Assessing parents’ knowledge and attitudes towards seasonal influenza vaccination of children before and after a seasonal influenza vaccination effectiveness study in low-income urban and rural Kenya, 2010–2011

BMC Public Health

Mark A Katz¹  Robert F Breiman³  David Mutonga²  Nancy Otieno³  Philip Muthoka²  Gideon Emukule³  Joshua M Wong³  Emmaculate Lebo³  Geoffrey Arunga³  Prisca Adhiambo Oria³ 

[1] Centers for Disease Control and Prevention, Atlanta, GA, USA;Ministry of Public Health and Sanitation, Nairobi, Kenya;Kenya Medical Research Institute/Centers for Disease Control and Prevention (KEMRI/CDC), Nairobi, Kenya

关键词: Kenya;    Low-income;    Children;    Parent;    Attitude;    Vaccination;    Seasonal influenza;   

Others  :  1162290
DOI  :  10.1186/1471-2458-13-391

 received in 2012-06-26, accepted in 2013-04-22,  发布年份 2013

【 摘 要 】

Background

Influenza vaccine is rarely used in Kenya, and little is known about attitudes towards the vaccine. From June-September 2010, free seasonal influenza vaccine was offered to children between 6 months and 10 years old in two Population-Based Infectious Disease Surveillance (PBIDS) sites. This survey assessed attitudes about influenza, uptake of the vaccine and experiences with childhood influenza vaccination.

Methods

We administered a questionnaire and held focus group discussions with parents of children of enrollment age in the two sites before and after first year of the vaccine campaign. For pre-vaccination focus group discussions, we randomly selected mothers and fathers who had an eligible child from the PBIDS database to participate. For the post-vaccination focus group discussions we stratified parents whose children were eligible for vaccination into fully vaccinated, partially vaccinated and non-vaccinated groups.

Results

Overall, 5284 and 5755 people completed pre and post-vaccination questionnaires, respectively, in Kibera and Lwak. From pre-vaccination questionnaire results, among parents who were planning on vaccinating their children, 2219 (77.6%) in Kibera and 1780 (89.6%) in Lwak said the main reason was to protect the children from seasonal influenza. In the pre-vaccination discussions, no parent had heard of the seasonal influenza vaccine. At the end of the vaccine campaign, of 18,652 eligible children, 5,817 (31.2%) were fully vaccinated, 2,073 (11.1%) were partially vaccinated and, 10,762 (57.7%) were not vaccinated. In focus group discussions, parents who declined vaccine were concerned about vaccine safety or believed seasonal influenza illness was not severe enough to warrant vaccination. Parents who declined the vaccine were mainly too busy [251(25%) in Kibera and 95 (10.5%) in Lwak], or their child was away during the vaccination period [199(19.8%) in Kibera; 94(10.4%) in Lwak].

Conclusion

If influenza vaccine were to be introduced more broadly in Kenya, effective health messaging will be needed on vaccine side effects and frequency and potential severity of influenza infection.

【 授权许可】

   
2013 Oria et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Izurieta HS, Thompson WW, Kramarz P: Influenza and the rates of hospitalization for respiratory disease among infants and young children. N Engl J Med 2000, 342(4):232-239.
• [2]Neuzil KM, Mellen BG, Wright PF, Mitchel EF Jr, Griffin MR: The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med 2000, 342(4):225-231.
• [3]Longini IM Jr, Koopman JS, Monto AS, Fox JP: Estimating household and community transmission parameters for influenza. Am J Epidemiol 1982, 115(5):736-751.
• [4]Fox JP, Hall CE, Cooney MK, Foy HM: Influenzavirus infections in Seattle families, 1975–1979. I. Study design, methods and the occurrence of infections by time and age. Am J Epidemiol 1982, 116(2):212-227.
• [5]Viboud C, Boelle PY, Cauchemez S: Risk factors of influenza transmission in households. Br J Gen Pract 2004, 54(506):684-689.
• [6]Clark TW, Pareek M, Hoschler K: Trial of 2009 influenza A (H1N1) monovalent MF59-adjuvanted vaccine. N Engl J Med 2009, 361(25):2424-2435.
• [7]Gavazzi G: Influenza vaccination for healthcare workers: from a simple concept to a resistant issue? Aging Clin Exp Res 2009, 21(3):216-221.
• [8]Maltezou HC, Drancourt M: Nosocomial influenza in children. J Hosp Infect 2003, 55(2):83-91.
• [9]Fitch P, Racine A: Parental beliefs about vaccination among an ethnically diverse inner-city population. J Natl Med Assoc 2004, 96(8):1047-1050.
• [10]Humiston SG, Lerner EB, Hepworth E, Blythe T, Goepp JG: Parent opinions about universal influenza vaccination for infants and toddlers. Arch Pediatr Adolesc Med 2005, 159(2):108-112.
• [11]Harris KM, Maurer J, Kellermann AL: Influenza vaccine–safe, effective, and mistrusted. N Engl J Med 2010, 363(23):2183-2185.
• [12]Gazmararian JA, Orenstein W, Prill M: Maternal knowledge and attitudes toward influenza vaccination: a focus group study in metropolitan Atlanta. Clin Pediatr 2010, 49(11):1018-1025.
• [13]Gachara G, Ngeranwa J, Magana JM: Influenza virus strains in Nairobi, Kenya. J Clin Virol 2006, 35(1):117-118.
• [14]Katz MA, Lebo E, Emukule G: Epidemiology, seasonality, and burden of influenza and influenza-like illness in urban and rural Kenya, 2007–2010. J Infect Dis 2012, 206(Suppl 1):S53-S60.
• [15]Feikin DR, Olack B, Bigogo GM: The burden of common infectious disease syndromes at the clinic and household level from population-based surveillance in rural and urban Kenya. PLoS One 2011, 6(1):e16085.
• [16]Salmon DA, Moulton LH, Omer SB, DeHart MP, Stokley S, Halsey NA: Factors associated with refusal of childhood vaccines among parents of school-aged children: a case–control study. Arch Pediatr Adolesc Med 2005, 159(5):470-476.
• [17]Freed GL, Clark SJ, Butchart AT, Singer DC, Davis MM: Parental vaccine safety concerns in 2009. Pediatrics 2010, 125(4):654-659.
• [18]Downs JS, de Bruin WB, Fischhoff B: Parents’ vaccination comprehension and decisions. Vaccine 2008, 26(12):1595-1607.
• [19]Oria PA, Matini W, Nelligan I: Are Kenyan healthcare workers willing to receive the pandemic influenza vaccine? Results from a cross-sectional survey of healthcare workers in Kenya about knowledge, attitudes and practices concerning infection with and vaccination against 2009 pandemic influenza A (H1N1), 2010. Vaccine 2011, 29(19):3617-3622.
• [20]Goodman MJ, Nordin JD, Harper P, Defor T, Zhou X: The safety of trivalent influenza vaccine among healthy children 6 to 24 months of age. Pediatrics 2006, 117(5):e821-e826.
• [21]Zangwill KM, Belshe RB: Safety and efficacy of trivalent inactivated influenza vaccine in young children: a summary for the new era of routine vaccination. Pediatr Infect Dis J 2004, 23(3):189-197.
• [22]Lowen AC, Mubareka S, Steel J, Palese P: Influenza virus transmission is dependent on relative humidity and temperature. PLoS pathogens 2007, 3(10):1470-1476.
• [23]Hajat S, Haines A: Associations of cold temperatures with GP consultations for respiratory and cardiovascular disease amongst the elderly in London. Int J Epidemiol 2002, 31(4):825-830.
• [24]Osoro EM, Munyua P, Muthoka P: Hospitalized patients with pandemic (H1N1) 2009, Kenya. Emerg Infect Dis 2011, 17(9):1744-1746.
• [25]Archer B, Cohen C, Naidoo D: Interim report on pandemic H1N1 influenza virus infections in South Africa, April to October 2009: epidemiology and factors associated with fatal cases. Euro Surveill: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 2009., 14(42)
• [26]Echevarria-Zuno S, Mejia-Arangure JM, Mar-Obeso AJ: Infection and death from influenza A H1N1 virus in Mexico: a retrospective analysis. Lancet 2009, 374(9707):2072-2079.
• [27]Louie JK, Schechter R, Honarmand S: Severe pediatric influenza in California, 2003–2005: implications for immunization recommendations. Pediatrics 2006, 117(4):e610-e618.