尼日利亚卫生机构的能力以及医护人员在乙肝疫苗首剂接种和产妇破伤风-白喉疫苗接种方面的知识、态度和做法：一项基线评估。
Health Facility Capacity and Health-care Worker Knowledge, Attitudes, and Practices of Hepatitis B Vaccine Birth-dose and Maternal Tetanus-Diphtheria Vaccine Administration in Nigeria: A Baseline Assessment.
作者信息
Uba Belinda V, Mohammed Yahaya, Nwokoro Ugochukwu Uzoechina, Fadahunsi Rhoda, Adewole Adefisoye, Ugbenyo Gideon, Simple Edwin, Wisdom Margeret Osas, Waziri Ndadilnasiya E, Michael Charles A, Okeke Lilian Akudo, Kanu Florence, Ikwe Hadley, Sandhu Hardeep S, Asekun Adeyelu, Tohme Rania A, Freeland Catherine, Minta Anna, Bashir Sulaiman Saidu, Isa Abdullahi, Vasumu James J, Bahuli Abubakar U, Ugwu George O, Obi Emmanuel I, Ismail Binta Aduke, Okposen Bassey Bassey, Bolu Omotayo O, Shuaib Faisal
机构信息
National Stop Transmission of Polio Program, African Field Epidemiology Network, Atlanta, GA, USA.
Global Immunization Division, US CDC, Atlanta, GA, USA.
出版信息
Ann Afr Med. 2024 Oct 23;24(1):113-23. doi: 10.4103/aam.aam_28_24.
BACKGROUND
Hepatitis B virus (HBV) and neonatal tetanus infections remain endemic in Nigeria despite the availability of safe, effective vaccines. We aimed to determine health facilities' capacity for hepatitis B vaccine birth dose (HepB-BD) and maternal tetanus-diphtheria (Td) vaccination and to assess knowledge, attitudes, and practices of HepB-BD and maternal Td vaccine administration among health facility staff in Nigeria.
MATERIALS AND METHODS
This was a cross-sectional study assessing public primary and secondary health facilities in Adamawa and Enugu States. A multistage sampling approach was used to select 40 facilities and 79 health-care workers (HCWs) from each state. A structured facility assessment tool and standardized questionnaire evaluated facility characteristics and HCW knowledge, attitudes, and practices related to HepB-BD and maternal Td vaccination. Frequencies and proportions were reported as descriptive statistics.
RESULTS
The survey of 80 facilities revealed that 73.8% implemented HepB-BD and maternal Td vaccination policies. HepB-BD was administered within 24 h of birth at 61.3% of facilities and at all times at 57.5%. However, administration seldom occurred in labor and delivery (35%) or maternity wards (16.3%). Nearly half of the facilities (46.3%) had HCWs believing there were contraindications to HepB-BD vaccination. Among 158 HCWs, 26.5% believed tetanus could be transmitted through unprotected sex, prevented by vaccination at birth (46.1%), or by avoiding sharing food and utensils. 65% of HCWs knew HBV infection had the worst outcome for newborns.
CONCLUSIONS
The limited implementation of national policies on HepB-BD and maternal Td vaccination, coupled with knowledge gaps among HCWs, pose significant challenges to timely vaccination, necessitating interventions to address these gaps.
背景
尽管有安全、有效的疫苗，但乙型肝炎病毒（HBV）感染和新生儿破伤风在尼日利亚仍然流行。我们旨在确定医疗机构实施乙肝疫苗首剂接种（HepB-BD）和孕产妇破伤风-白喉（Td）疫苗接种的能力，并评估尼日利亚医疗机构工作人员对HepB-BD和孕产妇Td疫苗接种的知识、态度和做法。
材料与方法
这是一项横断面研究，评估了阿达马瓦州和埃努古州的公立初级和二级医疗机构。采用多阶段抽样方法从每个州选取40家医疗机构和79名医护人员（HCW）。使用结构化的机构评估工具和标准化问卷评估机构特征以及医护人员与HepB-BD和孕产妇Td疫苗接种相关的知识、态度和做法。频率和比例作为描述性统计数据进行报告。
结果
对80家医疗机构的调查显示，73.8%的机构实施了HepB-BD和孕产妇Td疫苗接种政策。61.3%的机构在出生后24小时内接种了HepB-BD，57.5%的机构随时都在接种。然而，在分娩时（35%）或产科病房（16.3%）很少进行接种。近一半的机构（46.3%）的医护人员认为HepB-BD接种存在禁忌证。在158名医护人员中，26.5%的人认为破伤风可通过无保护性行为传播，可通过出生时接种疫苗（46.1%）或避免共用食物和餐具来预防。65%的医护人员知道HBV感染对新生儿的后果最严重。
结论
国家关于HepB-BD和孕产妇Td疫苗接种政策的实施有限，加上医护人员存在知识差距，对及时接种疫苗构成了重大挑战，因此需要采取干预措施来弥补这些差距。
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