Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar.
<h4>Background</h4>Recent research in two cholera-endemic communities of Zanzibar has shown that a majority (∼94%) of the adult population was willing to receive free oral cholera vaccines (OCVs). Since OCV uptake in the 2009 campaign reached only ∼50% in these communities, an evaluation...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2012-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22844489/?tool=EBI |
| _version_ | 1818435276311101440 |
|---|---|
| author | Christian Schaetti Said M Ali Claire-Lise Chaignat Ahmed M Khatib Raymond Hutubessy Mitchell G Weiss |
| author_facet | Christian Schaetti Said M Ali Claire-Lise Chaignat Ahmed M Khatib Raymond Hutubessy Mitchell G Weiss |
| author_sort | Christian Schaetti |
| collection | DOAJ |
| description | <h4>Background</h4>Recent research in two cholera-endemic communities of Zanzibar has shown that a majority (∼94%) of the adult population was willing to receive free oral cholera vaccines (OCVs). Since OCV uptake in the 2009 campaign reached only ∼50% in these communities, an evaluation of social and cultural factors and of barriers was conducted to understand this difference for future cholera control planning.<h4>Methodology/principal findings</h4>A random sample of 367 adult peri-urban and rural community residents (46.6% immunized vs. 53.4% unimmunized) was studied with a semi-structured interview that inquired about social and cultural features of cholera depicted in a vignette and barriers to OCV uptake. Symptoms (rectal pain, loose skin only in rural community) and perceived causes (uncovered food, contact with contaminated water) specific for severe diarrhea were associated with uptake. Purchasing drugs from pharmacies to stop diarrhea and vomiting was negatively associated with uptake. Increasing household size, age and previous enteric illness episode were positively related to uptake, the latter only at the rural site. The most prominent barrier to uptake was competing obligations or priorities (reported by 74.5%, identified as most important barrier by 49.5%). Next most prominent barriers were lacking information about the campaign (29.6%, 12.2%), sickness (14.3%, 13.3%) and fear of possible vaccine side effects (15.3%, 5.6%). The majority of unvaccinated respondents requested repetition of the vaccination with free OCVs.<h4>Conclusions/significance</h4>Factors associated with uptake indicated a positive impact of the vaccination campaign and of sensitization activities on vaccine acceptance behavior. Unlike communities opposed to cholera control or settings where public confidence in vaccines is lacking, identified barriers to uptake indicated a good campaign implementation and trust in the health system. Despite prospects and demand for repeating the vaccination, local decision-makers should reconsider how careful logistical arrangements may improve community coverage and thus effectiveness of vaccination campaigns. |
| first_indexed | 2024-12-14T16:50:19Z |
| format | Article |
| id | doaj.art-7b187caee1624d3ba0828b690e12d45c |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-14T16:50:19Z |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-7b187caee1624d3ba0828b690e12d45c2022-12-21T22:54:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0177e4152710.1371/journal.pone.0041527Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar.Christian SchaettiSaid M AliClaire-Lise ChaignatAhmed M KhatibRaymond HutubessyMitchell G Weiss<h4>Background</h4>Recent research in two cholera-endemic communities of Zanzibar has shown that a majority (∼94%) of the adult population was willing to receive free oral cholera vaccines (OCVs). Since OCV uptake in the 2009 campaign reached only ∼50% in these communities, an evaluation of social and cultural factors and of barriers was conducted to understand this difference for future cholera control planning.<h4>Methodology/principal findings</h4>A random sample of 367 adult peri-urban and rural community residents (46.6% immunized vs. 53.4% unimmunized) was studied with a semi-structured interview that inquired about social and cultural features of cholera depicted in a vignette and barriers to OCV uptake. Symptoms (rectal pain, loose skin only in rural community) and perceived causes (uncovered food, contact with contaminated water) specific for severe diarrhea were associated with uptake. Purchasing drugs from pharmacies to stop diarrhea and vomiting was negatively associated with uptake. Increasing household size, age and previous enteric illness episode were positively related to uptake, the latter only at the rural site. The most prominent barrier to uptake was competing obligations or priorities (reported by 74.5%, identified as most important barrier by 49.5%). Next most prominent barriers were lacking information about the campaign (29.6%, 12.2%), sickness (14.3%, 13.3%) and fear of possible vaccine side effects (15.3%, 5.6%). The majority of unvaccinated respondents requested repetition of the vaccination with free OCVs.<h4>Conclusions/significance</h4>Factors associated with uptake indicated a positive impact of the vaccination campaign and of sensitization activities on vaccine acceptance behavior. Unlike communities opposed to cholera control or settings where public confidence in vaccines is lacking, identified barriers to uptake indicated a good campaign implementation and trust in the health system. Despite prospects and demand for repeating the vaccination, local decision-makers should reconsider how careful logistical arrangements may improve community coverage and thus effectiveness of vaccination campaigns.https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22844489/?tool=EBI |
| spellingShingle | Christian Schaetti Said M Ali Claire-Lise Chaignat Ahmed M Khatib Raymond Hutubessy Mitchell G Weiss Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar. PLoS ONE |
| title | Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar. |
| title_full | Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar. |
| title_fullStr | Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar. |
| title_full_unstemmed | Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar. |
| title_short | Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar. |
| title_sort | improving community coverage of oral cholera mass vaccination campaigns lessons learned in zanzibar |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22844489/?tool=EBI |
| work_keys_str_mv | AT christianschaetti improvingcommunitycoverageoforalcholeramassvaccinationcampaignslessonslearnedinzanzibar AT saidmali improvingcommunitycoverageoforalcholeramassvaccinationcampaignslessonslearnedinzanzibar AT clairelisechaignat improvingcommunitycoverageoforalcholeramassvaccinationcampaignslessonslearnedinzanzibar AT ahmedmkhatib improvingcommunitycoverageoforalcholeramassvaccinationcampaignslessonslearnedinzanzibar AT raymondhutubessy improvingcommunitycoverageoforalcholeramassvaccinationcampaignslessonslearnedinzanzibar AT mitchellgweiss improvingcommunitycoverageoforalcholeramassvaccinationcampaignslessonslearnedinzanzibar |