Vonasek Bryan J, Bajunirwe Francis, Jacobson Laura E, Twesigye Leonidas, Dahm James, Grant Monica J, Sethi Ajay K, Conway James H
Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America.
Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda.
PLoS One. 2016 Feb 26;11(2):e0150131. doi: 10.1371/journal.pone.0150131. eCollection 2016.
Improving childhood vaccination coverage and timeliness is a key health policy objective in many developing countries such as Uganda. Of the many factors known to influence uptake of childhood immunizations in under resourced settings, parents' understanding and perception of childhood immunizations has largely been overlooked. The aims of this study were to survey mothers' knowledge and attitudes towards childhood immunizations and then determine if these variables correlate with the timely vaccination coverage of their children. From September to December 2013, we conducted a cross-sectional survey of 1,000 parous women in rural Sheema district in southwest Uganda. The survey collected socio-demographic data and knowledge and attitudes towards childhood immunizations. For the women with at least one child between the age of one month and five years who also had a vaccination card available for the child (N = 302), the vaccination status of this child was assessed. 88% of these children received age-appropriate, on-time immunizations. 93.5% of the women were able to state that childhood immunizations protect children from diseases. The women not able to point this out were significantly more likely to have an under-vaccinated child (PR 1.354: 95% CI 1.018-1.802). When asked why vaccination rates may be low in their community, the two most common responses were "fearful of side effects" and "ignorance/disinterest/laziness" (44% each). The factors influencing caregivers' demand for childhood immunizations vary widely between, and also within, developing countries. Research that elucidates local knowledge and attitudes, like this study, allows for decisions and policy pertaining to vaccination programs to be more effective at improving child vaccination rates.
提高儿童疫苗接种覆盖率和及时性是乌干达等许多发展中国家的一项关键卫生政策目标。在资源匮乏地区，已知有许多因素会影响儿童免疫接种的接受情况，但父母对儿童免疫接种的理解和认知在很大程度上被忽视了。本研究的目的是调查母亲对儿童免疫接种的知识和态度，然后确定这些变量是否与她们孩子的及时疫苗接种覆盖率相关。2013年9月至12月，我们对乌干达西南部希马区农村的1000名经产妇进行了横断面调查。该调查收集了社会人口统计学数据以及对儿童免疫接种的知识和态度。对于至少有一个年龄在1个月至5岁之间且有该儿童疫苗接种卡的妇女（N = 302），评估了该儿童的疫苗接种状况。这些儿童中有88%接受了适龄的按时免疫接种。93.5%的妇女能够指出儿童免疫接种可保护儿童免受疾病侵害。无法指出这一点的妇女，其孩子疫苗接种不足的可能性显著更高（PR 1.354：95% CI 1.018 - 1.802）。当被问及为何她们所在社区的疫苗接种率可能较低时，最常见的两个回答是“担心副作用”和“无知/不感兴趣/懒惰”（各占44%）。影响照顾者对儿童免疫接种需求的因素在不同发展中国家之间以及同一国家内部差异很大。像本研究这样阐明当地知识和态度的研究，能够使与疫苗接种计划相关的决策和政策在提高儿童疫苗接种率方面更有效。
