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疫苗安全性和孕产妇知识对增强乌干达农村地区孕产妇对免疫接种的接受度:一项定性研究方法。

Vaccines safety and maternal knowledge for enhanced maternal immunization acceptability in rural Uganda: A qualitative study approach.

机构信息

Makerere University Center for Health and Population Research (MUCHAP), Kampala, Uganda.

Julius Global Health, University Utrecht Medical Center, Utrecht, The Netherlands.

出版信息

PLoS One. 2020 Dec 10;15(12):e0243834. doi: 10.1371/journal.pone.0243834. eCollection 2020.

Abstract

BACKGROUND

Maternal immunization is a successful and cost-effective public health strategy. It protects pregnant women and their infants from vaccine-preventable diseases. Uganda is exploring new vaccines for pregnant women like replacing Tetanus Toxoid (TT) with Tetanus-Diphtheria (Td). Research on knowledge, attitudes, beliefs, and willingness among pregnant women is needed before the introduction of vaccines for pregnant women. This study was aimed at exploring maternal knowledge, attitudes, willingness, and beliefs towards maternal immunization among pregnant women in rural Uganda.

METHODS

This was a qualitative descriptive study. Ten focus group discussions (FGDs) were conducted at antenatal care (ANC) clinics and in a rural community of Uganda. Five key informant interviews (KIIs) were done with health workers, for triangulation. Considering context and research characteristics, data were collected and thematically analyzed.

RESULTS

Women were familiar with the importance of maternal vaccines, had positive attitudes, and expressed willingness to take them. Acceptance of a new vaccine could be affected by worries of pregnant women and that of their partners, who influence health seeking decisions in a home concerning adverse events, following the maternal immunization (AEFI). There were misconceptions about introduction of vaccines such as the belief that vaccines treat malaria and general body weakness, and being used as guinea pigs to test for the vaccine before its introduction to the larger population.

CONCLUSION

A range of diverse sentiments and beliefs may affect uptake and acceptability of vaccines that are introduced in communities. For instance, ignoring vaccine safety concerns may impede maternal immunization acceptability, because pregnant women and their husbands are concerned about AEFI. Moreover, husbands make all health-seeking decisions at home, and their opinion is key, when considering such interventions.

摘要

背景

母体免疫是一种成功且具有成本效益的公共卫生策略。它可以保护孕妇及其婴儿免受可预防疾病的侵害。乌干达正在探索为孕妇接种新疫苗,例如用破伤风类毒素(TT)替代破伤风-白喉(Td)。在为孕妇接种疫苗之前,需要研究孕妇对此类疫苗的知识、态度、信念和意愿。本研究旨在探索乌干达农村孕妇对孕妇免疫的知识、态度、意愿和信念。

方法

这是一项定性描述性研究。在乌干达农村的产前保健(ANC)诊所和社区进行了 10 次焦点小组讨论(FGD)。对卫生工作者进行了 5 次关键知情人访谈(KII),以进行三角分析。考虑到背景和研究特点,收集了数据并进行了主题分析。

结果

女性熟悉母体疫苗的重要性,态度积极,并表示愿意接种疫苗。新疫苗的接受程度可能会受到孕妇和其伴侣的担忧的影响,他们在家庭中会影响有关不良事件的寻医决策,从而影响母体免疫接种(AEFI)。人们对疫苗的引入存在误解,例如认为疫苗可以治疗疟疾和全身无力,并且被用作 guinea pigs 来测试疫苗,然后再将其引入更大的人群。

结论

在社区中引入疫苗时,可能会出现一系列不同的情绪和信念,这可能会影响疫苗的接种率和可接受性。例如,忽略疫苗安全性问题可能会阻碍母体免疫的可接受性,因为孕妇及其丈夫担心 AEFI。此外,丈夫在家中做出所有的寻医决策,当考虑此类干预措施时,他的意见至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a5a/7728220/3f2e685bceaa/pone.0243834.g001.jpg

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