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Tracking Demographic Movements and Immunization Status to Improve Children’s Access to Immunization: Field-Based Randomized Controlled Trial

BACKGROUND: Countries’ Expanded Program on Immunization (EPI) contribute to the reduction of mortality and morbidity, but access to these vaccines remains limited in most low-income countries. OBJECTIVE: We aim to assess whether involving community volunteers (CVs) to track children’s vaccination st...

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Autores principales: Ateudjieu, Jérôme, Tchio-Nighie, Ketina Hirma, Goura, André Pascal, Ndinakie, Martin Yakum, Dieffi Tchifou, Miltiade, Amada, Lapia, Tsafack, Marcelin, Kiadjieu Dieumo, Frank Forex, Guenou, Etienne, Nangue, Charlette, Kenfack, Bruno
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8924776/
https://www.ncbi.nlm.nih.gov/pubmed/35230249
http://dx.doi.org/10.2196/32213
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author Ateudjieu, Jérôme
Tchio-Nighie, Ketina Hirma
Goura, André Pascal
Ndinakie, Martin Yakum
Dieffi Tchifou, Miltiade
Amada, Lapia
Tsafack, Marcelin
Kiadjieu Dieumo, Frank Forex
Guenou, Etienne
Nangue, Charlette
Kenfack, Bruno
author_facet Ateudjieu, Jérôme
Tchio-Nighie, Ketina Hirma
Goura, André Pascal
Ndinakie, Martin Yakum
Dieffi Tchifou, Miltiade
Amada, Lapia
Tsafack, Marcelin
Kiadjieu Dieumo, Frank Forex
Guenou, Etienne
Nangue, Charlette
Kenfack, Bruno
author_sort Ateudjieu, Jérôme
collection PubMed
description BACKGROUND: Countries’ Expanded Program on Immunization (EPI) contribute to the reduction of mortality and morbidity, but access to these vaccines remains limited in most low-income countries. OBJECTIVE: We aim to assess whether involving community volunteers (CVs) to track children’s vaccination status and demographic movements and using recorded data to plan catch-up immunization sessions can improve children’s vaccination timeliness, completeness, and coverage. METHODS: This was a field-based randomized controlled trial and communities of the Foumban health district in West Cameroon were allocated to intervention or control groups. In the intervention group, a CV per community was trained to visit households monthly for a year to assess and record in a register, details of EPI-targeted children, their demographic movements and immunization status. The scanned recorded pages were sent to the health center immunization team through WhatsApp and used to organize monthly community catch-up immunization sessions. In the control group, EPI vaccination sessions were routinely conducted. Surveys were conducted at 6 and 12 months from the beginning of the intervention in both study groups to assess and compare immunization timeliness, coverage, and completeness. RESULTS: Overall, 30 buildings per cluster were surveyed at midline and endline. Of the 633 and 729 visited households in the intervention group at midline and endline, 630 (99.5%) and 718 (98.4%), respectively, consented to participate. In the control group, 507 and 651 households were visited and 505 (99.6%) and 636 (97.7%), respectively, consented to participate. At 12 months intervention, the month one timeliness of bacille Calmette–Guerin (BCG) vaccine did not increase in the intervention group compared with the control group for the age groups 0-11 months (adjusted odds ratio [aOR] 1.1, 95% CI 0.7-1.8) and 0-59 months (aOR 1.1, 95% CI 0.9-1.4), and significantly increased for the first-year BCG vaccine administration for the age group 0-23 months (aOR 1.5, 95% CI 1.1-2.2). The coverage of diphtheria-pertussis-tetanus and hepatitis B+Hemophilus influenzae type B (DPT-Hi +Hb) dose 3 (aOR 2.0, 95% CI 1.5-2.7) and of DPT-Hi+Hb dose 1 (aOR 1.8, 95% CI 1.4-2.4) vaccines increased significantly in the intervention group compared with the control group in the age groups 12-59 months and 12-23 months, respectively. Specific (DPT-Hi+Hb dose 1 to DPT-Hi+Hb dose 3: aOR 1.9, 95% CI 1.4-2.6) and general (BCG to measles: aOR 1.5, 95% CI 1.1-2.1) vaccine completeness increased significantly in the intervention group compared with the control group. CONCLUSIONS: Findings support that involving CVs to track children’s vaccination status and demographic movements and using recorded data to plan catch-up immunization sessions improve children’s vaccination timeliness, completeness, and coverage. This strategy should be adopted to improve access to vaccination for EPI target populations and the consistency verified in other contexts. TRIAL REGISTRATION: Pan African Clinical Trials Registry PACTR201808527428720; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3548
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spelling pubmed-89247762022-03-17 Tracking Demographic Movements and Immunization Status to Improve Children’s Access to Immunization: Field-Based Randomized Controlled Trial Ateudjieu, Jérôme Tchio-Nighie, Ketina Hirma Goura, André Pascal Ndinakie, Martin Yakum Dieffi Tchifou, Miltiade Amada, Lapia Tsafack, Marcelin Kiadjieu Dieumo, Frank Forex Guenou, Etienne Nangue, Charlette Kenfack, Bruno JMIR Public Health Surveill Original Paper BACKGROUND: Countries’ Expanded Program on Immunization (EPI) contribute to the reduction of mortality and morbidity, but access to these vaccines remains limited in most low-income countries. OBJECTIVE: We aim to assess whether involving community volunteers (CVs) to track children’s vaccination status and demographic movements and using recorded data to plan catch-up immunization sessions can improve children’s vaccination timeliness, completeness, and coverage. METHODS: This was a field-based randomized controlled trial and communities of the Foumban health district in West Cameroon were allocated to intervention or control groups. In the intervention group, a CV per community was trained to visit households monthly for a year to assess and record in a register, details of EPI-targeted children, their demographic movements and immunization status. The scanned recorded pages were sent to the health center immunization team through WhatsApp and used to organize monthly community catch-up immunization sessions. In the control group, EPI vaccination sessions were routinely conducted. Surveys were conducted at 6 and 12 months from the beginning of the intervention in both study groups to assess and compare immunization timeliness, coverage, and completeness. RESULTS: Overall, 30 buildings per cluster were surveyed at midline and endline. Of the 633 and 729 visited households in the intervention group at midline and endline, 630 (99.5%) and 718 (98.4%), respectively, consented to participate. In the control group, 507 and 651 households were visited and 505 (99.6%) and 636 (97.7%), respectively, consented to participate. At 12 months intervention, the month one timeliness of bacille Calmette–Guerin (BCG) vaccine did not increase in the intervention group compared with the control group for the age groups 0-11 months (adjusted odds ratio [aOR] 1.1, 95% CI 0.7-1.8) and 0-59 months (aOR 1.1, 95% CI 0.9-1.4), and significantly increased for the first-year BCG vaccine administration for the age group 0-23 months (aOR 1.5, 95% CI 1.1-2.2). The coverage of diphtheria-pertussis-tetanus and hepatitis B+Hemophilus influenzae type B (DPT-Hi +Hb) dose 3 (aOR 2.0, 95% CI 1.5-2.7) and of DPT-Hi+Hb dose 1 (aOR 1.8, 95% CI 1.4-2.4) vaccines increased significantly in the intervention group compared with the control group in the age groups 12-59 months and 12-23 months, respectively. Specific (DPT-Hi+Hb dose 1 to DPT-Hi+Hb dose 3: aOR 1.9, 95% CI 1.4-2.6) and general (BCG to measles: aOR 1.5, 95% CI 1.1-2.1) vaccine completeness increased significantly in the intervention group compared with the control group. CONCLUSIONS: Findings support that involving CVs to track children’s vaccination status and demographic movements and using recorded data to plan catch-up immunization sessions improve children’s vaccination timeliness, completeness, and coverage. This strategy should be adopted to improve access to vaccination for EPI target populations and the consistency verified in other contexts. TRIAL REGISTRATION: Pan African Clinical Trials Registry PACTR201808527428720; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3548 JMIR Publications 2022-03-01 /pmc/articles/PMC8924776/ /pubmed/35230249 http://dx.doi.org/10.2196/32213 Text en ©Jérôme Ateudjieu, Ketina Hirma Tchio-Nighie, André Pascal Goura, Martin Yakum Ndinakie, Miltiade Dieffi Tchifou, Lapia Amada, Marcelin Tsafack, Frank Forex Kiadjieu Dieumo, Etienne Guenou, Charlette Nangue, Bruno Kenfack. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 01.03.2022. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on https://publichealth.jmir.org, as well as this copyright and license information must be included.
spellingShingle Original Paper
Ateudjieu, Jérôme
Tchio-Nighie, Ketina Hirma
Goura, André Pascal
Ndinakie, Martin Yakum
Dieffi Tchifou, Miltiade
Amada, Lapia
Tsafack, Marcelin
Kiadjieu Dieumo, Frank Forex
Guenou, Etienne
Nangue, Charlette
Kenfack, Bruno
Tracking Demographic Movements and Immunization Status to Improve Children’s Access to Immunization: Field-Based Randomized Controlled Trial
title Tracking Demographic Movements and Immunization Status to Improve Children’s Access to Immunization: Field-Based Randomized Controlled Trial
title_full Tracking Demographic Movements and Immunization Status to Improve Children’s Access to Immunization: Field-Based Randomized Controlled Trial
title_fullStr Tracking Demographic Movements and Immunization Status to Improve Children’s Access to Immunization: Field-Based Randomized Controlled Trial
title_full_unstemmed Tracking Demographic Movements and Immunization Status to Improve Children’s Access to Immunization: Field-Based Randomized Controlled Trial
title_short Tracking Demographic Movements and Immunization Status to Improve Children’s Access to Immunization: Field-Based Randomized Controlled Trial
title_sort tracking demographic movements and immunization status to improve children’s access to immunization: field-based randomized controlled trial
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8924776/
https://www.ncbi.nlm.nih.gov/pubmed/35230249
http://dx.doi.org/10.2196/32213
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