Dissertations / Theses on the topic 'Immunization of children'
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Blank, Kristen L. "Exploring state childhood immunization practices /." View online, 2006. http://ecommons.txstate.edu/arp/105/.
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Ramnon, Merlene. "Maternal Characteristics and Childhood Immunization Series Completion Rates Among Children 2-Years-Old." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3200.
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Delays in childhood immunization may have adverse health implications. In the United States, childhood immunization among children who are below 3 years of age continues to be below Healthy People 2020 targets for some vaccines such as DTaP, PCV, HIB, Hep A, Rotavirus, and Hep B birth dose. The purpose of this study was to examine the association between maternal characteristics and childhood immunization series completion rates among children 2 years of age. The social learning theory and self-efficacy theory provided the theoretical foundation for the study. Data from the Florida Department of Health Immunization Surveys were used. ANOVA and multinomial statistical tests were used to analyze the data. According to the study results, maternal factors such as age, marital status, and educational level were significant predictors of childhood immunization completion rates. The findings from the study could lead to positive social change initiatives through education and inclusion of mothers' concerns during interventions to increase immunization rates in children. Increase in immunization completion rates can reduce communicable disease in the population. Insights from this study could assist health care providers, parents, and care givers in their responsibilities relative to childhood immunization practices.
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Hassan, Sufi Ahammad Sirinan Kittisuksathit. "Evaluation of programme factor affecting childhood immunization in Bangladese /." Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd381/4738653.pdf.
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Amarsi, Yasmin Noorali 1950. "Factors associated with immunization status of two year old children." Thesis, The University of Arizona, 1993. http://hdl.handle.net/10150/278367.
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A descriptive study was conducted to investigate the relationship between socio-demographic factors and the immunization status of two year old children. Secondary data were collected from records of 105 two year old children enrolled in the Well Child Clinics of a county health department. Results revealed that 37.5% of the sample had achieved complete immunization status. No statistically significant relationship was found between trimester prenatal care began, maternal age, number of children living in the home, neonatal problems, ethnicity, source of care, referral to Walk-In Clinic, and current visits by a PHN, and the immunization status of two year old children. A statistically significant relationship was found between potential for AHCCCS and incomplete immunization status. The variables that demonstrated significant predictive ability were ethnicity, maternal age, referral to walk-in clinic, potential for AHCCCS and neonatal problems.
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Zúñiga, de Nuncio María Luisa. "A prospective randomized study to determine the effects of a prenatal immunization intervention on timeliness of infant immunization schedule initiation in two San Diego County community clinics /." Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 1999. http://wwwlib.umi.com/cr/ucsd/fullcit?p9943947.
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Mohammed, Raji Tajudeen. "Assessment of factors associated with incomplete immunization among children aged 12-23 months in Ethiopia." University of the Western Cape, 2016. http://hdl.handle.net/11394/4989.
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Magister Public Health - MPHEthiopia has achieved its target for Millennium Development Goal 4 by recording 69 %reduction in its under-five mortality. The proportion of fully immunized children in Ethiopia has increased from 14 % in 2000 to 24 % in 2011. Though progress has been made, about 3 out of 4 children still remain incompletely immunized. The purpose of this study is to determine the socio-demographic and socioeconomic factors associated with incomplete immunization among children aged 12-23 months in Ethiopia. This study is based on secondary analysis of the 2011 Ethiopia Demographic and Health Survey. Information on 1,889 mothers of children aged 12–23 months were extracted from the children dataset. Records from vaccination cards and mothers’ self-reported data were used to determine vaccine coverage. The association between child immunization status and determinants of non-utilization of immunization services was assessed using bivariate and multivariate analyses. The findings of this study showed that the prevalence of incompletely immunized children is 70.9%. Children of mothers from the poor (AOR = 2.27; 95 % CI: 1.34 – 3.82) wealth quintile were more likely to be incompletely immunized. Children of mothers from Affar (AOR = 15.80; 95 % CI: 7.12 – 35.03), Amhara (AOR = 4.27; 95 %CI: 2.31 – 7.88), Oromiya (AOR = 8.10; 95 % CI: 4.60 – 14.25), Somali (AOR = 4.91;95 % CI: 2.65 – 9.10), Benishangul-Gumuz (AOR = 4.20; 95% CI: 2.34 – 7.57),Southern Nations Nationalities and Peoples’ (AOR = 4.76; 95 % CI: 2.53 – 8.94), Gambela (AOR = 7.75; 95 % CI: 3.68 – 16.30) and Harari (AOR = 3.22; 95 % CI: 1.77 –5.89) regions were more likely to be incompletely immunized. Mothers with inadequate exposure to media (AOR = 1.60; 95% CI: 1.21 – 2.14), who are not aware of community conversation programme (AOR = 1.80; 95% CI: 1.40 – 2.32) and who attended no antenatal care (AOR = 2.21; 95% CI: 1.72 – 2.83) were more likely to have incompletely immunized children. Despite efforts to increase rates of childhood immunization, the proportion of children with incomplete immunization in Ethiopia is considerably high. Therefore, targeted interventions at the identified socio-demographic factors are needed to increase immunization rates.
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Meyer, Cathy J., and University of Lethbridge Faculty of Arts and Science. "Understanding perspectives among young adults regarding immunization in the Chinook Health region of southern Alberta." Thesis, Lethbridge : University of Lethbridge, Faculty of Arts and Science, 2002, 2002. http://hdl.handle.net/10133/136.
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This thesis was designed to explore and describe the beliefs and behaviours of young adults (parents or future parents) in relation to immunization. Data were collected via in-depth interviews with 36 young adults (current university students) that resulted in more than 600 pages of documnetation for detailed analysis. Nursing and non-nursing student informants were compared under the categories of young adults who delay or refuse immunizations due to alternative health practices, vaccine concerns or religion. What emerged from the study was that young adults displayed lack of knowledge and disinterest about the immune system, immunizations and communicable diseases. This display of apathy towards disease prevention could subsequently contribute to a decrease in the population's herd immunity in the next generation. A review of more than 300 published journal articles and books was completed and integrated into a mosaic of Canadian immunization practice. Policy recommendations based on these findings are presented.x, 223 leaves : ill. ; 28 cm.
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Patail, Shoaib Chotoo. "Implications of a national immunization registry an alliance to win the race for the future care and accuracy of pediatric immunization." CSUSB ScholarWorks, 2004. https://scholarworks.lib.csusb.edu/etd-project/2600.
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This project examines the role of immunization registries and their effect on a health care delivery system. Recent efforts to attain coverage of child populations by recommended vaccines have included initiatives by federal and state agencies, as well as private foundations, to develop and implement statewide community-based childhood immunization registries.
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Chakraborty, Nitai. "Factors affecting the use of childhood immunization in a rural area of Bangladesh." Thesis, Canberra, ACT : The Australian National University, 1987. http://hdl.handle.net/1885/141470.
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Vandenberg, Shannon Y. "Saying no to childhood immunization : perceptions of mothers and health care professionals in Southern Alberta." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Health Sciences, c2013, 2013. http://hdl.handle.net/10133/3355.
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The purpose of this grounded theory study was two-fold; first, to explore how mothers develop an understanding of childhood immunization which contributes to the decision¬making process resulting in a decision not to participate in immunization. Second, the perceptions of childhood immunization of health care professionals were also examined. The understanding and decision-making process of eight mothers was compared with the perceptions of twelve health care professionals. A number of themes were constructed from the research and a grounded theory was developed which emphasizes the importance of collaboration between non-immunizing mothers and health care professionals to promote positive health outcomes in children. The findings will assist health care professionals in understanding the factors contributing to the immunization decision-making process, which will subsequently support in delivering immunization programs. Recommendations to promote support and respect for parents' decision not to immunize their children, and assist in educating parents on immunization are also included.xiii, 275 leaves ; 29 cm
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King, W. James. "Immunogenicity of quadrivalent meningococcal polysaccharide vaccine in children during a mass immunization campaign." Thesis, University of Ottawa (Canada), 1995. http://hdl.handle.net/10393/9939.
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Objective. To determine, in healthy children, the immune response induced at one month and one year by the serogroup C antigen of a quadrivalent meningococcal polysaccharide vaccine ($Menomune\sp{\rm TM}$) A/C/Y/W-135), during a mass vaccination campaign. Participants. 6 month-19 year old volunteers recruited during a Public Health Department mass immunization campaign. Methods. Serum was obtained pre, one month, and one year post immunization and measured by enzyme-linked immunosorbant assay (ELISA) and bactericidal assay (BA) for the immune response to serogroup C N. meningitidis polysaccharide antigen. Throat cultures were analyzed for oropharyngeal colonization of N. meningitidis and N. lactamica. Results. Pre-vaccination, almost all children had a negligible amount of ACPS antibody against group C N. meningitidis, regardless of age. At one month post-vaccination, a significant response was demonstrated in children older than 6 months of age with regard to total ACPS antibody concentration and in children older than 18 months of age with respect to SBA titre. In children less than 18 months old, despite a significant rise in total ACPS antibody concentration, this measure was not associated with the SBA titre. At one year post-vaccination, children less than 5 years of age had a substantial decline in their total ACPS antibody response, while children greater than 18 months old maintained their SBA levels. Implications. During an outbreak of invasive meningococcal disease, quadrivalent meningococcal polysaccharide vaccine can induce a 'protective' immune response in children older than 18 months and may be beneficial for children as young as 6 months of age. (Abstract shortened by UMI.)
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Ndhlovu, Nomathamsanqa. "The relationship between immunization and food allergy and sensitisation in South African children." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/25420.
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The prevalence of food allergies is higher in children compared to adults and it is increasing. The factors that influence food allergies in children are not clear. In light of the hygiene hypothesis, vaccinations may contribute towards to a predominant allergen specific response or exposure to the virus or microbe in the vaccine may decrease the risk for allergy. Previous studies have shown that the effect of vaccinations on food allergy and food sensitisation varies. Therefore, the aim of this study is to determine if a relationship exists between vaccinations and food allergies and food sensitisation in children in the first 18 months of life who live in urban Cape Town and in rural Mqanduli in the Eastern Cape. Secondary data analysis of an observational cross sectional study was carried out which involved univariate logistic regression to calculate odds ratios between self-reported immunisation status and food sensitisation and food allergy at a 95% confidence interval in children between 12 and 36 months of age. The same method was employed to investigate the relationship between immunisation and atopy. Multivariate analysis was utilised to adjust for potential confounders. Food sensitisation and food allergy were determined through skin prick tests (SPT) and oral food challenges respectively. The results indicate that, the number of participants positive for food sensitisation and allergy, eczema, hay fever and asthma were significantly greater in the urban sample (n= 708) compared to the rural sample (n= 400) (P<0.05). Further, in 708 urban children, those who had a BCG vaccine at birth were 0.05 (OR 0.05; 95% CI: 0.004 - 0.6) times less likely to have an SPT ≥ 7mm. The BCG unvaccinated cohort consisted of three individuals. There were no other significant associations between childhood vaccinations and food sensitization at SPT ≥ 1mm ,≥ 3mm and ≥ 7mm. There was no significant association between vaccinations and food allergy or other forms of atopy. In conclusion, there was very little evidence of an association between BCG vaccination in children and food allergic sensitisation or food allergy. However, in a small subgroup, there was evidence in an association between BCG and SPT ≥ 7 mm.
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Topham, Maren. "Parental Attitudes of Immunization in Children with Special Healthcare Needs: A Qualitative Study." BYU ScholarsArchive, 2017. https://scholarsarchive.byu.edu/etd/7271.
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Background and Purpose: Just over 15% of children under 18 years of age in the UnitedStates, or approximately 11.2 million children, are estimated to have special healthcare needs.Although children with special healthcare needs (CSHCN) make up a small percentage of thepediatric population, they account for over one third of pediatric medical care. Parental attitudesregarding immunization play a significant role in vaccination rates among children. The purposeof this research is to explore parental attitudes regarding immunization of CSHCN.Methods: This qualitative study focused on parental perceptions and beliefs aboutimmunizations for CSHCN. Sixteen participants, who were parents of CSHCN from onepediatric specialty care clinic participated in focus groups. Institutional review board approvalwas received prior to data collection.Results: While the purpose of this study was to determine the attitudes of parents ofCSHCN regarding immunizations, analysis revealed parents simply wanted to share their lifeexperiences rearing these children, with issues of immunization being secondary. Participantsdescribed the experience of caring for their CSHCN related to isolationism and the weight ofresponsibility as leader of their child<'>s care. Additionally, the majority of parents thatparticipated viewed childhood vaccinations in a positive light. Parents acknowledged that it wasimportant for their own children to receive vaccines. Participants also recognized that it wasimportant for the community to be vaccinated in order to protect their child. However, the desirefor individualized care, at times, caused parents to disregard the immunization schedulerecommended by Center for Disease Control and Prevention.Conclusions: Health care providers can be effective and influential members of the healthcare team by engaging in community based education about vaccines, building trustingrelationships with parents and helping parents understand the need to follow the recommendedschedule for immunizations.
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Khamsing, Vongkhamdy Junya Pattara-arechachai. "Knowledge and attitude on the immunization preventable disease of mothers with children 6-24 moths old and completeness of their children's immunization in Pakse district, Champasack province, LAO PDR /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-KhamsingV.pdf.
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Farooq, Ghulam Boonyong Keiwkarnka. "Utilization of immunization services among mothers of under 1 year old children in sub-district Turbat, district Kech, Balochistan, Pakistan /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-GhulamF.pdf.
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Tracy, Elizabeth Catherine. "The effects of host factors and environmental factors on immunization compliance in two year old children." Thesis, The University of Arizona, 1988. http://hdl.handle.net/10150/276885.
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Descriptive research was conducted to describe the relationships among host and environmental factors and immunization compliance in two year old children. Secondary data was collected from a sample of 306 well baby clinic records in a public health department in a Southwestern state. Results revealed statistically significant differences between the compliant and noncompliant groups for income and number of children living at home. Higher income, higher maternal age, fewer number of children, and races other than of Spanish origin were significantly correlated with children who received all immunizations at the appropriate age. Significant relationships were found between children who received all immunizations at the public health department versus children who received immunizations from both a public and private provider. Compliant children made more visits for immunizations and fewer other visits than noncompliant children. These factors can assist in identifying children at highest risk for failure to receive immunization on time.
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Daokeo, Siharath Kitti Shiyalap. "Utilization of immunization services among mothers with children 2-5 years of age in Sanakham district, Vientiane province, Lao Pdr /." Abstract, 2003. http://mulinet3.li.mahidol.ac.th/thesis/2546/4537459.pdf.
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Attique, Amer Boonyong Keiwkarnka. "Utilization of immunization services among mothers with children under five years of age in abbottabad district, Pakistan /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-AmerAttique.pdf.
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Mezones, Holguín Edward, Díaz Rafael Bolaños, Víctor Fiestas, César Sanabria, Aguado Alfonso Gutiérrez, Fabián Fiestas, Víctor J. Suárez, Morales Alfonso J. Rodríguez, and Adrian V. Hernández. "Cost-effectiveness analysis of pneumococcal conjugate vaccines in preventing pneumonia in Peruvian children." The Journal of Infection in Developing Countries, 2015. http://hdl.handle.net/10757/337985.
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emezones@gmail.comIntroduction: Pneumococcal pneumonia (PP) has a high burden of morbimortality in children. Use of pneumococcal conjugate vaccines (PCVs) is an effective preventive measure. After PCV 7-valent (PCV7) withdrawal, PCV 10-valent (PCV10) and PCV 13-valent (PCV13) are the alternatives in Peru. This study aimed to evaluate cost effectiveness of these vaccines in preventing PP in Peruvian children <5 yearsold. Methodology: A cost-effectiveness analysis was developed in three phases: a systematic evidence search for calculating effectiveness; a cost analysis for vaccine strategies and outcome management; and an economic model based on decision tree analysis, including deterministic and probabilistic sensitivity analysis using acceptability curves, tornado diagram, and Monte Carlo simulation. A hypothetic 100 vaccinated children/vaccine cohort was built. An incremental cost-effectiveness ratio (ICER) was calculated. Results: The isolation probability for all serotypes in each vaccine was estimated: 38% for PCV7, 41% PCV10, and 17% PCV13. Avoided hospitalization was found to be the best effectiveness model measure. Estimated costs for PCV7, PCV10, and PCV13 cohorts were USD13,761, 11,895, and 12,499, respectively. Costs per avoided hospitalization were USD718 for PCV7, USD333 for PCV10, andUSD 162 for PCV13. At ICER, PCV7 was dominated by the other PCVs. Eliminating PCV7, PCV13 was more cost effective than PCV10 (confirmed in sensitivity analysis). Conclusions: PCV10 and PCV13 are more cost effective than PCV7 in prevention of pneumonia in children <5 years-old in Peru. PCV13 prevents more hospitalizations and is more cost-effective than PCV10. These results should be considered when making decisions about the Peruvian National Inmunizations Schedule.
This study was funded by Instituto Nacional de Salud, Lima, Peru
Revisión pór pares
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Sarker, Shafiqul Alam. "Passive immunotherpy and probiotic agents in enteric infections in children /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7357-049-4/.
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Mennuti-Washburn, Jean Eleanor. "Gate coontrol theory and its application in a physical intervention to reduce children's pain during immunization injections." unrestricted, 2007. http://etd.gsu.edu/theses/available/etd-08062007-113816/.
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Thesis (M.A.)--Georgia State University, 2007.Title from file title page. Lindsey L. Cohen, committee chair;Lisa Armistead, Chris Henrich, committee members. Electronic text (67 p. : ill.) : digital, PDF file. Description based on contents viewed Dec. 13, 2007. Includes bibliographical references (p. 42-49) and index.
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Jared, Barbara. "The Impact of Teach-Back as a Patient Education Tool in Women with Inadequate Maternal Health Literacy Seeking Immunizations for their Children." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etd/3253.
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Health literacy is recognized as a contributor to health outcomes and maternal health literacy is important to the health and wellbeing of children and families. Of particular interest are mothers seeking immunization services for their children. The complexity of the recommended immunization schedule and the care management of children receiving immunizations have the potential to create negative health outcomes in the low health literate population. Assessment of maternal health literacy and provision of effective patient education adapted to the health literacy level of the individual is important for information transfer. The Teach-Back provides an opportunity to both assess understanding and reinforce teaching.
This study used an experimental design to study two groups of women for a total of 90 participants in a public health department setting. The control group received the usual immunization patient education using Vaccination Information Sheets. The intervention group also received patient education in this manner plus use of the Teach-Back. Immunization knowledge was assessed prior to and after patient education. Immunization currency was assessed as well.
The Newest Vital Sign was used to assess the maternal health literacy for 90 mothers bringing their children for immunizations. A demographic survey addressing both individual characteristics and social determinants of health variables was also administered.
Most of the participants were low health literate (84%) and low health literacy was related to lower immunization knowledge and poor immunization currency. Social determinants of health variables were related to maternal health literacy, immunization knowledge and immunization currency. The results demonstrated an improvement of immunization knowledge scores with the use of the Teach-Back method of patient education.
Additional research is needed in the area of patient education interventions specific to the low health literate population. The development of instruments to measure interactive and critical health literacy are needed and interventions to promote growth in health literacy are also needed. Clinically, improved patient education interventions for low health literate mothers has the potential to improve health outcomes and decrease health care costs of these women, their children and their families.
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Baynam, Gareth. "Genetic influences on vaccine response in children." University of Western Australia. School of Paediatrics and Child Health, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0259.
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Vaccination is one of the most efficacious public health interventions1 and has been increasingly used to combat non-infectious diseases. Mechanisms underlying vaccine responses overlap with those regulating immune responses in health and disease. Therefore, an understanding of mechanisms underpinning these responses will have broad implications. Variation in immune response genes contributes to impaired vaccine responses2-4. Understanding the contribution of genetic variants to vaccine responses is likely to be particularly important in early life given the generalized functional immaturity of the immune system in infants and the highly variable kinetics of its maturation over the first few years of life5-7. However, studies of genetic influences on early childhood vaccine responses are scarce. Since a number of genes from several pathways are likely to be important, a targeted approach is necessary. This thesis explored the effects and interactions of genes associated with atopy, as atopy, or the genetic risk for it, has been associated with modulation of early childhood vaccine responses. This thesis aimed to: 1) investigate genetic variants associated with atopy on early childhood vaccine responses; 2) examine interactions between these genetic variants and non-genetic factors; 3) approach developmental genetic influences on genetic effects and their interactions; and 4) extend findings on vaccine responses to other immunological phenotypes and disease outcomes.
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Kongxay, Phounphenghack Wirat Kamsrichan. "Knowledge and perception of mothers about immunization of children under 3 years of age in the Saythany district, Vientiane, Lao P.D.R. /." Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd399/4937993.pdf.
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Zhu, Bing. "The Role of Risk Communication for Improving the Immunization Coverage of Children in the Transitory Population in Hangzhou, China." Thesis, Griffith University, 2019. http://hdl.handle.net/10072/384945.
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Immunization has been one of the greatest public health successes, with the ability to prevent morbidity and mortality due to infectious diseases, particularly among children. Its success relies on high levels of coverage. However, globally immunization coverage is uneven and very low in certain populati ons resulting in high rates of avoidable disease burden and death. Evidence demonstrates that the population most at risk of low immunization coverage is the children of internal migrant laborers, moving from place to place to seek temporary or short term work. This is the case in China. In China, since a market economy was adopted four decades ago, a large number of people have been drawn from rural to urban areas to meet the increasing need for labor. Under China’s special housing registration system (t he Hukou system), people are registered to a particular area for housing and other social welfare entitlements. Rural migrants cannot obtain urban household registration status, nor are they entitled to the same social welfare and health services as urban residents. Moving from city to city in search of work, these transitory laborers are often called ‘the floating population’ due to the transitory nature of their work and residency. There is mounting evidence that children of this transitory population are more likely to miss immunizations and thus face greater threats from infectious diseases. Literature also points to the urgent need for effective strategies to improve immunization coverage for these transitory populations, not only to protect migrant chi ldren, but the community at large. However, little is known about how to address this problem. Studies have examined the complexities of the organizational, cultural, socio economic and personal factors influencing the transitory population’s participatio n in the immunization program. They reveal three key reasons why migrant children miss their immunizations: 1) the ir parents lack information regarding the benefits of immunization; 2) a lack of coordination and collaboration among relevant stakeholders in the immunization delivery system to reach out to and communicate with this population; and 3) the current immunization strategy only emphasizes health education without considering other factors, nor assessing the needs of relevant stakeholders such as de cision makers and program managers, Center for Disease Control staff, health practitioners, community leaders, the media, and most importantly the parents. This places a burden and an additional workload on local health workers to reach the transitory po pulation and provide better services. As evidence demonstrates, these practices have not succeeded in strengthening multi stakeholder collaboration to improve immunization coverage, nor in reaching the transitory migrant population who have missed immuniza tions. Thus, a well designed risk communication strategy may be crucial for the effective implementation of an immunization program for the children of the transitory population. Risk communication has been gaining increasing recognition in recent decades as a useful tool for conveying information about risk among stakeholders. It aims to build trust, enhance information flows and mutual understandings among stakeholders, and to build the public’s confidence in and adherence to public health policies. Apar t from communication about risk and uncertainty, risk communication also facilitates decision making, conflict resolution, two way communication, public participation, and multi sector al collaboration. Yet in China, risk communication’s role in improving i mmunization coverage among the transitory migrant labor population has not been thoroughly investigated. Consequently, strategies have not been developed to improve communication between key stakeholders to help overcome barriers to multi sector collaborat ion. To fill this gap, this research aims to examine the role of risk communication in improving immunization coverage for the children of the transitory population applying a stakeholder analysis and a comprehensive community needs assessment in Hangzhou City. It investigates how key stakeholders in selected settings perceive risk in immunization practice, and the various determinants impacting on their decision making over whether to accept immunization, on dealing with adverse events following immunization, a nd other conflicting interests between experts, organizations, communities and individuals. Stakeholders for the National Immunization Program delivery system are analyzed, then the community needs and the status of communication and collaboration between different stakeholders is assessed. Consequently, a risk communication strategy for improving the immunization coverage of children of the transitory population is developed. This study applies mainly qualitative methods supplemented by quantitative secon dary data available on immunization coverage and demographic characteristics. It collects qualitative data to assess stakeholders’ needs and to redefine the role of risk communication through a literature review, interviews and focus groups. In addition, i t conducts two case studies in two families, one with good resources, and another with limited resources which is more isolated. Participants of the study represent key stakeholders of Hangzhou’s immunization program delivery system and the transitory po pulation. The fifty seven interviewees and ten focus group participants come from multiple sectors and interest groups including ten immunization program coordinators and staff from national and provincial level Ministries of Health, and the Center for Dis ease Control and Prevention; twelve parents, twelve health workers, twelve local residents, and eleven community members. Key findings of t his study are: T he comprehensive community needs assessment of the transitory population reveals that, due to their social circumstances and inequitable access to social and health services the transitory population in contemporary China is faced with many health challenges. Of particular concern is their children’s low immunization coverage. T his has also increased the threats of communicable diseases to their health T he community needs assessment also reveals that the various stakeholders’ concerns and needs, particularly those of the transitory migrant population and local health workers, ha ve not been fully considered and fulfilled. T he stakeholder analysis describ es the delivery system of the National Immunization Program for children of the transitory population in Hangzhou This delivery system for the transitory population contai ns many sectors and departments Each of them has different functions and activities in the system . To effectively improve the Program’s performance, these departments need a better understanding of the system in which they operate, and sufficient cooperation betw een them must be fostered. I t would be necessary and helpful to integrated multi stakeholders efforts to improve the work of the immunization service This study indicates that risk communication is crucial for the success of public health intervention pr ograms such as the immunization program. To facilitate the risk communication, information sharing and development of cooperation mechanism s are necessary. This study collected t he contents and channels of information exchange between stakeholders. M ore important ly , the decision making factors for each stakeholder concerning immunization for children of the transitory population have been collected and analyzed Finding s of this study reveal that current communication between different stakeholders is not good. This is caused by ineffective communication methods, the simplistic contents of the communications, an imbalance of information among different groups, inefficient communication channels, and most importantly, the transitory population’s lack of tru st in the official information. Based on the researcher’s experience and the study findings, this study recommends that: A comprehensive community needs assessment should be conducted to identify the needs of both children from the transitory population a nd the grassroots health workers to inform the development of intervention programs tailored to them. The traditional health education approach to promote immunization to the transitory population has limitations. To facilitate program implementation, ris ks concerning the delivery of the National Immunization Program should be fully communicated to the different groups of stakeholders in accordance with the risk communication framework. A community empowerment framework should be applied to design strateg ies and to enable the target population to gain access to what they need through four means: resources, networks, information, and decision making. These include redistributing educational resources through the effective channels identified by the migrant population itself, recruiting community volunteers to reach and inform the migrant population on immunization , and reorienting the health service following suggestions from the migrant population and local health workers. Risk communication can help facili tate multi sectoral collaboration and empower vulnerable populations to participate in public health programs. Thus, it should be applied to broader areas of public health. The government service providers need comprehensive community needs assessments, c ommunity empowerment, and effective partnerships and capacity building to address the transitory population’s public health issues. Health workers from the grassroots level should be more involved in the design and assessment of public health intervention programs to achieve and sustain success. The results of this study should be applied to improve the immunization services for the transitory population and to form the basis for developing a risk communication strategy with a broader regional application. This study contributes to international health security in general, and to China in particular due to its substantial transitory population, whose children are at high risk of suffering from communicable diseases. It will increase our understanding of the ories, concepts and factors relating to decision making processes and risk communication strategies, which is an important knowledge gap in current public health emergency management, disease outbreak response, and population based program design, coordination and delivery.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Environment and Sc
Science, Environment, Engineering and Technology
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Mangual, Rebecca Bonilla. "Characteristic differences between parents/guardians who keep immunization records and those who do not." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2201.
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Tarrant, Marie. "Parents and childhood immunizations : a study of health beliefs and perceptions among Hong Kong Chinese parents." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2005. https://ro.ecu.edu.au/theses/657.
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As a result of immunizations and other child health initiatives, the rates of vaccine preventable diseases in Hong Kong have dropped dramatically over the past several decades. Hong Kong, however, is one of the most densely populated cities in the world which increases the vulnerability of the population to communicable disease outbreaks. Thus, high levels of immunization coverage are necessary to prevent disease outbreaks. Currently very little information exists about Hong Kong parents' perceptions of childhood immunizations or vaccine preventable diseases. The aims of this study were to explore Hong Kong parents' beliefs about childhood immunizations, to validate an instrument to measure those health beliefs, and to identify factors that are most predictive of age-appropriate immunization.
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Claesson, Susanna, and Jannica Brännström. "Jämförelse av två olika vaccinationstekniker på spädbarn : Dubbelvaccinering eller en itaget?" Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-184790.
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Syfte: Syftet med denna studie var att jämföra BVC-sjuksköterskors och föräldrars upplevelse av vaccinationstillfället samt skattning av barns smärta i form av skriktid vid två typer av vaccinationstekniker, dubbelvaccinering respektive en injektion i taget, när barnet ska ha två sprutor vid samma vaccinationstillfälle. Metod: Studien är en jämförande deskriptiv studie med kvantitativ ansats. Från både Stockholm och Uppsala valdes 50 barn ut konsekutivt varav 25 barn från Stockholms län samt 25 barn från Uppsala län. Datainsamling skedde med hjälp av enkäter samt mätning av skriktid. Dataanalysen genomfördes med hjälp av chitvåtest samt t-test. Resultat: Det fanns signifikanta skillnader vad gäller både BVC-sjuksköterskors och föräldrars upplevelser av vaccinationsproceduren. Skillnader kunde även ses såväl hos både föräldrar (p=0,020) och BVC-sjuksköterskor (p=0,032) när de fick skatta sin upplevelse av barnets smärta i samband med vaccinationen. Skriktiden visade inte någon signifikant skillnad (p=0,051) mellan de olika vaccinationsteknikerna. Slutsats: Resultatet av denna studie visade att barn som fick dubbelvaccinering upplevdes ha mindre ont när deras smärta skattades av både föräldrar och BVC-sjuksköterskor. Barn som fick sprutorna samtidigt skrek/grät generellt kortare tid än de barn som fick en spruta i taget, skillnaden visade dock ingen signifikans. Flertalat föräldrar i denna studie föredrog dubbelvaccinering.Aim: The aim of this study was to compare child health center nurses' and parents' experience of the immunization and the child's estimated pain in terms of cry duration when two types of vaccination techniques were used, simultaneous versus sequential immunization injections, when the child are given two shots at the same occasion. Methods: The study is a comparative descriptive study with quantitative approach. From both Stockholm and Uppsala 50 children were selected consecutively with 25 children from the Stockholm and 25 children from the Uppsala. Data collection was done by means of questionnaires and measurement of cry duration. Data analysis was performed using the chi-square test and t-test. Results: There were significant differences from both nurses' and parents' perceptions of the vaccination procedure. Differences could also be seen in terms of the child's pain when both parents' (p=0,020) and nurses' (p=0,032) rated the child's pain associated with the immunization. Cry duration did not show a significant difference (p=0,051) between the two vaccination techniques. Conclusions: The results of this study showed that the children who received two vaccinations simultaneously were experienced by both parents’ and nurses’ to have less pain. Children that received the two injections at the same time cried less in general then the children that received the two injections one by one, the difference was not however significant. Most of the parents in this study preferred that the injections should be given at the same time.
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Ciren, Yangzong. "BCG coverage and the association between selected factors and the immunization coverage among children under the age of two years in rural and semi-rural Lhasa District, Tibet /." Oslo : Medisinske fakeltetet, Universitetet i Oslo, 2007. http://www.duo.uio.no/publ/medisin/2007/69089/Cirenyangzong.pdf.
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Junqueira, Priscilla dos Santos. "Ensaio clínico randomizado para avaliação dos eventos adversos da vacina pentavalente em lactentes de Goiânia-Go." Universidade Federal de Goiás, 2014. http://repositorio.bc.ufg.br/tede/handle/tede/4323.
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Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG
The development of vaccines led to an increase in administration by intramuscular route on the vastus lateralis (VL) region of the thigh, a site that has been recommended by the Ministry of Health since 1993 and which is the most commonly used by professionals, and produces greater pain and more local adverse events. The ventrogluteal (VG) region, however, has been pointed out by many researchers as an alternative and immunogenic location for the application of drugs in children younger than two years of age. Thus, a safe location and which produces less suffering in the administration of vaccines is needed. OBJECTIVE: The aim of this study was to assess the pain and adverse events of the pentavalent vaccine (DTP/HB-Hib) administered in children assisted at a healthcare unit in the city of Goiânia, in the Brazilian state of Goiás, comparing the VG and the VL regions. METHODS: A randomized, controlled clinical trial of phase IV was conducted to assess the pain and adverse events associated with the application of the DTP/HBHib vaccine in the VL (comparison group) and the VG (intervention group) regions in children younger than two years of age. Pain was assessed before, at the time of application, and at one minute and three minutes after the vaccine, using the FLACC scale. Adverse events were assessed between 48 and 72 hours after the vaccine in the home of the children. Data were analyzed using the SPSS statistical program, descriptive statistics by means of arithmetic mean and standard deviation, and a Student’s t-test. Scores were considered statistically significant at p<0.05. This project was funded by FAPEG, PPPedict, and number 06/09 with Research Ethics Committee of Federal University of Goiás, registered CEP/UFG n◦052/12. RESULTS: Pain was assessed in 252 children and adverse events in 211 children. The two groups were comparable children characteristics (regarding gender, history of diseases, place of birth, maternal education, marital status of mother and family income, age, previous injections, period of exclusive breastfeeding and maternal age). The intensity of pain assessed in the children before the vaccine was similar in both groups, but it was lower in the children vaccinated in the VG region than in those vaccinated in the VL region (p=0.00) in the three moments during and after the vaccination. The adverse event induration was also more present in the VL than in the VG region (p=0.002). CONCLUSION: The evidences in this article increases the knowledge among health professionals about the applicability of administration technique in the VG region, reducing injuries in children vaccination and shows VG region as the best option for immunogens application in children regarding their safety, less pain during and after the injection and less local reaction.
Com o desenvolvimento das vacinas, houve um aumento do número de administração por via intramuscular em um sítio que é recomendado pelo Ministério da Saúde desde 1993 e mais utilizado pelos profissionais que é a região vasto lateral da coxa (VLC), e consequentemente produz maior dor e eventos adversos locais. Já a região ventro glútea (VG) tem sido citada por vários estudiosos como um local alternativo e imunogênico para a aplicação de fármacos em crianças menores de 2 anos. Assim, um local seguro e que produza menor sofrimento na administração das vacinas se faz necessário. OBJETIVO: Avaliar a dor e os eventos adversos da vacina pentavalente (DTP/HB-Hib) administrada nas crianças atendidas em uma unidade de saúde de Goiânia- Goiás, comparando as regiões VG versus VLC. METODOLOGIA: Ensaio clínico randomizado controlado de fase IV para avaliar a dor e os eventos adversos na aplicação da vacina DTP/HB-Hib nas regiões VLC (grupo de comparação) e VG (grupo de intervenção) em crianças menores de um ano de idade. A dor foi avaliada antes, no momento da aplicação da vacina, um e três minutos após a vacinação, utilizando a escala de FLACC. Os eventos adversos foram avaliados de 48 a 72 após a vacinação no domicílio da criança. A análise foi realizada no programa estatístico SPSS, análise descritiva por meio de média aritmética e desvio padrão, utilizando teste-t de Student e valores de p<0,05 foram considerados estatisticamente significantes. Projeto financiado pela FAPEG Edital PPP n°.06/09, com Comitê de Ética em Pesquisa da Universidade Federal de Goiás, protocolado CEP/UFG nº052/12. RESULTADOS: A avaliação da dor foi realizada em 252 crianças e os eventos adversos em 211 crianças. Os dois grupos foram comparáveis em relação às características das crianças (sexo, antecedentes de doença, naturalidade, renda familiar, estado civil da mãe, escolaridade materna, idade, injeções prévias, tempo de amamentação exclusiva e idade da mãe). A intensidade da dor nas crianças avaliada no momento antes da vacinação foi semelhante em ambos os grupos, mas nos 3 momentos durante a vacinação, um e três minutos após a vacinação, observando que no grupo de crianças vacinadas na região VG foi menor que as vacinadas na VLC (p=0,00), assim como o evento adverso enduração, sendo mais presente na região VLC do que na região VG (p=0,002). CONCLUSÃO: As evidências deste estudo contribuem para o maior conhecimento sobre a aplicabilidade da técnica de administração na região VG entre os profissionais da saúde, na redução de agravos na vacinação das crianças apresentando a região VG como local mais adequado para a aplicação de imunógenos em crianças, por sua segurança, menor dor durante e após a aplicação da injeção e menor reação local.
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Eren, Erdal Örmeci Ahmet Rıfat. "İkinci ve üçüncü kez kızamık aşısı yapılan çocuklarda bağışıklık düzey değişimleri /." Isparta: SDÜ Tıp Fakültesi, 2006. http://tez.sdu.edu.tr/Tezler/TT00280.pdf.
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Emilsson, Johanna, and Agnetha Fredin. "Skolsköterskans omvårdnadsåtgärder vid vaccinering." Thesis, Högskolan Kristianstad, Sektionen för hälsa och samhälle, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-13303.
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Bakgrund: Skolbarn kan utsättas för onödig smärta vid vaccinering vilket kan leda till ofullständigt vaccinationsskydd samt minskat förtroende för hälso- och sjukvårdspersonal. I Sverige vaccineras barn i skolålder av skolsköterskan. Vaccinationer är den vanligaste orsaken till procedursmärta hos barn. Syfte: Att beskriva skolsköterskans omvårdnadsåtgärder för att minska smärta och oro vid vaccinering. Metod: Studien genomfördes som en allmän litteraturstudie baserad på 14 artiklar som kvalitetsgranskades och analyserades. Resultat: Avledning som omvårdnadsintervention är av betydelse vid vaccinering av skolbarn. Enligt litteraturstudiens resultat innebär avledning information/undervisning, medverkan, träning, miljöanpassning, specifik omvårdnad samt olika former av stöd och läkemedelshantering. Diskussion: Avledning utifrån resultatet är delvis överförbart till liknande situationer som till exempel venprovtagning. Trots att stöd finns för omvårdnadsåtgärd vid vaccinering saknas implementering för det. Slutsats: Skolsköterskan behöver identifiera barns behov och utifrån det välja omvårdnadsintervention. Skolsköterskan ska värna om en god kommunikation samt förtroendefull relation med barn. Vaccinationen kan då genomföras med minskad smärta och oro för barn.Background: Schoolchildren may be exposed to unnecessary pain during immunization which might lead to incomplete vaccination protection and reduced confidence in healthcare professionals. In Sweden school aged children are vaccinated by the school nurse. Immunization is considered the most common reason for iatrogenic pain in children. Aim: To describe the school nurse’s interventions to reduce pain and anxiety. Methods: The study was conducted as a general literature review based on 14 articles which were quality examined and analysed. Results: Distraction as nursing intervention is of significance in immunization of schoolchildren. According to the result of the literature review distraction includes information/training, involvement, practice, environment adjustment, specific nursing, different form of support and medication. Discussion: Accordingto the result distractionis partly transmittable to similar situations such as venous sampling. Despite supporting evidence that distracting reduces pain and anxiety the interventions are not incorporated. Conclusion:The school nurse should identify the child’s needs and based on this select nursing intervention. The school nurse has to advocate good communication and trustful relation with the child. Immunization can then be conducted with decreased pain and anxiety.
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Dias, Vania Ferreira Gomes. "Avaliação da dor em crianças de 0 a 23 meses: em busca de elementos para o aprimoramento das práticas durante a vacinação." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/7/7141/tde-17082011-094918/.
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A vacinação ocupa um papel de destaque na prevenção de doenças e proteção da saúde, tanto no âmbito individual quanto coletivo. Contudo sua realização impõe uma série de condições desagradáveis, principalmente às crianças pequenas. Dentre os vários aspectos críticos que compõem os momentos de vacinação, destaca-se a dor provocada pela aplicação da vacina, por suas implicações para as crianças e seus familiares. Dado que o foco do atendimento nas Salas de Vacina está colocado, principalmente, sobre a vacina (preparação, aplicação, conservação, entre outros), outros aspectos críticos da vacinação das crianças não estão contemplados durante os atendimentos. Visando contribuir para a qualidade da assistência nas Salas de Vacina, este estudo busca levantar na literatura científica elementos que facilitem aos profissionais envolvidos no atendimento e na organização das Salas de Vacina, o reconhecimento da dor pela qual passam as crianças durante sua vacinação, através de instrumentos de avaliação. Para tal foi feita uma revisão da literatura, buscando instrumentos de avaliação de dor em crianças menores de dois anos. A busca foi estruturada a partir do acrônimo PICO em dez diferentes bases. Os descritores foram adaptados para atender às especificidades das mesmas e foi utilizado o Endnoteweb® para sistematização e compartilhamento das informações. Foram identificados 295 estudos entre 1993 e 2010 cujos resumos foram analisados e, aplicando-se os critérios de exclusão chegou-se a um conjunto de 24 artigos que foram lidos na íntegra. Tendo em vista a finalidade chegou-se a uma amostra final de 12 artigos que apresentavam 8 escalas. Constatou-se que as escalas mais adequadas para avaliação das crianças durante a vacinação são: MBPS, CHIPPS, NIPS e ABC. Estas escalas utilizam os parâmetros consagrados na literatura, em composições e especificações diferentes.Vaccination has an important role to prevent diseases and protect health, both for individuals and for collectives. However its implementation requires a series of unpleasant conditions, especially to small children. Among several critical aspects that are present at the time of vaccination, there is the pain caused by the adistration of vaccine, because of its implications for children and their families. Since the focus of attention in the rooms vaccine is placed primarily on the vaccine (preparation, implementation, maintenance, etc.), other critical aspects of vaccination of children are not covered during the sessions. To contribute to the quality of care in rooms vaccine, this study raises some elements in the scientific literature to facilitate the professionals involved in care and organization of rooms vaccine, the recognition of pain that children may have during their vaccination, through assessment instruments. It was developed a review of the literature, searching for tools to evaluate pain in children under two years. The search was structured from the acronym PICO in ten different bases. The descriptors were adapted to meet the specific needs of these and Endnoteweb© was used to systematize and share information. Were identified 295 studies between 1993 and 2010 whose abstracts were reviewed and, applying the exclusion criteria was reached at a sample of 24 articles that were read in full. Given the goal was reached a final sample of 12 articles that presented eight scales. It was found that the most appropriate scale for assessing children for vaccination are: MBPS, CHIPPS, NIPS and ABC using the parameters established in the literature with compositions and different specifications.
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Franco, Marília Miranda. "Idade com fator de risco para gravidade e complicações nos acidentes botrópicos atendidos no Hospital Vital Brazil do Instituto Butantan/SP." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5134/tde-17102014-150345/.
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Alguns estudos têm proposto que os acidente ofídicos em crianças estão associados a maior gravidade e ao maior risco de desenvolvimento de complicações comparados aos acidentes em adultos. Este estudo retrospectivo descreve as características de acidentes causados por serpentes do gênero Bothrops admitidos no Hospital Vital Brazil/Instituto Butantan/SP (HVB/IB) e compara a gravidade, e necessidade de soroterapia antiveneno e o risco para o desenvolvimento de complicações entre crianças (menores de 13 anos) e adultos. Trata-se de uma coorte histórica que utilizou dados de prontuários do arquivo do HVB/IB de dezembro de 1999 a junho de 2003. Foram incluídos no estudo pacientes que trouxeram a serpente ou apresentavam manifestações clínicas ou laboratoriais compatíveis com envenenamento botrópico. Não foi observada diferença estatisticamente significante na freqüência da gravidade dos envenenamentos, no número de ampolas administradas e na freqüência de complicações entre os dois grupos estudados. O estudo sugere que os acidentes ofídicos causados por serpentes do gênero Bothrops apresentam gravidade semelhante na avaliação admissional e evolução com a mesma proporção de complicações em crianças quando comparados aos acidentes em adultosSome studies propose that the level of severity of the accidents caused by snakes in children can be associated with a stronger envenoming and a higher risk of later complication if compared to the same accidents in adults. This retrospective study aim to describe the caracteristics of snakebites acidents of the genus Bothrops, and compare their severities, necessity of antivenom, and the risk of developing later complications between children (less than 13 years) and adults, all the accidents where admitted at Hospital Vital Brazil/Instituto Butantan/SP, Brazil (HVB). This retrospective cohort study was carried out by using HVB\'s records of snakebite victims, from December 1999 to June 2003. Patients included were those who brought the snake and/or have the clinical or laboratorial presence of abnormalities compatible with Bothrops envenoming. No statistic differences were found between the two groups of this study concerning the severity of envenoming, number of antivenom vials and the frequency of complications. This study suggests that snakebite accidents are similar between adults and children. Age is not supposed to be a predictor of complication in such accidents
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Huggins, Leslie Jane. "Immunization Status of NICU Graduates at a Tertiary Care Children's Hospital." BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/6333.
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The objectives of this study were to determine the current rates of immunization and identify variables associated with immunizations of NICU graduates who were 60 days of age or older at time of discharge. This is a descriptive pilot study utilizing retrospective paper chart review. The relationships between immunization status and study variables were examined using logistic regression. Of 43 infants discharged at least 60 days of age or older from the NICU, 74.4% were up to date for immunizations in accordance with AAP recommendations. Additional variables were not significant. Immunization needs to be a priority in order to give NICU infants every advantage regarding their future health status.
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Mcnair, Chauntel Mckenzie. "Factors Influencing Vaccination Decisions in African American Mothers of Preschool Age Children." Scholar Commons, 2013. https://scholarcommons.usf.edu/etd/5073.
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Rates and coverage levels of immunizations of African-American children are reduced compared to other races. Few studies have identified factors that influence vaccination decisions of African-American mothers. This study assessed the mothers' vaccination decisions using a self-administered questionnaire and a screening instrument for determining health literacy. This instrument is called Rapid Estimate of Adult Literacy in Medicine (REALM). The sample was 92 African American mothers, recruited from a large metropolitan church in Jacksonville, Florida, who had at least one child under the age of seven. A cross-sectional research design was used to administer survey instruments to identify and interpret parental barriers and decision-making regarding childhood vaccination. The results of this study showed that the there was a decrease in scores across the levels of education which indicated that education had a significant impact on the parental perception for the vaccination of their children. Interventions can now be tailored to improve the childhood immunization rates and provide a foundation for developing effective childhood vaccination educational materials for this population.
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Segraves, Laura J. "Improving Vaccination Compliance Among Amish Children in Knox County, Ohio." Otterbein University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1429908515.
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Mennuti-Washburn, Jean Eleanor. "Gate Control Theory and its Application in a Physical Intervention to Reduce Children's Pain during Immunization Injections." Digital Archive @ GSU, 2007. http://digitalarchive.gsu.edu/psych_theses/38.
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Vaccinations provide protection against deadly diseases and children are scheduled to receive many immunization injections before the age of six. However, painful procedures, such as immunizations cause negative short- and long-term consequences for children. The Gate Control Theory of Pain suggests that physical interventions may be helpful, but they have not yet been validated as an effective intervention to manage children’s acute pain. This randomized trial examined the effectiveness of the ShotBlocker®, a physical intervention designed to decrease children’s injection pain, in a sample of 89 4- to 12- year-old children receiving immunizations at a pediatric practice. An ANOVA revealed no significant effect of treatment group (Typical Care Control, Placebo, and ShotBlocker®) on any measure of child distress. Clinical and theoretical implications are discussed.
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Dicko, Alassane. "Le Traitement Intermittent Préventif comme stratégie de lutte contre le paludisme chez les enfants." Thesis, Bordeaux 2, 2010. http://www.theses.fr/2010BOR21767/document.
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Le paludisme est l’une des maladies infectieuses la plus fréquente au monde avec 40% de la population mondiale exposée. En dépit des stratégies actuelles de lutte notamment la prise en charge rapide des cas, l’utilisation de matériaux imprégnés et la pulvérisation intra domiciliaire d’insecticide, le paludisme reste une des premières causes de morbidité et de mortalité notamment en Afrique subsaharienne. Cette partie du monde totalise à elle seule plus de 90% des cas de décès par paludisme dont 88% chez les enfants de moins de moins de 5 ans. En absence de vaccin utilisable en santé publique, il y a donc un besoin urgent de trouver une stratégie efficiente et simple de contrôle du paludisme. Le traitement préventif intermittent (TPI) définie comme l’administration d’un antipaludique à dose curative à des intervalles de temps prédéfinis réduit l’incidence du paludisme et apparaît aujourd’hui comme une des stratégies les plus prometteuses. Cette stratégie couplée au Programme Elargi de Vaccination (PEV) chez les enfants de moins de 1 an réduit l’incidence du paludisme de 30%. Des résultats plus importants sont obtenus chez les enfants de 0 à 5 ans voire de 0 à 10 ans lorsque la stratégie est appliquée en ciblant la saison de transmission. Nos travaux de recherche au Mali ont porté sur :- l’impact de la mise en œuvre du TPI couplé à la vaccination du PEV (TPin) sur i) la résistance P. falciparum à la Sulfadoxine pyrimethamine (SP), ii) la couverture des vaccins du PEV, iii) le taux de mortalité des enfants âgés de 4 à 18 mois.- l’efficacité du TPI chez les enfants ciblant la saison de transmission (TPIe) dans un contexte de faible et de forte couverture en des Moustiquaires Imprégnés d’Insecticides (MII). Nos résultats ont montré qu’après une année de mise en œuvre à l’échelle du district sanitaire, le TPIn a entrainé une augmentation de la couverture des vaccins du PEV. Cette couverture était de 53% en zone de non-intervention contre 69.5% en zone d’intervention (p<0.01). Il y a eu une réduction de la mortalité globale de 27% (RR= 0,73, IC95% : 0,55-0,97, p=0,029) chez les enfants âgés de 4 à 18 mois. Les fréquences des marqueurs moléculaires de la résistance de P. falciparum à SP en début et en fin la mise en œuvre et entre la zone d’intervention et la zone de non –intervention après une année de mise en œuvre étaient similaires. Deux doses de SP données en TPI à 8 semaines d’ intervalle durant la saison de transmission réduit le taux d’incidence du paludisme pendant la saison de transmission de 69,4% chez les enfants de moins de 5 ans et de 63,4% chez les enfants de 5-10 ans dans un contexte de très faible utilisation de MII (<5%). Dans une autre étude que nous avons menée, le TPI avec SP + Amodiaquine (AQ) donné en 3 occasions à un mois d’ intervalle pendant la saison de transmission a réduit le taux d’ incidence du paludisme clinique non compliqué de 82% (IC à 95%: 78%– 85%; P<0.001) et les formes graves de paludisme de 87% (IC à 95% 42% – 99%, P=0.001) chez les enfants âgés de 3 à 59 mois en dépit un taux d’utilisation des MII de plus de 99%. Nous n’avons pas documenté d’événement indésirable grave lié à l’utilisation de la SP ou de la SP + AQ en TPI durant ces deux études. Nos résultats étayent la recommandation du TPI, ciblant la saison de transmission ou couplée au PEV, pour la lutte antipaludique chez les enfantsMalaria is one of the most common infectious diseases in the world and 40% of the world population is exposed to malaria. Despite the current control strategies such as rapid diagnosis and treatment of disease cases, use of insecticide impregnated materials and indoor residuals spraying with insecticides, malaria remained a main cause of morbidity and mortality particularly in sub Saharan Africa. More than 90% of the deaths due to malaria occurred in this region and 88% of these deaths occurred in children aged less than 5 years of age. In absence of vaccine that can be used in public health, there is an urgent need for a simple and efficient control strategy. Malaria intermittent preventive treatment (IPT) defined as the administration of curative dose of anti-malarial drug at predefined time intervals, appears as one of the most promising strategies. Given through the Expanded Program of Immunization (EPI), the strategy reduced the incidence of malaria by 30%. More drastic reductions were obtained in children aged 0-5 years and even 0-10 years when the malaria transmission season was targeted for the administration of the strategy. Our research work in Mali has assessed the following:- The impact of implementation of IPT administrated through EPI (IPTi) on: i) the resistance of P. falciparum to Sulfadoxine pyrimethamine (SP); ii) EPI vaccine coverage, and iii) mortality of children of 4-18 months of age. - The efficacy of IPT in children targeting the malaria transmission season (IPTe) in a context of low and high coverage of insecticide impregnated nets (ITN).We have found that the implementation of IPTi at the district level has resulted in an augmentation of the EPI vaccine coverage. The EPI vaccine coverage was 53% in the non-intervention zone compared to 69.5% in the intervention zone (p<0,01). There was a reduction in all cause mortality of 27% (RR= 0.73, 95% CI : 0.55-0.97, p=0.029) in children aged 4-18 months. The frequencies of molecular markers of the resistance of P. falciparum to SP were similar at the beginning and the end of the one year implementation period and between the intervention and non-intervention zones.Two doses of SP given at 8 weeks interval during the transmission season, reduced the incidence of malaria episodes during the transmission season by 69.4% in children aged less than 5 years and by 63.4% in children aged 5-10 years in a context of very low ITN use (<5%). In another study that we have conducted, IPT with SP + Amodiaquine (AQ) given at three occasions at one month interval during the transmission season reduced the incidence rate of clinical malaria by 82% (95% CI: 78%– 85%; P<0.001), and the incidence of severe and complicated malaria by 87% (95% IC 42% – 99%, P=0.001) in children aged 3 to 59 months of age despite an ITN use of greater than 99%.There was no serious adverse event related to the use of SP or SP+AQ in IPT during the two studies. Our results support the recommendation of IPT targeting the transmission season and IPT given through the EPI for malaria control in children
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Cabral, Ivna Costa. "Avaliação da rede de frio local do distrito sanitário III de João Pessoa - PB." Universidade Federal da Paraíba, 2013. http://tede.biblioteca.ufpb.br:8080/handle/tede/5114.
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Previous issue date: 2013-03-27Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
Immunization is a strategy of excellence in decreasing infant morbidity and mortality for immunopreventable diseases. The National Immunization Program is responsible for the standardization of the procedures to be adopted in the cold chain which aims to ensure the quality of immunobiological, keeping them at a temperature between +2 ° and +8 ° C. This study aimed to evaluate of local cold network of Family Health Units from Sanitary District III of the public health network in the city of João Pessoa - PB. This is a descriptive study with a quantitative approach, of normative-evaluative type, the items applied were: general aspects of vaccination room and cold network from the Supervision s Instrument of Immunization Rooms (PAISSV version 2.0, 2004) in 23 May and June 2012. Data were tabulated and analyzed using descriptive statistics. As a parameter for quality evaluation, 51 items were selected, where the positive responses obtained weight "1" and the negative "0", with subsequent summation of points and ranked according to a given score. The quality of cold network was evaluated between good and regular. It was found that 95,7% nursing technicians have training in vaccine, but 73.9% did not receive training in cold chain. In regards to the vaccination rooms: 30.4% were not exclusive to vaccination, 78.3% did not have adequate size and there was no protection against direct sunlight in 47.8% of the rooms, moreover, 95.7% had no air conditioning system. So, there is need on structural improvement in the local cold chain in intent to achieve the regulations established by the Health Ministry as well as systematic implementation of permanent education for professionals who work in the vaccination rooms.
O Programa Nacional de Imunização é o responsável pela normatização dos procedimentos a serem adotados na Rede de Frio, a qual tem como objetivo assegurar que todos os imunobiológicos oferecidos à população mantenham suas características iniciais, a fim de conferir imunidade, de forma segura para a população. Este estudo avaliou o serviço da Rede de Frio local do Distrito Sanitário III da rede pública de saúde do município João Pessoa PB. Trata-se de um estudo com abordagem quantitativa, descritivo, do tipo avaliativo-normativo; para avaliação da rede de frio, utilizou-se o instrumento do Programa de Avaliação do Instrumento de Supervisão de Salas de Vacinação (PAISSV versão 2.0, 2004). Participaram da pesquisa 23 salas de vacina das Unidades Isoladas de Saúde da Família do Distrito Sanitário III do município de João Pessoa. A coleta foi realizada, após aprovação pelo Comitê de Ética e Pesquisa do Centro de Ciências da Saúde da Universidade Federal da Paraíba entre maio e junho de 2012, utilizando os itens aspectos gerais da sala de vacina e rede de frio do questionário do PAISSV. Os dados foram tabulados e analisados no Programa Statistical Package Social Science 18.0 e analisados de forma quantitativa, utilizando estatística descritiva. Nas salas de vacina existem técnicos de enfermagem trabalhando sem capacitação específica; a estrutura física carece de manutenção e adequações para atender às normas; a temperatura do ambiente é inadequada; os refrigeradores mantêm boa manutenção, organização e registro da temperatura interna. Há necessidade implantação sistematizada da educação permanente e contínua para capacitar e atualizar os profissionais, assim como na melhoria estrutural da Rede de Frio Local a fim de atender às normativas preconizadas pelo Ministério da Saúde.
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Thomas, Gaëtan. "La routine vaccinale. Enquête sur un programme français de rationalisation par les nombres, 1949-1999." Thesis, Paris Sciences et Lettres (ComUE), 2018. http://www.theses.fr/2018PSLEH049/document.
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Cette thèse examine l’apport du travail statistique à la normalisation de la vaccination en France, des années 1950 au milieu des années 1990, une période au cours de laquelle la vaccination a fait l’objet de peu de controverses. Au moyen d’opérations statistiques de rationalisation, de régulation et de justification, l’épidémiologie (entendue comme un ensemble de pratiques plutôt qu’une discipline universitaire autonome) a largement contribué à maintenir cet état de fait – un processus que je qualifie de routinisation. L’enquête est construite sur des archives issues de diverses institutions, nationales et internationales, ainsi que sur une série d’entretiens avec les principaux acteurs du domaine. Elle éclaire le rôle d’un groupe d’épidémiologistes associés au Centre international de l’enfance (1949-1999), qui mit en œuvre un programme de rationalisation et de simplification de la vaccination. Dans cette période coloniale et postcoloniale, l’Afrique subsaharienne était un de leurs terrains de prédilection : ils y réalisèrent de nombreux essais, simultanément à leurs activités métropolitaines. L’implication de l’OMS dans le domaine de la vaccination a conforté la dimension internationale de cette routinisation : les épidémiologistes français se sont appropriés des opérations statistiques popularisées par Genève. À la fin de la période considérée, la controverse de la vaccination contre l’hépatite B a perturbé cette routinisation et mis en évidence un écart croissant entre les logiques de l’épidémiologie et l’expérience des individus vaccinés. Cette recherche éclaire d’une lumière nouvelle la façon dont l’intervention de santé publique la plus courante a été normalisée et gouvernée par des nombresThis dissertation studies the entanglement between statistical production and the normalization of immunization practices in France from the 1950s to the mid-1990s, a period during which immunization remained largely uncontroversial. By rationalizing, regulating, and justifying immunization, epidemiology (understood as a collection of practices, rather than a discrete academic discipline) has contributed greatly to this normalization – a process I term “routinization.” This research project is based on archival findings, both in France and internationally, as well as a series of interviews with significant actors in the field. It is primarily focused on a group of epidemiologists affiliated with the Centre international de l’enfance (French International Children’s Center, 1949-1999), whose mission was to rationalize and simplify immunization for children. Throughout the institution’s history, which overlaps with the late colonial period and the process of de-colonization, there is a significant engagement with Francophone Africa: numerous trials were carried out simultaneously in Sub-Saharan Africa and the Paris region. The transnational nature of this activity is also due, in part, to the involvement of the World Health Organization in matters of immunization – French epidemiologists appropriated calculations popularized on a global scale. At the end of the period in question, the Hepatitis B vaccine controversy disrupted the routinization process and shed light on the rising gap between the discourse and practice of epidemiology and the experience of vaccinated individuals. This study offers new insights into the role of numbers in the maintenance and governance of the most common public health intervention
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Hallock, Norma E. "Factors Influencing Parents' Decisions Regarding Immunization for their Children." 1987. https://scholarworks.umass.edu/theses/3216.
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The purpose of this research was to determine the factors motivating parents' decisions regarding immunizations for their children according to the recommended schedule of childhood immunizations (DTP, Polio and MMR). The health belief model was used as a basis for the theory. Likert scales were used for the independent variables of susceptibility, seriousness, benefits, barriers and external factors motivating decision. A convenience sample of 79 parents was chosen from those who bring their babies to Amherst Medical Associates for care. Parents were given a questionnaire that addressed concepts in the health belief model using the Likert scales, a true/false format was used to test parents' knowledge of the diseases and immunizations and demographic information was requested. The nurse practitioner or physician also completed a brief questionnaire regarding the child's health and immunization status. The hypotheses of parents immunizing on the recommended schedule and their perceptions of their child's susceptibility to the disease, benefits of the vaccine, barriers to immunizations, and external motivating factors were supported. Seriousness was not a motivating factor in decision making. Demographic variables also did not influence decision.
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Spice, Elizabeth Flannery Jeanne. "A comparison study of immunization adherence and case management." 2004. http://etd.lib.fsu.edu/theses/available/etd-07092004-185126.
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Thesis (M.S.)--Florida State University, 2004.Advisor: Dr. Jeanne Flannery, Florida State University, School of Nursing, Dept. of Graduate Studies. Title and description from dissertation home page (viewed Sept 27, 2004). Includes bibliographical references.
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Waanders, Patricia A. "Advanced practice nursing guidelines for the immunization of children with stable chronic illness a report submitted in partial fulfillment ... for the degree of Master of Science (Parent-Child Nursing) ... /." 1997. http://catalog.hathitrust.org/api/volumes/oclc/68799587.html.
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McCormick, Catherine Carol Flannery Jeanne. "A comparison of immunization adherence rates for indigent and non-indigent 2-year-olds." 2004. http://etd.lib.fsu.edu/theses/available/etd-04072004-210219.
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Thesis (M.S.)--Florida State University, 2004.Advisor: Dr. Jeanne Flannery, Florida State University, School of Nursing, Dept. of Graduate Studies. Title and description from dissertation home page (viewed June 21, 2004). Includes bibliographical references.
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Ara, Nighat. "Immunization status of children in Varanasi and Srinagar innovation of some simple education material for the improvement of the immunization status of children in both the study areas." Thesis, 1987. http://hdl.handle.net/2009/6110.
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Liu, Ding-Ping, and 劉定萍. "Benefits and Effectiveness of Pneumococcal Immunization Policies for Young Children in Taiwan." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/22007870796701445820.
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博士國立臺灣大學
健康政策與管理研究所
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Background: Invasive pneumococcal disease (IPD) is one of the leading causes for hospitalization and deaths among children and the elderly. Pneumococcal conjugate vaccine (PCV) has been introduced by Taiwan government for different target groups of children under 5 years of age since 2009. The effectiveness of the programs has not yet been evaluated. Objectives: 1. To evaluate the PCV coverage and effectiveness for children under 5 years of age; 2. To assess the effectiveness of one dose regimen of PCV for 2-5 years of age; 3. To evaluate the synergy effects for co-administration of PCV and influenza vaccine. Methods: 1. We analyzed long term trend of PCV coverage, IPD prevalence and medical utilization among children under 5 years of age in Taiwan by using CDC registration data and National Health Insurance claim data. 2. For children aged 2-5 years old in 2011-2012, we evaluated the one-dose regimen by comparing medical utilization between vaccinated and non-vaccinated groups. Propensity score matching (1:2) was used to increase the comparability of the two groups; the statistics methods used were generalized linear model with negative binomial regression and logarithmic link and gamma distribution. 3. For children under 5 years of age during 4 influenza seasons from 2009-2013, we classified the subjects into 4 groups: influenza vaccinated, 4-dose PCV vaccinated, both, or none, and compared the all-cause death and medical utilization. In addition, a cost-effectiveness analysis (CEA) was also conducted in this study. Results: 1. The number of IPD cases among children 2-5 years of age have decreased significantly since 2012 (p<.0001); the number of cases under 2 (p<.01) and 5-64 (p<.05) years old have also decreased since 2013. Compared with previous 8 years, pneumococcal infection related costs claimed for National Health Insurance among children 2-5 years of age in 2012 and 2013 decreased 17.5% and 30.3%, respectively. 2. OPD visits related to IPD in vaccinated group is 33% less than that of unvaccinated group (p<.001). Hospitalization related to IPD and pneumonia in vaccinated group is 70% and 31% less than that of unvaccinated group, respectively (p<.001); the cost related to IPD and pneumonia in vaccinated group is 32% and 17% (p<.001) less than unvaccinated group, respectively. 3. Compared with none-vaccinated groups, the three vaccinated groups were all with lower risks for hospitalization caused by pneumonia & flu, respiratory disease and acute otitis media (AOM). The risks of all-cause death of PCV and PCV+FLU groups during flu season were only 18% and 21% of the none vaccinated group, respectively (p<.0001). Nevertheless, there is no synergy effect for those receiving both PCV and flu vaccines. The three vaccination strategies were considered cost-effective with 1.74-1.91 Gross Domestic Product (GDP) per capita needed per life-year gained. The cost of PCV vaccination strategy was higher than influenza vaccination; yet it was still cost-effective with an incremental cost-effectiveness ratio (ICER) per life-year gained reached the WHO criterion. Conclusion: PCV vaccination programs for children were not only effective but also cost-effective; it’s worthy to be included in the national programs.
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Douba, Alfred. "An Analysis of Risk Factors for Incomplete Immunization for Children in Côte d’Ivoire: Examination of 1998-1999 and 2011-2012 Demographic and Health Survey Data." 2015. http://scholarworks.gsu.edu/iph_theses/375.
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Background: Immunization is said to be the most effective public health intervention to prevent morbidity, complications, and mortality due to infectious disease among children. Due to the importance of vaccination in terms of infectious disease prevention, in terms of high cost-effectiveness ratio, international organizations, governments, and donors have intensified efforts to increase immunization coverage globally. Despite the efforts, thousands of children remain unimmunized or not fully vaccinated worldwide.
Objective: To identify factors associated with incomplete immunization among children in Côte d’Ivoire.
Method:The 1998-1999 and 2011-2012 Côte d’Ivoire Demography and Health Survey (DHS) data were used in this study. The included 3878 children aged 12 to 59 months with 1326 children from 1998-1999 DHS, and 2552 children from 2011-2012 DHS. Descriptive analysis was performed. Spearman’s correlation coefficient was computed to examine the relationship between variables. Univariate analysis was performed to examine the association between the dependent variable (incomplete immunization) and each independent variable using logistic regression. Variables with a p-value less than .05 in the univariate analysis were included in the multivariate analysis. Multivariate analysis was performed to determine predictors of immunization status using logistic regression (stepwise method).
Results: About 42.7% and 50.1% of Côte d’Ivoire were not fully immunized in 1998-1999 and 2011-2012, respectively. Child birth place, mothers’ access to media, mothers’ literacy, place of residence, and religion were the best predictors of incomplete immunization.
Conclusion:Health authorities in Côte d’Ivoire should take into account these immunization status predictors in order to address the issue of incomplete immunization.
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"Policy implications of migration for immunization of Chinese children in Hong Kong and Shenzhen." Thesis, 2011. http://library.cuhk.edu.hk/record=b6075408.
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Fong, Hildy Felicia.Thesis (Ph.D.)--Chinese University of Hong Kong, 2011.
Includes bibliographical references (leaves 221-234).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstract and appendix also in Chinese.
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Mercae, Arlette. "From immunology to social policy : epistemology and ethics in the creation and administration of paediatric vaccines /." 2003. http://adt.lib.utas.edu.au/public/adt-TU20041117.161706.
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