Knowledge and Perceptions of Adverse Events Following Immunization among Healthcare Professionals in Africa: A Case Study from Ghana

Abstract

The spontaneous reporting of suspected adverse events following immunization (AEFI) by healthcare professionals (HCPs) is vital in monitoring post-licensure vaccine safety. The main objective of this study was to assess the knowledge and perceptions of AEFIs among healthcare professionals (HCPs) in Africa, using the situation in Ghana as a case study. The study was of a cross-sectional quantitative design, and was carried out from 1 July 2017 to 31 December 2017 with doctors, pharmacists, and nurses as the study participants. A 28-item paper-based questionnaire, delivered by hand to study participants, was the data collection tool in the study. The study was conducted in 4 hospitals after ethical approval was granted. The desired sample size was 686; however, 453 consented to partake in the study. Data were analyzed using SPSS (software version 22, IBM, Armonk, NY, USA), and chi-square and binary logistic regression tests were used for tests of association between HCPs’ characteristics and their knowledge and perceptions. Detailed knowledge of AEFIs was ascertained with a set of 9 questions, with 8 or 9 correctly answered questions signifying high knowledge, 5 to 7 correctly answered questions signifying moderate knowledge, and below 5 correctly answered questions signifying low knowledge. A set of 10 questions also ascertained HCPs’ positive and negative perceptions of AEFI. Results revealed that knowledge of AEFIs was high in 49 (10.8%) participants, moderate in 213 (47.0%) participants, and low in 191 (42.2%) participants. There was no statistically significant correlation between AEFI knowledge and professions. The highest negative perception was the lack of desire to learn more about how to diagnose, report, investigate, and manage AEFI, whereas the lowest was the lack of belief that surveillance improves public trust in immunization programs. There was a general awareness of AEFIs among HCPs in this study. However, negative perceptions and the lack of highly knowledgeable HCPs regarding AEFIs were possible setbacks to AEFI diagnosis, management, prevention, and reporting. More training and sensitization of HCPs on AEFIs and vaccine safety will be beneficial in improving the situation. Future research should focus on assessing the training materials and methodology used in informing HCPs about AEFIs and vaccine safety.

Correlates of Health Care Workers’ Knowledge and HIV-Exposed Infant Immunization Counseling Practice in Northern Nigeria

“…The low proportion (32.3%) of respondents with adequate knowledge of HIV exposed/infected infant immunization is similar to the figures from other Nigerian centers (17%-50%), 24 but lower than reports from other parts of Africa (54%-69%) 25 , 26 and Asia (55.6%). 17 , 27 This finding could result in health care workers, who are often considered as trusted sources of health information, serving as conduits for misinformation to HIV-positive mothers regarding recommended vaccines, schedules, and contraindications.…”

“… 35 The predictive role of age and work experience could be attributed to the impact of cumulative experience and in-service training opportunities. Further, the finding of knowledge disparity between the professions, though this conflicts with reports from Ghana, 26 could reflect differences in pre-service curricula, roles, and responsibilities as well as access to continuing education opportunities. 36 …”

Knowledge of adverse events following immunization, its prevalence and actions of mothers of children aged 0–23 months in a tertiary health institution in Jos, North Central Nigeria

“…[ 14 ] However, a contrary finding was obtained in another Ghanaian study where majority of the respondents demonstrated good understating of the concept and definition of AEFI. [ 15 ] Though the assessment of the understanding the concept of AEFI was done among mothers of under-fives in this study while the Ghanaian studies had its assessments among health care workers. However, the variation that exists between the studies conducted in Ghana could be attributable to the fact the one of the studies was conducted in a rural district while the others included a mix of health care workers including medical doctors, nurses and pharmacist cutting across all the levels of health care.…”

“…[ 17 ] Additionally, other studies carried out in Nigeria, Kenya, Albania and Ghana reported varying level of knowledge of AEFI ranging from poor to fair. [ 9 , 15 , 18 , 19 ] It is important to note that the variation that existed in the levels of knowledge of AEFI could be attributed to the categories of the respondents. While in this study, mothers of under-fives were the subjects and other studies used health care workers of which all but one found the health care workers demonstrating lower levels of knowledge of AEFI than the mothers.…”

Assurance of quality, safety and efficacy of vaccines through compliance of quality management processes

“…These training protocols cater identification, prevention and treatment of AEFI. 21,24,25 New vaccines: an increasingly complex situation With introduction of new combination vaccines in market the assurance of vaccine quality has become more complex and cumbersome process. As a result, NRA has increased the regulatory requirements for the manufacturers to meet the safety and efficacy criterions.…”