Kaljee Linda M, Pham Van, Son Nguyen Dinh, Hoa Nguyen Thai, Thiem Vu Dinh, Canh Do Gia, Thoa Le Thi Kim, Ali Mohammad, Ochiai Rion Leon, Danovaro-Holliday M Carolina, Acosta Camilo J, Stanton Bonita, Clemens John
Department of Pediatrics, School of Medicine, University of Maryland, Baltimore MD, USA.
Trop Med Int Health. 2007 Jan;12(1):25-36. doi: 10.1111/j.1365-3156.2006.01751.x.
To identify demand for Vi typhoid fever vaccine for school-age children; obstacles and enabling factors for vaccine delivery; and socio-behavioural factors associated with trial participation and possible predictors of future vaccine acceptance, in Hue City, Viet Nam.
Pre- and post-trial surveys of randomly selected households with children aged 6-17 years. Simple multinomial logistic analyses for ratios of relative risks (RRR) and significance on trial participation by demographics and variables related to typhoid fever, vaccination, and pre-trial experiences with information and consents. Multiple logistic regressions to assess differences in participation based on child's characteristics.
As many as 62.6% of households let all school age children participate, 10.2% let some participate, and 26.8% let none of their children participate in the trial. Factors associated with all children participating included past use of healthcare facilities (RRR, 0.45; 95% CI, 0.24-0.83), knowledge of vaccines (RRR, 0.17; 95% CI, 0.03-0.86), and perceived causes of typhoid fever (RRR, 0.90; 95% CI, 0.81-0.99). Factors associated with some children participating included utilization of healthcare facilities (RRR, 0.08; 95% CI, 0.01-0.66) and perceived severity of typhoid fever (RRR, 0.64; 95% CI 0.46-0.88). Participation was associated with satisfaction regarding pre-vaccination information and consent procedures. Children and adolescents were active decision-makers. Only 14 of 461 (2.2%) respondents would not use the Vi vaccine in the future for their child(ren).
Inter-related factors contribute to participation in a clinical vaccine trial, which may differ from desire to participate in a public health campaign. Educational campaigns need to be targeted to children and adolescents, and consideration for assent procedures for minors. Obtaining informed consent may affect trial participation within a social and political system unaccustomed to these procedures.
确定越南顺化市学龄儿童对Vi伤寒疫苗的需求；疫苗交付的障碍和促成因素；以及与试验参与相关的社会行为因素和未来疫苗接受度的可能预测因素。
对随机选择的有6至17岁儿童的家庭进行试验前和试验后调查。对相对风险率（RRR）以及按人口统计学和与伤寒、疫苗接种以及试验前信息和同意相关变量的试验参与显著性进行简单多项逻辑分析。进行多元逻辑回归以评估基于儿童特征的参与差异。
多达62.6%的家庭让所有学龄儿童参与，10.2%的家庭让部分儿童参与，26.8%的家庭不让任何孩子参与试验。与所有儿童参与相关的因素包括过去使用医疗保健设施（RRR，0.45；95%置信区间，0.24 - 0.83）、疫苗知识（RRR，0.17；95%置信区间，0.03 - 0.86）以及伤寒热的感知病因（RRR，0.90；95%置信区间，0.81 - 0.99）。与部分儿童参与相关的因素包括医疗保健设施的使用（RRR，0.08；95%置信区间，0.01 - 0.66）以及伤寒热的感知严重程度（RRR，0.64；95%置信区间0.46 - 0.88）。参与与疫苗接种前信息和同意程序的满意度相关。儿童和青少年是积极的决策者。461名受访者中只有14名（2.2%）表示未来不会为其子女使用Vi疫苗。
相互关联的因素促成了对临床疫苗试验的参与，这可能与参与公共卫生运动的意愿不同。教育活动需要针对儿童和青少年，并考虑未成年人的同意程序。在一个不习惯这些程序的社会和政治体系中，获得知情同意可能会影响试验参与。
