International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 4(3), February, 2012

Pages: 115-120

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KNOWLEDGE AND OPINION OF CAREGIVERS REGARDING CHILDHOOD ADDITIONAL VACCINES
IN AGARTALA, WEST TRIPURA

Author: Majumder Nilratan, Datta Shib Sekhar, Boratne Abhijit Vinodrao, Majumder Nilanjan, Basu Majumder Chandrika

Category: Healthcare

Abstract:Introduction: Despite growing vaccine-preventable infections, immunization campaigns still suffer due to parental resistance. Knowledge and opinion of caregivers about childhood additional vaccines becomes imperative before we stress upon any such promotion under UIP. Objective: To assess knowledge and opinion of caregivers regarding childhood additional vaccines in Agartala, Tripura. Methods: Present study was undertaken during Jul-Dec 2011 in a child clinic at Agartala. Data was collected using pre-designed and pre-tested proforma by interview technique. Information regarding background characteristics of parents, source of information, knowledge and opinion regarding childhood additional vaccines was collected after obtaining written consent. Data analysed using Microsoft Excel and Epi_Info version 6.04. Chi-square test was used and p< 0.05 considered statistically significant. Results: Information was gathered from parents of 180 children. Doctors (73.33%) were main source of information followed by television (18.89%). 26.67% and 32.78% parents respectively knew timing and against which diseases additional vaccines are used. 73.89% parents reported vaccination as best way to prevent these diseases. 76.11% opined additional vaccines should be available at govt. hospitals. 46.67% recognized polyvalent vaccines better than monovalent. Numbers of injections (89.29%), cost (21.43%), numbers of visits (16.67%) and less complications (15.48%) were cited for such preference. Financial constrain (46.11%), family disagreement (26.67%), time constrain (20%), fear of complication (18.89%) and non-availability (8.89%) were stated as barriers. Parents' education (69.44%) and economic status (41.11%) were stated as family related reason for poor acceptance of additional vaccines.

Conclusion:
Parents' knowledge-gap, opinion and operational issues should be addressed before launching and promoting any childhood additional vaccine campaign.

Keywords: Care givers, Childhood Additional vaccine, Immunization, Parents

Full Text:

INTRODUCTION
Immunizing children against vaccine preventable diseases responsible for child mortality and morbidity is not an easy task. In a resource poor developing country like India, the numbers of target population across geographically diverse regions and difficult areas make universal immunization a mammoth task.1 Immunization coverage in India are still lagging and current level of ?fully immunized‘ children undCONCLUSIONer the national immunization programme is quite low, as pointed by previous studies.2,3 Factors such as parents‘ knowledge about routine and additional vaccination and their attitudes towards them does influence vaccine coverage. Despite growing and emerging vaccine-preventable infections, reassurance from researchers on safety and efficacy of vaccines, and tremendous efforts by health care professionals, immunization campaigns still suffer on accounts of parental resistance.4,5 It is imperative to understand the current level of knowledge and opinion of caregivers about childhood additional vaccines before we put emphasis on any such promotion to be included under the national immunization schedule as suggested by Indian Academy of Paediatrics (IAP) 6 in India and especially in remote and difficult part of north-east India like Tripura state. Objective: The present study was conducted to assess knowledge and opinion of caregivers regarding childhood additional vaccines in Agartala, West Tripura.
 

MATERIALS AND METHODS
Study setting: The present facility based observational study was undertaken during July-December 2011. For this purpose, a specialist child clinic situated in the urban area of Agartala, Tripura served as study center. The child clinic has a regular OPD attendance of around 20-25 children (upto 12 years age) per day. The clinic is run by a senior child specialist and 2 trained medical assistants. Data collection: Data was collected by a predesigned and pre-tested proforma using interview technique by senior child specialist at the child speciality clinic. Each parent(s) of children aged 2-5 years attending the clinic were explained about need of the study and those who consented to participate in the study after proper description and rationale of the interview questionnaire, were included in the study. Information regarding background characteristics of parents, source of information, knowledge and opinion regarding childhood additional vaccines was collected. Additional vaccines: For study purpose, optional vaccines recommended by IAP6 such as H influenza B (HiB), Hepatitis A, Chicken Pox, Meningococcal Vaccine, Pneumococcal Vaccine, Influenza Vaccine and Rota Virus Vaccine were considered as childhood additional vaccines. Data analysis: The data were analysed using Microsoft Excel and Epi_Info software package version 6.04. To compare data sets Chi-square test was used and p < 0.05 was considered statistically significant (Yates‘ correction applied wherever applicable). Ethical consideration: Written consent was obtained from all the study participants before assessing their knowledge and opinion about childhood additional vaccines.

opinion regarding childhood additional vaccines were gathered from parents of total 180 children. Among them, 112 (62.22%) were parents of male and 68 (37.78%) parents of female children. Majority (96.67%) of the respondents were Hindu and 104 (57.78%) belonged to joint families. 131 (72.78%) mothers of children were graduate and 144 (80%) were housewives. 151 (83.89%) fathers were graduate and 107 (59.45%) were in service. (Table 1) Knowledge regarding additional vaccines Doctors (73.33%) were main source of information regarding childhood additional vaccines followed by television (18.89%) and friends (17.78%). 48 (26.67%) and 59 (32.78%) parents respectively knew the timing of these additional vaccines and against which diseases these vaccines are being used. 133 (73.89%) parents reported vaccination as best way to prevent these diseases. 86 (76.79%) parents of male children reported that vaccination is the best approach to prevent these diseases as compared to 47 (69.12%) parents of female children (p=0.033). Further, 101 (56.11%) parents correctly knew the routine immunization schedule. (Table 2) Opinion regarding additional vaccines 137 (76.11%) parents opined that additional vaccines should be available at govt. hospitals. 84 (46.67%) parents recognized polyvalent vaccines better than monovalent vaccine. Numbers of injections (89.29%), cost (21.43%), numbers of visits (16.67%) and less complications (15.48%) were cited for such preference. Financial constrain (46.11%), family disagreement (26.67%), time constrain (20%), fear of complication (18.89%) and non-availability (8.89%) were stated as barriers; and parents‘ education (69.44%) and economic status (41.11%) were stated as foremost family related reason for poor acceptance of childhood additional vaccines. (Table 3)
 

DISCUSSION
Study findings indicate that knowledge and opinion of parents regarding childhood additional vaccines pose as significant factor towards successful immunization campaign. Doctors remained important source of information (73.33%) for parents in regard to childhood additional vaccines. Majority of parents opined that vaccines are best method to prevent these diseases (73.89%) and those vaccines should be made available in govt. hospitals (76.11%). These results are similar to findings documented by previous researchers. 7,8 However, in the present study, only 26.67% and 32.78% parents respectively knew the timing and rationale of selected childhood additional vaccines. Previous researchers have mentioned that modusoperandi towards knowledge and concerns raised by parents regarding childhood immunization determines action taken by parents, and thus immunization coverage in particular area.9,10 It has been recommended that parents who resist immunization campaign because of background characteristics, traditional beliefs or situational perceptions; health care providers must assess the socio-cultural, economic and scientific basis for resistance before promoting such campaign.11 Financial constrain, parental knowledge, family disagreement, fear of complication and non-availability of additional vaccines were stated as main barriers for poor acceptance and coverage of childhood additional vaccines. Similar findings has already been compiled and documented in this respect through studies conducted in Africa and Asia.12 In general, parents‘ knowledge about childhood additional vaccines still remains poor in third world countries. However, it has been argued that public often accepts vaccination despite limited knowledge about it.13 It is recommended that parents‘ knowledge and concerns must be addressed to promote and maintain childhood additional vaccination campaign once we plan to start this campaign. Further, to improve vaccination coverage and child survival, a sense of urgency is must from national as well as community level.14 Measures which can lever promotion and popularization of childhood additional vaccination may include addressing knowledge gap among parents and their concerns, making these vaccines available at govt. hospitals, engaging private health providers/facilities and monitoring the progress to sustain the impact. Performance of MCH services still remains a matter of concern in India and it has been recommended to engage and monitor services rendered by anganwadis towards improvement of immunization services. 15 The strong association between parents‘ education and vaccination coverage has been recognized in NFHS-3 and UNICEF coverage surveys in India and other developing countries. 16, 17 This fact may also be may be utilized considering higher education level of parents in the study area to promote and sustain coverage of childhood additional vaccines in the study are as suggested by Indian Academy of Paediatrics.

Limitations: Debatable limitations of the present study may include urban setting of the study and already sensitized respondents otherwise clients of the same private health care facility. This arguably may have led to an inflated response and thus puts question on application of the study findings in other difficult, remote and rural India.


CONCLUSION
Parents‘ knowledge and opinion regarding childhood additional vaccines is a matter of concern. This knowledge-gap and other operational issues should be addressed before launching and promoting any such campaign.

ACKNOWLEDGEMENT
We acknowledge all study participants for valuable information towards improving vaccination coverage among children. We acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. We are also grateful to authors /editors /publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Source of financial support: Nil Conflict of interest: None declared

References:

1. Sharma R, Bhasin SK. Routine immunization - Do people know about it? A study among caretakers of children attending pulse polio immunization in east Delhi. Indian Journal of Community Medicine 2008; 33(1):31-34.

2. Bhatia V, Swami HM, Rai SR, Gulati S, Verma A, Parashar A, et al. Immunization status in children. Indian J Pediatr 2004; 71:313-315.

3. Yadav RJ and Singh P. Immunization of children and mothers in northeastern states. Health and Population - Perspectives and Issues 2004; 27(3):185- 93.

4. Chen RT, DeStefano F, Pless R, Mootrey G, Kramarz P, Hibbs B. Challenges and controversies in immunization safety. Infect Dis Clin North Am. 2001; 15(8):21- 39.

5. Offit PA, Jew RK. Addressing parents‘ concerns: Do vaccines contain harmful preservatives, adjuvants, additives, or residuals? Pediatrics. 2003; 112:1394- 1397.

6. Singhal T. Recommendation: Consensus recommendations on immunization, 2008. Indian Academy of Pediatrics Committee on Immunization (IAPCOI). Indian Paediatrics 2008; 45(8):635-48.

7. Gellin BG, Maibach EW and Marcuse EK. Do parents understand immunizations? A national telephone survey. Pediatrics. 2000;106(5):1097-1102.

8. Manjunath U, Pareek RP. Maternal knowledge and perceptions about the routine immunization programme: A study in a semi-urban area in Rajasthan. Indian J Med Sci 2003;57:158-63.

9. Gust DA, Kennedy A, Shui I, Smith PJ, Nowak G and Pickering LK. Parent attitudes toward immunizations and healthcare providers: The role of information. Am J Prev Med. 2005;29:105-112.

10. Keane MT, Walter MV, Patel BI, et al. Confidence in vaccination: a parent model. Vaccine. 2005;23:2486-2493.

11. Dawson A. The determination of ?best interests? in relation to childhood vaccinations. Bioethics. 2005;19:188-205.

12. Jheeta M and Newell J. Childhood vaccination in Africa and Asia: the effects of parents‘ knowledge and attitudes. Bull World Health Organ 2008;86(6):419-420.

13. Nichter M. Vaccinations in the Third World: A consideration of community demand. Soc Sci Med 1995; 41: 617-632.

14. Kumar S. Indians can do better at improving child survival. Indian Journal of Community Medicine 2011; 36(3): 171-173.

15. Datta SS, Boratne AV, Cherian J, Joice YS, Vignesh JT and Singh Z. Performance of anganwadi centers in urban and rural area: A facility survey in coastal south India. Indian Journal of Maternal and Child Health 2010; 12(4): 1-9.

16. Luman ET, McCauley MM, Shefer A, Chu SY. Maternal characteristics associated with vaccination of young children. Pediatrics 2003; 111(5 Part 2): 1215-1218.

17. International Institute for Population Sciences (IIPS) and ORC Macro. National Family Health Survey (NFHS-3), 2005- 06. Mumbai, India: IIPS; 2007.

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Dr. Pramod Kumar Manjhi joined Editor-in-Chief since July 2021 onwards

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Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

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‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

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A study by Muhas C. et al. entitled \"Study on Knowledge & Awareness About Pharmacovigilance Among Pharmacists in South India\" is awarded Best article for Vol 14 issue 22
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A study by Singh R. et al. entitled \"A Prospective Study to Find the Association of Astigmatism in Patients of Vernal Keratoconjunctivitis (VKC) in a Tertiary Health Care Centre in India (Vindhya Region MP)\" is awarded Best Article for Vol 14 issue 15
A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14
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A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
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A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
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A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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