Immunization coverage and risk factors for failure to immunize within the Expanded Programme on Immunization in Kenya after introduction of new Haemophilus influenzae type b and hepatitis b virus antigens

Ndiritu, Moses; Cowgill, Karen D.; Ismail, Amina; Chiphatsi, Salome; Kamau, Tatu; Fegan, Greg; Feikin, Daniel R.; Newton, Charles R.; Scott, J. Anthony G.

doi:10.1186/1471-2458-6-132

Cited by 106 publications

(114 citation statements)

References 17 publications

(17 reference statements)

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“…If these isolates were excluded from our analysis, S. aureus becomes the predominant pathogen which is in keeping with other studies published from developing countries [11]. In this study, group B Streptococcus was observed only in 1% of the cases whereas in rural Kenya, the isolation rate has been observed up to 9%, especially in cases with early neonatal sepsis [6].…”

Section: Discussionsupporting

confidence: 66%

“…Despite having the necessary expertise required to isolate Haemophilus spp, we were not able to do so in these samples. Generally isolation rates in Africa are low and this has been attributed to the use of Haemophilus B vaccine which was introduced to Kenya in 2001 [6,11,12]. Among Gram-negative isolates, resistance to gentamicin was 27.6%, which is comparable to the observations of a study done at one of the public referral hospitals [7]; however, none of the common isolates in our study exhibited more than 50% resistance to the first-and second-line antibiotics used in empiric treatment of neonatal sepsis (Table 3).…”

Section: Discussionmentioning

confidence: 99%

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A ten-year review of neonatal bloodstream infections in a tertiary private hospital in Kenya

Kohli-Kochhar

Omuse

Revathi

2011

J Infect Dev Ctries

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Introduction: Neonatal mortality in developing countries is usually due to an infectious cause. The gold standard of investigation in developing countries is a positive blood culture. It is important to know the aetiology of neonatal bloodstream infections so that empiric treatment can be effective. Methodology: We conducted a retrospective clinical audit over ten years between January 2000 until December 2009, looking at the aetiology of both early and late onset neonatal sepsis. We analysed data from 152 (23%) patient isolates out of 662 suspected cases of neonatal sepsis. Results: Our study revealed that Gram-positive organisms were the predominant cause of both early and late onset sepsis; the common isolates were Staphylococcus epidermidis (34%) and Staphylococcus aureus (27%). There were no isolates of group B Streptococcus. Candida species was isolated only in patients with late onset sepsis (6.9%). Bacterial isolates were relatively sensitive to the commonly used first-and second-line empiric antibiotics. Conclusion: Gram-positive organisms remain the major cause of neonatal bloodstream infections in our setup. The findings of this study will guide clinicians in prescribing the right empiric therapy in cases of suspected neonatal sepsis before the definitive culture results are obtained.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

A ten-year review of neonatal bloodstream infections in a tertiary private hospital in Kenya

Kohli-Kochhar

Omuse

Revathi

2011

J Infect Dev Ctries

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“…45 A study conducted in a poor district in Kenya showed that immunization rate ratios of the pentavalent vaccine decreased with each kilometer of distance from vaccine clinics to homes. 46 In this regard, a study conducted in Burkina Faso demonstrated that mortality of children under five years of age increased by 50% when the walking distance to healthcare facilities was longer than four hours, 47 and a study conducted in Pakistan showed that proximity to government healthcare centers led to increase in children's immunization coverage. 10 Another study conducted among the Bedouin Arabs in southern Israel, many of whom have lived a nomadic lifestyle away from Maternal and Child Centers, and are thus similar to populations in low-income countries, demonstrated low infant immunization coverage prior to the establishment of a population-specific intervention program.…”

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confidence: 99%

The effect of social determinants on immunization programs

Glatman‐Freedman

Nichols

2012

Human Vaccines & Immunotherapeutics

102

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“…6,9,10 This was due to better literacy and socioeconomic condition of Christians. Intervention programs need to be tailored specifically for Muslim community through an in-depth analysis of psycho-social needs and subsequent corrective actions.…”

Section: Discussionmentioning

confidence: 99%

“…There is a strong association between use of family planning and use of immunization services or it may indicate that mothers at home are unable to bring their infant for the practical difficulties and expense of having other children at home. 9 It was found that mothers with 2-3 children are 20% less likely and those with >4 children are 40% less likely to have vaccinated children than those with 1 child. 12 Study conducted in Malawi, where 72% of 1st born, 64% of 2nd/3rd born, 63% 4th/5th born and 58% of 6+ order were fully immunized.…”

mentioning

confidence: 99%

Immunization status of children less than 5 years attending to tertiary care hospital out-patient department in an urban area, prospective-descriptive study

Chavan

Maralihalli

2016

Int J Contemp Pediatr

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INTRODUCTIONThe Indian population has swollen to 1.21 billion. 1 Children below 5 years constitute 12-15% of this population. In the 1980's the percentage of immunization was less than 5% according to government figures. The campaign picked up in the early 1990's. 2The scenario changed rapidly in the 90's, as the government took up the issue of national immunization. In 1995-96 the immunization was almost 97.1% for BCG, 91.6% for polio, 82.6% for measles. Karnataka too saw such a growth in immunization status. ABSTRACT Background:The Indian population has swollen to 1.21 billion.1 Children below 5 years constitute 12-15% of this population. To determine the immunization status of children <5 years of age attending Tertiary care hospital Outpatient department and the various factors influencing immunization status. Methods: Design of the study was Prospective-descriptive hospital based study. Patients/subjects were one thousand children <5 years of age. Subjects were selected by random sampling method, Immunization status of these children was analyzed and the cause for partial and non-immunization were studied. Information on socio demographic factors and immunization status was analyzed. Results: One thousand children under 5 years were studied for distribution of gender, age, residence, socio-economic status, religion, literacy, type of family, order of birth, type of delivery, number of children, age and occupation of mother. Of all parameters studied there were significant correlation between low maternal education, paternal education , low maternal age (15-20years), agriculture, higher birth order , joint family, low socio-economic, Muslim followed by Hindu, Christian, rural population, age group of 1-5 years, total number of children >2 with partial immunization. Conclusions: We observed that only 32.6% children were fully immunized. Financial problem, Lack of knowledge, immunisation at government hospital, ignorance seems to be a major contributing factors for under immunization. Female gender, rural back ground, belonging to Muslim community, low socioeconomic status, low maternal age, uneducated parents and being from joint family are the other contributing factors for the poor immunization coverage and were found to be statistically significant. Our study shows children had 100% immunised for BCG, OPV-0, OPV-1 and DPT-1.

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Immunization coverage and risk factors for failure to immunize within the Expanded Programme on Immunization in Kenya after introduction of new Haemophilus influenzae type b and hepatitis b virus antigens

Cited by 106 publications

References 17 publications

A ten-year review of neonatal bloodstream infections in a tertiary private hospital in Kenya

A ten-year review of neonatal bloodstream infections in a tertiary private hospital in Kenya

The effect of social determinants on immunization programs

Immunization status of children less than 5 years attending to tertiary care hospital out-patient department in an urban area, prospective-descriptive study

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