Parental knowledge, attitude, and behavioral factors in immunization response following a diphtheria outbreak in children in 2018-2019

Abstract

Background A diphtheria outbreak was declared at the end of 2017. The outbreak response immunization (ORI) was a key Indonesian government strategy to control diphtheria in three outbreak areas. This strategy was implemented starting December 11, 2018. Parents’ positive knowledge, attitude, and behavior regarding diphtheria and the diphtheria ORI may influence the coverage of diphtheria ORI in Indonesia.
 Objective To assess for relationships between parental knowledge, attitude, and behavior to coverage of diphtheria ORI in children. 
 Method This cross-sectional study was conducted at Kapuk Muara Public Elementary School 03, North Jakarta from November 2018 to August 2019. The respondents were parents of the schoolchildren. Parents filled questionnaires about their knowledge, attitude, and behavior with regards to diphtheria ORI coverage in children.
 Results The coverage of diphtheria ORI in children was 61.8%. From 110 respondents, 40.9% of parents had at least sufficient knowledge, 73.8% had good attitude, and 55.5% had good behavior regarding diphtheria and diphtheria ORI. Parental knowledge had no significant association to coverage of diphtheria ORI in their children. However, there were significant relationships between parental attitude and behavior to coverage of diphtheria ORI in their children.
 Conclusion The coverage of diphtheria ORI needs improvement. Most parents have sufficient level of knowledge, good attitude, and good behavior towards diphtheria and diphtheria ORI. There is no association between parental knowledge about diphtheria and diphtheria ORI to coverage of diphtheria ORI, but there are significant association of parental attitude and behavior toward diphtheria ORI coverage.

The Impact of Promotion and Basic Immunization Counseling Program on Mother’s Knowledge and Attitude

“…This is different from the research of Nabila Arfimita et al 2020 regarding knowledge. Still, there is no significant relationship between parents' knowledge about diphtheria disease and (Outbreak Response Immunization) diphtheria ORI on diphtheria ORI coverage (P=0.075) 15 . Parents with a master's degree and having a monthly income between Rs 20,000 and 30,000 have much better knowledge than others.…”

“…The total sampling in this study was 64 people. The total sampling was all mothers who had children <2 years old 4,8,15,[17][18][19][20][21][22][23][24] . As well as those who have children who have received complete basic immunization, which is given including one dose of Bacillus Calumet Guerin (BCG) vaccination against tuberculosis at birth or at first clinical contact, three doses of pentavalent vaccine (DPT).…”

“…Respondents provided informed consent and notification of being volunteered for use for research purposes 10,15 . Data was collected directly from respondents through questionnaires regarding mothers' knowledge and attitudes regarding basic immunization.…”

“…Data was collected directly from respondents through questionnaires regarding mothers' knowledge and attitudes regarding basic immunization. The group intervened by researchers was given a questionnaire before and after promotion and counseling 8,[15][16][17][19][20][21][24][25][26] as many as 64 people. Data collection was carried out using a questionnaire that had been prepared and filled in directly by the subject with supervision from the researcher 9 .…”

“…Lack of knowledge about child vaccination schedules and vaccine-preventable diseases among mothers and caregivers may increase the risk of children not being fully immunized, especially those who have not attended pregnant women's conferences 8,14 . The knowledge and attitude of a child's parents significantly impact their child's basic immunization, with most having sufficient knowledge and good behavior towards diphtheria and diphtheria ORI 3,15 . Some mothers argue that vaccines aren't important due to their parents' lack of vaccination, highlighting the need for proper health education to prevent misbeliefs and affect mothers' attitudes 3,16 .…”