University of Alberta Hospital Acute and Convalescent Polio Care and the Reintegration of Polio Patients into Albertan Communities, 1953-80

Following Canada's largest polio epidemic in 1953, Station 67 at the University of Alberta Hospital (UAH) in Edmonton became home to patients who contracted the virus. As young as nine years old, some of these patients lived at the UAH for more than three decades. Akin to wartime services, the epidemic banded together families, patients, doctors, nurses, community members, and later respiratory, physical, and occupational therapists. The nature of the disease, the government response, and the social and economic climate dramatically affected the lived experiences of patients in Alberta's fight against polio. Drawing on archival research and oral interviews, this article argues that it was the agency and resilience of patients, the contributions of healthcare providers to rapid developments in acute and convalescent care, and the dedication of families that were primarily responsible for the recovery and reintegration of polio patients back into the community.

Socio-economic determinants and inequities in coverage and timeliness of early childhood immunisation in rural Ghana

OBJECTIVES

To assess the extent of socio-economic inequity in coverage and timeliness of key childhood immunisations in Ghana.

METHODS

Secondary analysis of vaccination card data collected from babies born between January 2008 and January 2010 who were registered in the surveillance system supporting the ObaapaVita and Newhints Trials was carried out. 20 251 babies had 6 weeks' follow-up, 16 652 had 26 weeks' follow-up, and 5568 had 1 year's follow-up. We performed a descriptive analysis of coverage and timeliness of vaccinations by indicators for urban/rural status, wealth and educational attainment. The association of coverage with socio-economic indicators was tested using a chi-square-test and the association with timeliness using Cox regression.

RESULTS

Overall coverage at 1 year of age was high (>95%) for Bacillus Calmette-Guérin (BCG), all three pentavalent diphtheria-pertussis-tetanus-haemophilus influenzae B-hepatitis B (DPTHH) doses and all polio doses except polio at birth (63%). Coverage against measles and yellow fever was 85%. Median delay for BCG was 1.7 weeks. For polio at birth, the median delay was 5 days; all other vaccine doses had median delays of 2-4 weeks. We found substantial health inequity across all socio-economic indicators for all vaccines in terms of timeliness, but not coverage at 1 year. For example, for the last DPTHH dose, the proportion of children delayed more than 8 weeks were 27% for urban children and 31% for rural children (P < 0.001), 21% in the wealthiest quintile and 41% in the poorest quintile (P < 0.001), and 9% in the most educated group and 39% in the least educated group (P < 0.001). However, 1-year coverage of the same dose remained above 90% for all levels of all socio-economic indicators.

CONCLUSIONS

Ghana has substantial health inequity across urban/rural, socio-economic and educational divides. While overall coverage was high, most vaccines suffered from poor timeliness. We suggest that countries achieving high coverage should include timeliness indicators in their surveillance systems.

«Polio Hysteria» : La rentrée scolaire montréalaise de 1946 et l'épidémie de poliomyélite

Lors de l’épidémie de poliomyélite à Montréal en 1946, la remise de la rentrée scolaire est rapidement devenue un débat public, qui permet d’observer les discours de plusieurs acteurs sociaux qui tentent d’imposer leur autorité dans la gestion de l’épidémie. Cet article rappelle la persistance des jugements des autorités scolaires et médicales quant à la capacité des parents à prendre soin de la santé de leurs enfants, de même qu’il met en lumière le renforcement des parents en tant qu’intervenants sociaux au sein du Québec d’après-guerre. Appréhendée dans son contexte plus large, cette étude de cas permet également d’explorer la valorisation de l’enfance dans la société des années 1940 et de l’immédiat après-guerre.