDIN MA, SARPDAĞI Y, TAYYEB M, GENGATHARAN K, UDDİN A, MAJUMDER S, MAGGOON U, OKYAR G. Determining the Health Literacy Levels and Attitudes of Individuals in Different Countries Towards Vaccination. Turkish Journal of Internal Medicine 2021. [DOI: 10.46310/tjim.850652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
9
|
Clavé Llavall A, de Wildt G, Meza G, Tattsbridge J, Jones L. Nurses' and teachers' perceived barriers and facilitators to the uptake of the Human Papilloma Virus (HPV) vaccination program in Iquitos, Peru: A qualitative study. PLoS One 2021; 16:e0255218. [PMID: 34324573 PMCID: PMC8320989 DOI: 10.1371/journal.pone.0255218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 07/12/2021] [Indexed: 11/18/2022] Open
Abstract
Globally, over 300,000 women die of cervical cancer annually. Given that human papillomavirus vaccines are highly effective in the primary prevention of cervical cancer, it is important to explore the barriers and facilitators to vaccination uptake in areas where the burden of disease remains high. This study, informed by the socio-ecological model, aimed to qualitatively explore vaccination uptake via in-depth interviews with eleven nurses and ten teachers involved in vaccine delivery in Iquitos, Peru. The results highlighted that vaccine uptake was influenced by multiple factors including individuals’ knowledge and attitudes, community beliefs, geography, and policy level variables. Findings suggested that professionals were informed and supportive of the HPV vaccination program but perceived that parents were uninformed about the vaccine. There is a need for community education programs, for a revision of the process of obtaining parental consent, for improved communication between professionals and for involvement of grassroots staff in policy making.
Collapse
Affiliation(s)
- Anna Clavé Llavall
- University of Birmingham Medical School, University of Birmingham, Birmingham, United Kingdom
| | - Gilles de Wildt
- Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Graciela Meza
- Facultad de Medicina Humana, Universidad Nacional de la Amazonia Peruana, Iquitos, Perú
| | - Jasmine Tattsbridge
- University of Birmingham Medical School, University of Birmingham, Birmingham, United Kingdom
| | - Laura Jones
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- * E-mail:
| |
Collapse
|
10
|
Araujo Z, Fernández de Larrea C, López D, Isern-Kebschull J, de Waard JH, Hagel I, Camargo M, Vanegas M, Patarroyo MA. ESAT-6 and Ag85A Synthetic Peptides as Candidates for an Immunodiagnostic Test in Children with a Clinical Suspicion of Tuberculosis. Dis Markers 2021; 2021:6673250. [PMID: 34306256 DOI: 10.1155/2021/6673250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 06/16/2021] [Indexed: 11/17/2022]
Abstract
Background Tuberculosis (TB) is being underdetected in children as most are smear-negative. This work was aimed at evaluating ESAT-6 and Ag85A synthetic peptides' serodiagnostic potential for diagnosing children having a clinical suspicion of TB. Methods The study involved 438 children: 77 Creole nonindigenous (13 suspected of having TB and 64 healthy ones) and 361 Warao indigenous children (39 suspected of TB and 322 healthy children). The approach's diagnostic information was compared using operational characteristics and receiver-operating characteristic (ROC) curves. Results Ag85A P-29879 had 94.6% sensitivity (AUC = 0.741: 0.651 to 0.819 95% CI) in indigenous children. ESAT-6 P-12036 and P-12037 had 100% and 92.3% of sensitivity (AUC = 0.929: 0.929: 0.846 to 0.975 95% CI and 0.791: 63.9 to 98.7 95% CI, respectively) in Creole children. ESAT-6 peptides also allowed a differentiation between children with TB and healthy ones. Conclusions Further validation of this approach could lead to developing a complementary tool for rapid TB diagnosis in children.
Collapse
|
11
|
Wong LP, Wong PF, AbuBakar S. Vaccine hesitancy and the resurgence of vaccine preventable diseases: the way forward for Malaysia, a Southeast Asian country. Hum Vaccin Immunother 2020; 16:1511-1520. [PMID: 31977285 DOI: 10.1080/21645515.2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
This study engaged health professionals in in-depth, semi-structured interviews to explore their opinions concerning the issues surrounding vaccine hesitancy in Malaysia and strategies to improve vaccination to stamp the rise of vaccine preventable diseases (VPDs). Opinions on how to address the resurgence of VPDs in the era of increasing vaccine hesitancy were obtained. Eight health professionals, including geriatricians, pediatricians, microbiologists, public health specialists, and family medicine specialists were interviewed. The influence of anti-vaccination propaganda, past-experience of adverse event following immunization (AEFI), perceived religious prohibition, a belief that traditional complementary and alternative medicine (TCAM) use is safer, pseudoscience beliefs, and anti-vaccine conspiracy theories were identified as reasons for refusing to vaccinate. The interplay of social, cultural and religious perspectives in influencing perceived religious prohibition, pseudoscience beliefs, and the use of TCAM contributing to vaccine refusal was found. Five broad themes emerged from the health professionals regarding strategies to address vaccine hesitancy, including establishing an electronic vaccination registry, increasing public awareness initiatives, providing feedback to the public on the findings of AEFI, training of front-line healthcare providers, and banning the dissemination of anti-vaccine information via social media. With regards to identifying strategies to address the resurgence of VPDs, mandatory vaccination received mixed opinions; many viewed supplementary immunization activity and the prevention of travel and migration of unvaccinated individuals as being necessary. In conclusion, the present study identified unique local cultural, traditional and religious beliefs that could contribute to vaccine hesitancy in addition to issues surrounding vaccination refusal similarly faced by other countries around the world. This information are important for the formulation of targeted intervention strategies to stamp vaccine hesitancy in Malaysia which are also a useful guide for other countries especially in the Southeast Asia region facing similar vaccine hesitancy issues.
Collapse
Affiliation(s)
- L P Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - P F Wong
- Department of Pharmacology, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - S AbuBakar
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
- Tropical Infectious Diseases Research and Educational Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
- WHO Collaborating Centre for Arbovirus Reference and Research (Dengue and Severe Dengue) MAA-12, University of Malaya , Kuala Lumpur, Malaysia
| |
Collapse
|
12
|
Wong LP, Wong PF, AbuBakar S. Vaccine hesitancy and the resurgence of vaccine preventable diseases: the way forward for Malaysia, a Southeast Asian country. Hum Vaccin Immunother 2020; 16:1511-1520. [PMID: 31977285 DOI: 10.1080/21645515.2019.1706935] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
This study engaged health professionals in in-depth, semi-structured interviews to explore their opinions concerning the issues surrounding vaccine hesitancy in Malaysia and strategies to improve vaccination to stamp the rise of vaccine preventable diseases (VPDs). Opinions on how to address the resurgence of VPDs in the era of increasing vaccine hesitancy were obtained. Eight health professionals, including geriatricians, pediatricians, microbiologists, public health specialists, and family medicine specialists were interviewed. The influence of anti-vaccination propaganda, past-experience of adverse event following immunization (AEFI), perceived religious prohibition, a belief that traditional complementary and alternative medicine (TCAM) use is safer, pseudoscience beliefs, and anti-vaccine conspiracy theories were identified as reasons for refusing to vaccinate. The interplay of social, cultural and religious perspectives in influencing perceived religious prohibition, pseudoscience beliefs, and the use of TCAM contributing to vaccine refusal was found. Five broad themes emerged from the health professionals regarding strategies to address vaccine hesitancy, including establishing an electronic vaccination registry, increasing public awareness initiatives, providing feedback to the public on the findings of AEFI, training of front-line healthcare providers, and banning the dissemination of anti-vaccine information via social media. With regards to identifying strategies to address the resurgence of VPDs, mandatory vaccination received mixed opinions; many viewed supplementary immunization activity and the prevention of travel and migration of unvaccinated individuals as being necessary. In conclusion, the present study identified unique local cultural, traditional and religious beliefs that could contribute to vaccine hesitancy in addition to issues surrounding vaccination refusal similarly faced by other countries around the world. This information are important for the formulation of targeted intervention strategies to stamp vaccine hesitancy in Malaysia which are also a useful guide for other countries especially in the Southeast Asia region facing similar vaccine hesitancy issues.
Collapse
Affiliation(s)
- L P Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - P F Wong
- Department of Pharmacology, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - S AbuBakar
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia.,Tropical Infectious Diseases Research and Educational Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia.,WHO Collaborating Centre for Arbovirus Reference and Research (Dengue and Severe Dengue) MAA-12, University of Malaya , Kuala Lumpur, Malaysia
| |
Collapse
|
13
|
Guzman-Holst A, DeAntonio R, Prado-Cohrs D, Juliao P. Barriers to vaccination in Latin America: A systematic literature review. Vaccine 2020; 38:470-481. [DOI: 10.1016/j.vaccine.2019.10.088] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/14/2019] [Accepted: 10/18/2019] [Indexed: 11/16/2022]
|
14
|
Díaz Crescitelli ME, Ghirotto L, Sisson H, Sarli L, Artioli G, Bassi MC, Appicciutoli G, Hayter M. A meta-synthesis study of the key elements involved in childhood vaccine hesitancy. Public Health 2019; 180:38-45. [PMID: 31838344 DOI: 10.1016/j.puhe.2019.10.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/26/2019] [Accepted: 10/30/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Immunization is one of the most successful and cost-effective interventions to improve health outcomes. However, internationally, the phenomenon of parental vaccine hesitancy is increasing and presents a growing challenge for health professionals. This article summarizes the evidence surrounding childhood vaccine hesitancy from the perspective of parents. STUDY DESIGN We conducted a systematic review and meta-synthesis of qualitative studies. METHODS We searched for qualitative research articles in electronic databases from inception to March 2018. In addition, a manual search of the retrieved articles and their references was conducted to identify other potential articles. We used the Critical Appraisal Skills Programme to examine study validity, adequacy and potential applicability of the results. No articles were excluded for reasons of quality. By performing a meta-synthesis, we identified descriptive themes and, subsequently, the conceptual elements of vaccine hesitancy. RESULTS The review included 27 studies involving a total of 1557 parents who were hesitant about vaccinating their child. Five overarching categories were identified: (1) risk conceptualization; (2) mistrust towards vaccine-related institutions, pharmaceutical companies, researchers, health professionals and the information from media; (3) parental alternative health beliefs about childhood immunity, vaccine scheduling and the perceived toxicity of vaccinations; (4) philosophical views on parental responsibility; and (5) parents' information levels about vaccination. CONCLUSIONS Healthcare providers need to approach this difficult situation considering that parents desire to do what they feel right for the child. Understanding the core elements of hesitancy will allow health professionals to adopt effective communication and behavioural strategies.
Collapse
Affiliation(s)
| | - L Ghirotto
- Azienda USL - IRCCS di Reggio Emilia, Italy
| | - H Sisson
- Faculty of Health Sciences, University of Hull, UK
| | - L Sarli
- Department of Medicine and Surgery, University of Parma, Italy
| | - G Artioli
- Azienda USL - IRCCS di Reggio Emilia, Italy
| | - M C Bassi
- Azienda USL - IRCCS di Reggio Emilia, Italy
| | | | - M Hayter
- Faculty of Health Sciences, University of Hull, UK
| |
Collapse
|
15
|
Yan J, Wei J, OuYang Z, Vinnikova A, Zhao D, Zhang H. The influence of parents’ information processing on childhood vaccine acceptance after a vaccine crisis in China. Health, Risk & Society 2019. [DOI: 10.1080/13698575.2019.1619672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Jing Yan
- School of Management, University of Science and Technology of China, Hefei, China
- Institute of Economics, Anhui Academy of Social Sciences, Hefei, China
| | - Jiuchang Wei
- School of Management, University of Science and Technology of China, Hefei, China
| | - Zhe OuYang
- Department of Business Administration, Nanjing University of Finance and Economics, Nanjing, China
| | - Anna Vinnikova
- School of Management, University of Science and Technology of China, Hefei, China
| | - Dingtao Zhao
- School of Management, University of Science and Technology of China, Hefei, China
| | - Haibo Zhang
- School of Government, NanJing University, Nanjing, China
| |
Collapse
|
16
|
Abstract
PURPOSE OF REVIEW Treatment options for inflammatory bowel disease (IBD) have rapidly expanded as the treatment paradigm has shifted from controlling symptoms to reducing lifetime inflammatory burden. Families are confronted with the actual and perceived risks of this ever-expanding array of choices. We aim to review the shared decision-making process in pediatric IBD to ensure an optimal therapeutic plan for the child and their family. RECENT FINDINGS Mucosal healing is a critical treatment target in pediatric IBD but it may not coincide with clinical symptoms. Evidence-based therapies carry important risks, some of which may be less severe than previously suspected, and a family's understanding of these risks plays a crucial role in how they make health decisions. To form an effective shared therapeutic plan, the physician must incorporate an understanding of the values of both the child and family along with their lived experience of illness. SUMMARY To limit harm and promote health in pediatric IBD, the physician must communicate collaboratively with the child and their family to form mutually understood goals of care - both subjective experiential and objective biological - and appreciate actual and perceived risks of treatment options to effectively educate families and navigate toward the best treatment choices. VIDEO ABSTRACT.
Collapse
|