Incomplete Immunization Status Research Articles

Status Kelengkapan Imunisasi Difteri Pada Kejadian Difteri Di Wilayah Surabaya

One of the diseases of Extraordinary Events in East Java Province is diphtheria disease. Diphtheria is an acute infectious disease of the upper respiratory tract in the system caused by the bacterium Corynebacterium Diphtheria. One of the factors that may affect the incidence of diphtheria is an incomplete immunization status. The purpose of this research is to analyze the relationship status of the completeness of immunization with diphtheria incidence in the region of Surabaya. Design research Analytic approach with Cross-Sectional Correlation. The independent variable complete immunization status of diphtheria and dependent variable is diphtheria occurrence. The population of the research was as many as 29 people who suffered from diphtheria in 2017 and sample as many as 27 people who suffered from diphtheria in 2017in the city of Surabaya. Using a technique Simple Random sampling. The instruments of research using questionnaires, observation secondary data: laboratory results and sheet book KMSfor incomplete immunization status data and diphtheria incidence, tested use the spearman rho correlation. Statistical results with Spearman Rho Correlations test obtained ρ = 0.03 with ρ ≤ 0.05. It states that H0 is rejected H1 accepted as well as the result of correlation coefficient – 0.411. This shows the existence of the relationship between complete immunization status of diphtheria with diphtheria occurrence in the region of Surabaya. The implications of this research show that the diphtheria immunization incompleteness affects the incidence of diphtheria. Expected health workers can better do health promotion about the importance of immunization and prevention of diphtheria transmission, registration, and grant of immunization in the community.Keywords: Diphtheria, Immunization, Surabaya

Urban-rural differences in factors associated with incomplete basic immunization among children in Indonesia: A nationwide multilevel study

Identifying risk factors of incomplete immunization among children is crucial to developing relevant policies to improve immunization coverage. In this study, we investigated factors associated with incomplete immunization among children in Indonesia and elucidated differences in risk factors between urban and rural areas. The data came from a national-wide survey, the 2017 Indonesia Demographic Health Surveys. In total, 3264 children aged 12-23 months were included in the study. An incomplete immunization status was defined as a child who did not complete the ten doses of basic vaccinations, consisting of one dose of bacille Calmette-Guérin, one dose of hepatitis B, three doses of pentavalent vaccine (diphtheria, pertussis, tetanus, hemophilus influenza type B, and hepatitis B vaccine), four doses of polio vaccine, and one dose of measles vaccine. Generalized linear mixed models were constructed to examine the effects of different levels of risk factors on the incomplete immunization status. We further conducted stratified analyses by urban and rural areas. About 40% of the 3264 children were incompletely immunized, among whom 45.3% were in urban areas and 54.7% were in rural areas. Eight of the 34 provinces had incomplete immunization rates exceeding 50%, and the Papua and Maluku regions had the highest rates of incomplete child immunization. The multivariate analyses showed that when women attended fewer than four antenatal care sessions and resided outside the Nusa Tenggara region, their children were more likely to have incomplete immunization in both urban and rural areas. On the other hand, having no health insurance was positively associated with incomplete immunization in urban areas, whereas having received a tetanus vaccination during pregnancy was negatively associated with incomplete immunization in rural areas. Results of this study suggest that tailored interventions should be developed to address significant risk factors in rural and urban areas.

Determinants of Incomplete Vaccination Among Children Age 12-23 Months in Southwest Ethiopia: A Case-Control Study

Many children in the world particularly in low resource countries are still left unvaccinated and it remains to be a public health problem. So, the main objective of this study was to identify determinants of incomplete vaccination among children 12-23 months of age in Semen Bench district, Bench Maji Zone, Southwest Ethiopia, 2018. A community based unmatched case-control study was undertaken among randomly selected children aged 12 to 23 months and with a total sample size of 316 (106 cases and 212 controls). Simple random sampling was used to get representative cases and controls. Data was collected using a structured questionnaire and analyzed using SPSS version 21. Bivariate and multivariable logistic regression analyses were done to identify independent factors for incomplete immunization status of children. P-values <0.05 was used as cut value. A total of 104 cases from 106 and 208 controls from 212 were selected giving a response rate of 98.2%. Based on the multivariable analysis the incomplete immunization status of children was significantly associated with having no antenatal care visits, [AOR=8.3(95%CI; 1.87-36.91], home delivery [AOR=4.5(95%CI; 1.411-14.27], having no postnatal care visit [AOR=4.2(95%CI; 1.67-10.41], and inconvenient appointment time [AOR=3.44(95% CI:1.65-7.16)]. Children of mothers having no antenatal and postnatal care, having home delivery, and with an inconvenient appointment timewere significantly associated with incomplete vaccination. Therefore, integrating the immunization service to other elements of primary health care is crucial.

Hubungan Tingkat Pengetahuan Ibu Terhadap Pemberian Imunisasi Dasar Pada Bayi Di Wilayah Kerja Puskesmas Kassi-Kassi Makassar

Based on Basic Health Research 2018, showed that children with aged 12-23 months who did not get complete basic immunizations in South Sulawesi were 31.7%. There are still different understanding in society about immunization, so there are still a lot of babies and toddlers who do not get immunization services. The purpose of this study is to determine the relationship between the level of mother's knowledge with basic immunization in infants at the working area of Public Health Center Kassi-Kassi Makassar. This study was an analytic observational study with a cross sectional design. This research was conducted at the working area of Public Health Center Kassi-Kassi Makassar with a sample of 55 mothers who had a ³9 month old baby who were selected by accidental sampling. The research data was obtained through primary data from interviews and checking the KIA book. The results of this study indicate that 60% of respondents have less knowledge level with incomplete infants basic immunization status and 40% with complete infants basic immunization status, 11.1% of respondents have sufficient level of knowledge with incomplete infants basic immunization status and 88,9% with complete infants basic immunization status and 100% of respondents have a high level of knowledge with complete infants basic immunization status. The results of the analysis using the Chi-Square test obtained a significant value of 0,000 (p<0.05). The results of this study indicate that there is a significant relationship between the level of mother's knowledge of basic immunization in infants at the working area of Public Health Center Kassi-Kassi Makassar.

GAMBARAN KARAKTERISTIK DAN STATUS IMUNISASI PENDERITA DIFTERI DI PROVINSI JAWA TIMUR TAHUN 2018

In 2016 East Java was the region with the highest cases of diphtheria, namely 209 cases with 6 deaths. In 2017 diphtheria cases in East Java increased to 460 cases with 16 deaths, and continued to increase in 2018, namely 758 cases with a death rate of 3 people. This research aims to describe the characteristics and immunization status of diphtheria sufferers in East Java Province in 2018. This research is a descriptive research type with a cross sectional study design. The research population were all people who were declared diphtheria in East Java Province in 2018. The method of sampling is to use the total population. The variables were the characteristics and immunization status of diphtheria sufferers. Data were analyzed using univariate analysis with frequency table. The result shows that characteristics of diphteria sufferers were dominated by age ≥19 years (33.11%) and male sex (50.6%). Diphtheria sufferers are dominated by incomplete immunization status (98.15%). The conclusion shows that completeness of 7-dose diphtheria immunization plays an important role in the occurrence of diphtheria cases in East Java Province in 2018, especially patients who have not carried out immunizations at all.

EPIDEMIOLOGY CHARACTERISTICS AND IMMUNIZATION STATUS OF DIPHTHERIA PATIENTS IN EAST JAVA PROVINCE IN 2018

Background: East Java Province is the region with the highest incidence of diphtheria in Indonesia. In the past three years, the number of diphtheria cases amounted to 758 cases and resulted in three mortalities. Objective: This study aims to describe the epidemiological characteristics and diphtheria immunization status of patients in East Java province in 2018. Methods: This study employed descriptive research with cross-sectional design. This study utilized secondary data of publication profiles from the East Java Provincial Health Office in 2018. The population was the entire diphtheria patients in East Java province, 2018. The samples were taken by using the total population sampling technique. The variables in this study were epidemiological characteristic and immunization status of diphtheria patients. The data analysis employed a univariate analysis by providing the frequency table. Results: Based on the records, diphtheria infected the children more often but, in 2018, it was also found in adults. This circumstance is proven by the findings that the patients were aged ≥19 years (33.11%) and were males (50.60%). In 2018, diphtheria patients number experienced an increase and decrease fluctuatingly as well as quite prevalence in some areas in the province of East Java. Diphtheria patients were predominanted by incomplete immunization status and unimmunized patients. Conclusion: The completeness status of diphtheria immunization has a very important role in the incidence of diphtheria cases in East Java Province in 2018, particularly the status of patients who is not complete and unimmunized.

Faktor Risiko Kejadian Recurrent Respiratory Infection pada Anak Usia 2-5 Tahun

<p class="AbstractNormal"><strong><em>Introduction:</em></strong><em> Acute Respiratory Infection (ARI) is the most prevalent disease with high mortality and morbidity on infant. ARI that happens more than five times annually is called Recurrent Respiratory Infection (RRI). Some mortality of ARI comes from kind of ARI that developed from diseases that could be prevented by immunization. This study aimed to find correlation between immunization status, nutritional status, crowding, smoker in house, mother education level, family income level and RRI incident on children age 2-5 years old in Sibela Primary Health Care (PHC) work area, Surakarta.</em></p><p class="AbstractNormal"><strong><em>Methods</em></strong><em>:</em><em> This was an observational analytic study with cross-sectional approach. Sample for this study was children age 2-5 years old from Sibela PHC work area, Surakarta. Sample was taken by cluster sampling method as much as 121 children, the parent interviewed using questioner and children was measured for their height and weight. Data of immunization history was obtained from Kesehatan Ibu dan Anak (KIA) Book and PHC data information system for ARI diagnosis. Data was analyzed using chi-square and logistic regression.</em></p><p class="AbstractNormal"><strong><em>Result</em></strong><em>:</em><em> Chi-square result shows significant correlation between incomplete immunization status and incident of RRI (p=0,000) and OR = 18,774. Logistic regression results shows significant correlation between immunization status and incident of RRI (p=0,000; OR=21,3). </em></p><p class="AbstractNormal"><strong><em>Conclusions</em></strong><em>:</em> <em>Incomplete immunization status significantly correlate to increasing RRI incident 21,3 times on children age 2-5 years old than children which acquired complete immunization status.</em> <em>Nutritional status, crowding, smoker in house, mother educational level, and family income level has no significant correlation with RRI incidence.</em></p>

Factors influencing basic vaccination coverage in Myanmar: secondary analysis of 2015 Myanmar demographic and health survey data

BackgroundImmunization is one of the most effective measures for preventing disease when vaccination coverage is sufficient. Although vaccination coverage is known to be influenced by social and cultural barriers, the determinants of childhood immunization in Myanmar remain poorly understood. This study analyzed factors that influenced complete vaccination status (one dose each for Bacillus Calmette-Guérin and measles and three doses each for diphtheria-pertussis and polio) using 2015 data from the Myanmar Demographic Health and Survey.MethodsData from 12 to 23-month-old children and their mothers were extracted from the nationally representative survey results. Bivariate and multivariate analyses with survey-weighted logistic regression were performed to examine the relationships between vaccination status and various sociodemographic and medical factors. The independent variables for the analyses included area of residence, economic status, maternal age, marital status, education, literacy, employment status, antenatal care attendance, tetanus vaccination, place of delivery, postnatal evaluations, child’s sex, number of children, previous child death, decision maker(s) regarding child’s health, frequency of healthcare visits, paternal education, and paternal occupation.ResultsA representative sample of 904 cases were extracted for the analysis. The overall complete vaccination rate was 55.4%. In the multivariate analysis with backward step-wise selection, complete vaccination was independently associated with middle or high economic status (adjusted odds ratio [AOR]: 2.64, 95% confidence interval [CI]: 1.85–3.78), older maternal age (AOR: 2.87, 95% CI: 1.62–5.10), ≥4 antenatal care visits (AOR: 1.87, 95% CI: 1.28–2.73), and maternal tetanus vaccination before delivery (AOR: 3.26, 95% CI: 1.82–5.85).ConclusionThe first Demographic and Health Survey in Myanmar revealed that only approximately one-half of 12–23-year-old children had received complete vaccination, which was lower than the estimated rate from routine administrative coverage. Our results indicate that incomplete immunization status was associated with low economic status, younger maternal age, fewer antenatal care visits, and no maternal tetanus vaccination. These findings may help improve the targeting and strategic implementation of the Expanded Programme on Immunization.

Incomplete immunization among children aged 12\u201323\xa0months in Togo: a multilevel analysis of individual and contextual factors

BackgroundInadequate immunization coverage remains a public health problem in Africa. In Togo, only 62% of children under one year of age were fully immunized in 2013. This study aimed to estimate the immunization coverage among children aged 12–23 months, and to identify factors associated with incomplete immunization status in Togo.MethodsA cross-sectional survey was conducted in the six health regions of Togo. Children aged 12 to 23 months who were living with one of their parents or guardians from selected households were recruited for the study. Data was collected using a pre-tested questionnaire through face-to-face interviews. Multilevel logistic regression analyses were performed to assess factors associated with incomplete immunization coverage.ResultsA total of 1261 households were included. Respondents were predominantly women (91.9%) and 22.8% had secondary or higher education level. Immunization cards were available for 85.3% of children. Complete immunization coverage was 72.3%, 95% confidence interval (CI): [69.7–74.8]). After controlling for both individual and contextual level variables, children whose mothers attended secondary school or above were 33% (adjusted Odds Ratio (aOR) = 0.67, CI [0.47–0.94]) less likely to have an incomplete immunization coverage compared to those with no education. The likelihood of incomplete immunization in children decreased with the increase in household’s income (aOR = 0.73, 95% CI [0.58–0.93]), children who did not have an immunization card (aOR = 13.41, 95% CI [9.19–19.57]) and those whose parents did not know that children immunization was free of charge (aOR = 1.82, 95% CI [1.00–3.30]) were more likely to have an incomplete immunization. Finally, children whose parents had to walk half an hour to one hour to reach a healthcare center were 57% (aOR = 1.57, 95% CI [1.15–2.13]) more likely to have an incomplete immunization coverage than those whose parents had to walk less than half an hour.ConclusionThe goal of 90% coverage at the national level has not been achieved in 2017. Innovative strategies such as using electronic cards and strengthening sensitization activities must be initiated in order to attain a complete immunization coverage in Togo.

Sex, Status of DPT Immunization, and Pnemonia Incidence among Children Under Five in Puskesmas Tanjung Baru East Baturaja District

Background Each year, over 2 million children die of pneumonia, it means that 1 in 5 people in the world under five die of pneumonia and almost all (99.9%) deaths from pneumonia occur in developing countries (least developed). Order to determine the relationship of sex and DPT immunization status with the incidence of pneumonia in children under five (ages 1-59 months) at Tanjung Baru sub-district Puskesmas UPTD East Balfour. Method This research use analytical survay with cross sectional approach. The study population was all children under five who seek treatment at the health center UPTD Tanjung Baru during the study, with a sample of 73 people. Data analysis using univariate analysis and bivariate analysis using distribution table and Chi-Square statistical test, with 95% confidence degree. Results univariate analysis, of 73 respondents obtained 26% of respondents who suffered from pneumonia and 74% who do not suffer from pneumonia, 28.8% of respondents with male sex and 71.2% of respondents with female sex, 12.3% Respondents with incomplete DPT immunization status and 87.7% of respondents with complete DPT immunization status. The bivariate analysis results indicate no relationship sex with pneumonia (p value 0.003) and there was a DPT immunization status relationship with the incidence of pneumonia (p value 0.008). Keywords: DPT immunization status incidence of pneumonia, sex

A study of malnutrition and associated risk factors among children of age 06-59 months in rural area of Jabalpur district, Madhya Pradesh

Background: “Malnutrition is a silent emergency”. Malnutrition is not only an important cause of childhood mortality and morbidity, but also leads to permanent impairment of both physical and mental growth of those who survive. Aims & Objectives: To determine the prevalence of malnutrition and association with various risk factors among children of age 06-59 months in rural area of Jabalpur district Madhya Pradesh. Material and Methods: Study was conducted among 517 children of age group 06-59 months in two randomly selected blocks of Jabalpur District. Multistage random sampling technique was used. Predesigned questionnaire was used to collect data and anthropometric measurements were done. Data analysis was done using Epi Info™ 7.1.5 and SPSS 20.0 (free trial version). Result: The prevalence of underweight, stunting and wasting were found to be 35.8%, 41.4% and 19.7% respectively while the prevalence of obese and overweight was 2.7% & 5.6% respectively. Children born with low birth weight, having higher birth order, more number of siblings, those with incomplete immunization status and inappropriate feeding practices were associated with malnutrition. Conclusion: The present study demonstrates the multiple risk factors for childhood malnutrition requiring multisectoral approach to fight against this silent killer.

Factors associated to infant vaccination in madurese, Indonesia

In Madura, a lot of infan-ts have incomplete immunization status in which one of the areas with low immunization coverage is Burneh sub-district. The coverage of complete basic immunization in Burneh only 64% in 2015. The aim of this study was to analyze factors related to vaccination in Madurese, using cross sectional design. The sample were 97 mothers with babies 0-1 years old in Burneh sub-district. Data were collected using questionnaires, then analyzed using Chi square test. The results showed the correlation between knowledge (p = 0.027), condence (p = 0.000), attitude (p = 0.003), culture (p = 0.000), access to health care (p = 0.013), family support (p = 0.034), and support of health professionals (p = 0.021) with the basic immunization status. Meanwhile, the support of community leaders (p = 0.054) had no correlation with the basic immunization status.

A study of malnutrition and associated risk factors among children of age 06-59 months in urban area of Jabalpur district (M.P.)

Background: “Malnutrition is a silent emergency”. Malnutrition is not only an important cause of childhood mortality and morbidity, but also leads to permanent impairment of both physical and mental growth of those who survive. Methods: Cross sectional study was conducted among 720 children of age group 06-59 months in randomly selected eight wards of Jabalpur District. Multistage random sampling technique was used for the selection of study subjects. Predesigned questionnaire was used to collect data and anthropometric measurements were done. Data entry and analysis was done using Epi Info™ 7.1.5 and SPSS 20.0 (free trial version). Results: The prevalence of underweight, stunting and wasting were found to be 34.3%, 41.5% and 18.9% respectively while the prevalence of obese and overweight was 3.1% and 7.4% respectively. Malnutrition was found to be higher among the children born with low birth weight, having higher birth order, more number of siblings, those with incomplete immunization status and inappropriate feeding practices i.e. lack of exclusive breast feeding and improper weaning. Conclusions: The present study demonstrates the multiple risk factors for childhood malnutrition, encompassing sectors other than health alone like social and economic sectors, requiring multisectoral approach to fight against the silent killer of childhood malnutrition.

Faktor-Faktor Risiko Status Imunisasi Dasar Tidak Lengkap pada Anak (Studi di Wilayah Kerja Puskesmas II Kuala Tungkal)

Background : Basic immunization is a program conducted to protect the body from disease. Mother behavior, health care and environmental factor serve as a benchmark in the basic immunization status. This study aimed to analyze the risk factors of incomplete basic immunization in children.Methods : The research used observational analytic and cross sectional studynsupported by qualitative approach of in-depth interview method. The research population was all mothers with children aged 12 to 24 months with sample size of 92 respondents. Sampling method was conducted by purposive random sampling. Data collection was done by interviewing and the measuring instrument used is an questionaire. Data was analyzed by univariate, bivariate and multivariate.Results : Multivariate analysis showed poor maternal knowledge (p=0.0001) and lack of supportive attitudes of mothers toward immunization (p=0.0001), is a risk factor for incomplete basic immunization status in children. While mother's age, mother's education, mother's occupation, mother's perception of health facility condition, mother's perception on immunization staff role, number of child in the household and information media are not the risk factors of incomplete basic immunization status in children. A qualitative approach with in-depth interviews indicates that poor knowledge of immunization and the lack of supportive attitude of mothers toward immunization resulting in an incomplete basic immunization status.Conclusion : Risk factors for incomplete basic immunization status in children are poor mother's knowledge and lack of supportive attitudes of mothers toward immunization

Faktor-Faktor Risiko Status Imunisasi Dasar Tidak Lengkap pada Anak (Studi di Wilayah Kerja Puskesmas II Kuala Tungkal)

Background : Basic immunization is a program conducted to protect the body from disease. Mother behavior, health care and environmental factor serve as a benchmark in the basic immunization status. This study aimed to analyze the risk factors of incomplete basic immunization in children.Methods : The research used observational analytic and cross sectional studynsupported by qualitative approach of in-depth interview method. The research population was all mothers with children aged 12 to 24 months with sample size of 92 respondents. Sampling method was conducted by purposive random sampling. Data collection was done by interviewing and the measuring instrument used is an questionaire. Data was analyzed by univariate, bivariate and multivariate.Results : Multivariate analysis showed poor maternal knowledge (p=0.0001) and lack of supportive attitudes of mothers toward immunization (p=0.0001), is a risk factor for incomplete basic immunization status in children. While mother's age, mother's education, mother's occupation, mother's perception of health facility condition, mother's perception on immunization staff role, number of child in the household and information media are not the risk factors of incomplete basic immunization status in children. A qualitative approach with in-depth interviews indicates that poor knowledge of immunization and the lack of supportive attitude of mothers toward immunization resulting in an incomplete basic immunization status.Conclusion : Risk factors for incomplete basic immunization status in children are poor mother's knowledge and lack of supportive attitudes of mothers toward immunization

Hepatitis B status in hemodialysis patients.

Patients on chronic dialysis present a high prevalence of hepatitis B virus infection. Despite infection-control practices, surveillance of serological markers, and hepatitis B vaccination, there are still outbreaks of the disease in dialysis centers. This study aims to assess the serologic and vaccination status for hepatitis B in hemodialysis patients. This cross-sectional study assessed serologic markers and hepatitis B vaccination status of chronic kidney disease patients on regular dialysis program in São Carlos, SP, Brazil. Patients without information about hepatitis B status (anti-HBc, HBsAg and anti-HBs) were referred for testing. Individuals with uncertain or incomplete immunization status and without serological conversion (anti-HBs <10mIU/mL) were referred to vaccination, with adverse effects monitored. The study included 130 from a total of 181 dialysis patients. The majority were male (63.8%), mean age 53.9 years. All patients were already screened and negative for HBsAg, and 73.8% were vaccinated against hepatitis B (59.2% complete and 14.6% incomplete schedule), with a seroconversion rate of 75.3%. Only 11 (8.5%) patients had prior dosage of anti-HBc (negative). Among the 47 patients referred for anti-HBc testing, four were anti-HBc positive and one indeterminate. Of the total of patients referred to immunization, 34 have actually received HBV vaccine; among them five had mild adverse effects. Despite the benefit of dosing of anti-HBc and anti-HBs before admission to dialysis, economic constraints have reduced the screening to only HBsAg. Since occult HBV infection has already been demonstrated in hemodialysis patients, the measure of anti-HBc should be encouraged.

An evaluation of primary immunization coverage among 12-23 months old children in an urban area of Western Maharashtra: A community-based study

Introduction: Immunization is a process whereby a person is made immune to infectious diseases. In 1985, Universal Immunization Programme started in India with the aim of achieving at least 85% coverage of primary immunization. A child is considered fully immunized if he/she received one dose each of Bacille Calmette-Guérin and measles and three doses of oral polio vaccine, hepatitis B virus, and DPT before the age of 1 year. Objectives: To determine primary immunization coverage among 12-23 months old children and the factors affecting primary immunization coverage. Materials and Methods: A cross-sectional community-based study conducted from March 2011 to June 2011 in Miraj city of Maharashtra. The WHO 30 by 7 cluster sampling technique was used to collect data from 210 study subjects. Results: Among 210 (100%) children, 127 (60.5%) children were fully immunized while remaining 83 (39.5%) were partially immunized or unimmunized. Negligence of parents toward immunization was the main reason for incomplete immunization status of children. Conclusion: Health education activities for parents, especially in mothers, emphasizing the importance and need of immunization of children at right time could be arranged in communities. Equitable, participatory and intersectoral approach is need of hour for health care of children.

Predictors for critical care admission among children presenting to emergency department with recurrent wheezing.

Context:Children with recurrent wheezing contribute to a significant burden of inpatient hospital admission in developing countries. However, many patients could be managed at home following a short observation period in emergency unit.Aim:This study aimed to determine the predictors of critical care admission in a population of children aged 6 months to 2 years attending pediatric emergency department (ED) for recurrent wheezing.Setting and Design:This is a case–control study conducted in pediatric ED of a tertiary care center in North India.Patients and Methods:Demographic and clinical details were recorded for children aged 6 months to 2 years who presented to ED for “recurrent wheezing” within 48 h of onset of symptoms. Those who were admitted to critical care unit were considered cases and those who were discharged within 6 h of stay at short observation units of ED were considered controls.Statistical Analysis:Logistic regression model was used to determine which of the various demographic and clinical factors best predicted the need for critical care admission.Results:The cases (n = 58) had significantly higher number of emergency visits in the preceding 1 month (P = 0. 018), had more episodes of wheezing in the last 3 months (P = 0.025), had higher respiratory rate (P < 0.001), and had higher clinical severity score (P < 0.001) when compared to control (n = 58) group. Logistic regression model revealed incomplete immunization status of children (P = 0.005) to be a significant risk factor that determine the need for critical care admission.Conclusion:The present cross-sectional study with limited sample size revealed incomplete immunization status of children to be a significant risk factor that determined the need for critical care admission among children below 2 years of age presenting to ED with recurrent wheezing.

Increasing Immunization Compliance by Reducing Provisional Admittance.

Students in Vermont with incomplete or undocumented immunization status are provisionally admitted to schools and historically had a calendar year to resolve their immunization status. The process of resolving these students' immunization status was challenging for school nurses. We conducted a school-based quality improvement effort to increase student compliance with Vermont immunization regulations using a collaborative learning approach with public health school liaisons and school nurses from public schools to reduce provisional admittance in 2011-2012. Strategies included using a tracking system, accessing the immunization registry, promoting immunization importance, tracking immunization plans, and working with medical homes to update records. Participating school nurses observed decreases in the number of provisionally admitted students, although this reduction was not significantly different than matched comparison schools. We also found the number of provisionally admitted students fluctuated throughout the year and resolving the immunization status of New Americans and exchange students required special attention. Our approach supports the coordinated school health model and demonstrates the critical role school nurses play in improving population health outcomes.

Factors associated with incomplete childhood immunization in Arbegona district, southern Ethiopia: a case--control study.

BackgroundThe prevention of child mortality through immunization is one of the most cost-effective and widely applied public health interventions. In Ethiopia, the Expanded Program on Immunization (EPI) schedule is rarely completed as planned and the full immunization rate is only 24 %. The objective of this study was to identify determinant factors of incomplete childhood immunization in Arbegona district, Sidama zone, southern Ethiopia.MethodsA community based unmatched case-control study was undertaken among randomly selected children aged 12 to 23 months and with a total sample size of 548 (183 cases and 365 controls). A multi-stage sampling technique was used to get representative cases and controls. Data was collected using a structured questionnaire and analyzed using SPSS version 16 statistical software. Bivariate and multiple logistic regression analyses were done to identify independent factors for incomplete immunization status of children. Qualitative data were also generated and analyzed using thematic framework.ResultsThe incomplete immunization status of children was significantly associated with young mothers (AOR = 9.54; 95 % CI = 5.03, 18.09), being born second to fourth (AOR = 3.64; 95 % CI = 1.63, 8.14) and being born fifth or later in the family (AOR = 5.27; 95 % CI = 2.20, 12.64) as compared to being born first, a mother’s lack of knowledge about immunization benefits (AOR = 5.51; 95 % CI = 1.52, 19.94) and a mother’s negative perception of vaccine side effects (AOR = 1.92; 95 % CI = 1.01, 3.70). The qualitative finding revealed that the migration of mothers and unavailability of vaccines on appointed immunization dates were the major reasons for partial immunization of children.ConclusionTo reduce the number of children with incomplete immunization status, the Arbegona district needs to consider specific planning for mothers with these risk profiles. A focus on strengthening health communication activities to raise immunization awareness and address concerns of vaccine side effects at community level is also needed. This could be achieved through integrating the immunization service to other elements of primary health care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2678-1) contains supplementary material, which is available to authorized users.