Journal Article > ResearchFull Text
PLOS Glob Public Health. 26 September 2022; Volume 2 (Issue 9); e0001012.; DOI:10.1371/journal.pgph.0001012
Yakum MN, Funwie AD, Ajong AB, Tsafack M, Ze LEE, et al.
PLOS Glob Public Health. 26 September 2022; Volume 2 (Issue 9); e0001012.; DOI:10.1371/journal.pgph.0001012
Immunization is the most cost-effective health intervention in the world yet, vaccination uptake is still low with less than 50% of children aged 12–23 months fully vaccinated in Cameroon by 2018. The objective of this study was to estimate the burden of vaccine hesitancy associated with routine vaccines in Yaounde-Cameroon. A two-stage cross-sectional cluster survey was conducted in Yaoundé in November 2021, targeting parents/guardians of children 0–59 months. Clusters were selected with probability proportionate to size (PPS) and household’s selection done using a restricted sampling method. Data collection was done using an interviewer-administered questionnaire, “Core Closed Questions” and “Likert Scale Questions” proposed by the WHO Vaccine Hesitancy Technical Working Group in 2014. Vaccine hesitancy was analyzed as proportions of parent’s/guardian’s self-reported vaccine refusal or delay in vaccination with 95% confidence interval. This was stratified by household wealth level and tested using Chi-Square test to appreciate the effect of household wealth on vaccine hesitancy. A total of 529 participants were enrolled out of 708 visited, giving a non-response rate of 25%. In total, vaccine hesitancy was reported in 137(25.90[22.35–29.80] %), and oral polio vaccine(OPV) was the most affected vaccine with hesitancy of 10%. Vaccine hesitancy prevalence did not vary significantly across different households’ wealth levels (p-value = 0.3786). However, in wealthy households’ refusal of vaccines (14%) was less than in poorer households (20%). Lack of trust was reported as the leading cause of vaccine refusal (43%). Vaccine hesitancy prevalence in Yaounde is high and oral polio vaccine(OPV) was the most affected vaccine. The level of weath does not affect vaccine hesitancy and lack of trust was the leading cause of vaccine hesitancy related to routine immunization in Yaounde-Cameroon. We, recommend that the burden of vaccine hesitancy should be assessed at national scale and root causes investigated.
Journal Article > ResearchFull Text
PLOS One. 26 August 2022; Volume 17 (Issue 8); e0273515.; DOI:10.1371/journal.pone.0273515
Yakum MN, Funwie AD, Ajong AB, Tsafack M, Ze LEE, et al.
PLOS One. 26 August 2022; Volume 17 (Issue 8); e0273515.; DOI:10.1371/journal.pone.0273515
BACKGROUND
The routine vaccination card is an important health record for children, but recent findings suggest that vaccination card retention in Cameroon is low, varying from 29%-53%. The aim of this study was to assess factors associated with children’s routine vaccination card retention in Cameroon.
METHODS
This cross-sectional survey was conducted in Yaoundé in November 2021, targeting children aged 0–59 months. Participants were selected using a 2-stage systematic cluster sampling in which households were selected by a restricted sampling technique. Data were collected by interviewing the children’s parents/guardians, and a vaccination card was said to be retained if it was presented to the interviewer by the interviewees. Data were analysed using multiple logistics regression with R version 4.1.0 (2021-05-18).
FINDINGS
A total of 529 households were assessed with 361 children aged 0–59 months enrolled: 51% girls and 49% boys. Children aged 0–11 months represented 24.4% of all participants, and children aged 12–59 months were 74.6%. Vaccination card retention was 24% (87), and positive predictors of card retention included: girl child (adjusted Odds Ratio = 1.34, p-value = 0.0269), the respondent being one of the biological parents of the child: mother (adjusted Odds Ratio = 5.97, p-value = 0.0034) or father(adjusted Odds Ratio = 4.69, p-value = 0.0067), and living in a richer household (adjusted Odds Ratio = 1.56, p-value = 0.038). On the other hand, negative predictors of card retention were: child aged 12–23 months (adjusted Odds Ratio = 0.44, p-value = 0.0209) or aged 24-59months (adjusted Odds Ratio = 0.13, p-value = 0.0000), and having an employed mother (adjusted Odds Ratio = 0.34, p-value = 0.0066).
CONCLUSION
Vaccination card retention in children aged 0–59 months in Yaoundé is low when compared with findings reported by studies from other locations in Cameroon. Besides, the poor and older children have lower odds of keeping routine vaccination cards. There is a need to design interventions to improve vaccination card retention, which considers household wealth and the age of the child.
The routine vaccination card is an important health record for children, but recent findings suggest that vaccination card retention in Cameroon is low, varying from 29%-53%. The aim of this study was to assess factors associated with children’s routine vaccination card retention in Cameroon.
METHODS
This cross-sectional survey was conducted in Yaoundé in November 2021, targeting children aged 0–59 months. Participants were selected using a 2-stage systematic cluster sampling in which households were selected by a restricted sampling technique. Data were collected by interviewing the children’s parents/guardians, and a vaccination card was said to be retained if it was presented to the interviewer by the interviewees. Data were analysed using multiple logistics regression with R version 4.1.0 (2021-05-18).
FINDINGS
A total of 529 households were assessed with 361 children aged 0–59 months enrolled: 51% girls and 49% boys. Children aged 0–11 months represented 24.4% of all participants, and children aged 12–59 months were 74.6%. Vaccination card retention was 24% (87), and positive predictors of card retention included: girl child (adjusted Odds Ratio = 1.34, p-value = 0.0269), the respondent being one of the biological parents of the child: mother (adjusted Odds Ratio = 5.97, p-value = 0.0034) or father(adjusted Odds Ratio = 4.69, p-value = 0.0067), and living in a richer household (adjusted Odds Ratio = 1.56, p-value = 0.038). On the other hand, negative predictors of card retention were: child aged 12–23 months (adjusted Odds Ratio = 0.44, p-value = 0.0209) or aged 24-59months (adjusted Odds Ratio = 0.13, p-value = 0.0000), and having an employed mother (adjusted Odds Ratio = 0.34, p-value = 0.0066).
CONCLUSION
Vaccination card retention in children aged 0–59 months in Yaoundé is low when compared with findings reported by studies from other locations in Cameroon. Besides, the poor and older children have lower odds of keeping routine vaccination cards. There is a need to design interventions to improve vaccination card retention, which considers household wealth and the age of the child.
Journal Article > Pre-PrintFull Text
medRxiv. 21 February 2022; DOI:10.1101/2022.02.17.22271108
Yakum MN, Funwie AD, Ajong AB, Tsafack M, Ebaze LE, et al.
medRxiv. 21 February 2022; DOI:10.1101/2022.02.17.22271108
Immunization is the most cost-effective health intervention in the world yet, vaccination uptake is still low with less than 50% of children aged 12-23 months fully vaccinated Cameroon. The objective of this study was to estimate the burden of vaccine hesitancy associated with routine EPI vaccines in Yaounde-Cameroon. A two-stage cross-sectional cluster survey was conducted in Yaoundé in May-June 2022, targeting parents/guardians of children 0-59 months. Clusters were selected with probability proportionate to size (PPS) and household’s selection done using a restricted sampling method. Data collection was done using an interviewer-administered questionnaire. Data were cleaned using MS-Excel 2019, and analyzed with R version 4.1.0 (2021-05-18). A total of 529 participants were enrolled out of 708 visited, giving a non-response rate of 25%. In total, vaccine hesitancy was reported in 137(25.90[22.35-29.80] %), and vaccine hesitancy prevalence did not vary significantly across different households’ wealth levels (p-value= 0.3786). However, in wealthy households’ refusal of vaccines (14%) was less than in poorer households (20%). Lack of trust, confidence, and perceived complacency are the leading causes of vaccine hesitancy related to routine immunization in Yaounde-Cameroon. We, therefore, recommend that the burden of vaccine hesitancy should be assessed at national scale and identify sources of misinformation that are at the origin of vaccine hesitancy. Having a clear notion of the effect of social media(Facebook, Instagram, WhatsApp, etc,), radio, TV, and other information sources might guide interventions to combat vaccine hesitancy.
Journal Article > Pre-Print
medRxiv. 21 February 2022; DOI:10.1101/2022.02.17.22271070
Yakum MN, Funwie AD, Tsafack M, Ebaze LE, Ajong AB, et al.
medRxiv. 21 February 2022; DOI:10.1101/2022.02.17.22271070
OBJECTIVE
The objective of this study was to determine the validity of parent’s recall for immunization using the vaccination card as the reference in Yaounde-Cameroon.
SETTINGS
This study was a communitybased study in all the 6 health districts in Yaounde, Cameroon
PARTICIPANTS
The study targeting parents of children aged 0-59months who had their children’s vaccination cards. The immunization history of each child was taken based on both parent’s recall and vaccination card. Using the vaccination card as a reference, the sensitivity, specificity, positive predictive value and negative predictive value of parent’s recall were calculated. The degree of agreement and the kappa statistics between the two methods were calculated using R version 4.1.0 (2021-05-18).
RESULTS
A total of 529 households were visited and 87 eligible parents enrolled. Approximately 55.2% of the 27 children were girls and 53% of them were aged 12-59 months. In total, 94.25% of the participants enrolled were one of the biological parents of the children, with mothers making the majority 86.20% of participants. When combined for all vaccines, the sensitivity, specificity, positive predictive value, and negative predictive value of parent’s recall were 63%, 60%, 90%, and 23% respectively. The degree of agreement between the two sources was highest for BCG(94%) and lowest with Polio2(32%). Parent’s recall(94%) was most likely to correctly predict BCG vaccination status of a child than using the scars on the forarm(74%).
CONCLUSION
Our conclusion is that validity and reliability of parent’s recall vary a lot across different vaccines and parent’s recall is not very reliable for immunization status assessment in children. Parent’s recall is preferred for verifying BCG immunization to scars on the forarm. In general, we recommend that parent’s recall for routine immunization should be used only as a last resort or for BCG, and measles and Yellow Fever vaccines.
The objective of this study was to determine the validity of parent’s recall for immunization using the vaccination card as the reference in Yaounde-Cameroon.
SETTINGS
This study was a communitybased study in all the 6 health districts in Yaounde, Cameroon
PARTICIPANTS
The study targeting parents of children aged 0-59months who had their children’s vaccination cards. The immunization history of each child was taken based on both parent’s recall and vaccination card. Using the vaccination card as a reference, the sensitivity, specificity, positive predictive value and negative predictive value of parent’s recall were calculated. The degree of agreement and the kappa statistics between the two methods were calculated using R version 4.1.0 (2021-05-18).
RESULTS
A total of 529 households were visited and 87 eligible parents enrolled. Approximately 55.2% of the 27 children were girls and 53% of them were aged 12-59 months. In total, 94.25% of the participants enrolled were one of the biological parents of the children, with mothers making the majority 86.20% of participants. When combined for all vaccines, the sensitivity, specificity, positive predictive value, and negative predictive value of parent’s recall were 63%, 60%, 90%, and 23% respectively. The degree of agreement between the two sources was highest for BCG(94%) and lowest with Polio2(32%). Parent’s recall(94%) was most likely to correctly predict BCG vaccination status of a child than using the scars on the forarm(74%).
CONCLUSION
Our conclusion is that validity and reliability of parent’s recall vary a lot across different vaccines and parent’s recall is not very reliable for immunization status assessment in children. Parent’s recall is preferred for verifying BCG immunization to scars on the forarm. In general, we recommend that parent’s recall for routine immunization should be used only as a last resort or for BCG, and measles and Yellow Fever vaccines.