Determinants of Caregivers’ Involvement in Vaccination Activities in the Polio Eradication Process in Kumbo-East and Nkambe Health Districts, North West Region of Cameroon

Dickson Shey Nsagha^1, , Eunice Kisifen Tatah¹, Alfred Kongnyu Njamnshi², Martyn Sama¹, Vincent Siysi Verla³, Obinchemti Thomas Egbe⁴ and William Tantoh Farnyu⁵

¹Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea 63, Cameroon

²Department of Neurology, Central Hospital Yaoundé/ Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, / Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon

³Department of Internal Medicine and Paediatrics, Faculty of Health Sciences, University of Buea, Buea 63, Cameroon

⁴Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Buea, Buea 63, Cameroon

⁵Department of Sociology & Anthropology, Faculty of Social and Management Sciences, University of Buea, Buea 63, Cameroon

Cite this paper:
Dickson Shey Nsagha, Eunice Kisifen Tatah, Alfred Kongnyu Njamnshi, Martyn Sama, Vincent Siysi Verla, Obinchemti Thomas Egbe and William Tantoh Farnyu. Determinants of Caregivers’ Involvement in Vaccination Activities in the Polio Eradication Process in Kumbo-East and Nkambe Health Districts, North West Region of Cameroon. American Journal of Epidemiology and Infectious Disease. 2020; 8(1):16-29. doi: 10.12691/ajeid-8-1-4

Abstract

Background: Immunization remains one of the most important public health interventions and cost-effective strategies to reduce child mortality and morbidity. In Cameroon, five confirmed cases of the wild polio species were reported in 2014 with one case from the North-West Region. Thus the complete eradication of poliomyelitis remains a major public health concern especially in areas where coverage, knowledge and perceptions about vaccination is low. This study assessed health determinants of caregivers on vaccination activities in the polio eradication process in the Kumbo-East and Nkambe Health Districts. Methods: This was a community-based cross-sectional study. A two-stage cluster sampling method was used to select participants from the study area. Fifteen (68.2%) health areas studied were randomly selected from Kumbo-East and Nkambe Health Districts. Within the health areas (based on probability proportionate to size method), households were randomly selected. Caregivers (15 to 70 years) of children between the ages of 0-59 months who signed a consent form and whose assents were obtained were administered a structured questionnaire through an interview. The questionnaires collected information on knowledge and practices from 1544 caregivers residing in 30 health areas, randomly selected from the Kumbo-East and Nkambe Health Districts. Ethical approval and administrative clearance were obtained for this study. Data was analyzed using stata 13. Descriptive and binary logistic regression was used to analyze the data. A P-value of < 0.05 was set to indicate statistical significance and a 95% confidence interval was considered. Results: The proportion of caregivers with a good knowledge and practices on vaccination activities in the polio eradication process were 53.0%, 49.2% and 74.2% respectively. Independent predictors of good knowledge were being 37 years or older (AOR = 1.3; 95% CI: 1.01 – 2.68) and having an educational level above primary (AOR = 6.42; 95% CI: 3.16 – 13.25). Independent predictors of good practices were being older (≥ 37 years) (AOR = 3.88; 95%CI: 1.44-10.43), being married (AOR = 2.15; 95%CI: 1.34-3.52), having an educational level above primary (AOR = 5.97; 95%CI: 1.69-21.48), antenatal care follow-up (AOR = 7.19; 95%CI: 2.25-22.5), residing less than 5km away from the vaccination site (AOR = 2.01; 95%CI: 1.05 - 4.97), having sufficient knowledge on vaccination (AOR = 3.78; 95%CI: 2.05-6.54) and having positive practices on vaccination (AOR = 2.15; 95%CI: 1.26-3.71). Conclusion: The knowledge and practices of caregivers on vaccination activities in the polio eradication process were not good. Many caregivers and health system-related factors still hinder caregivers from having good knowledge and practices on vaccination activities in the polio eradication process. Our results could help health planners to improve on the perception and coverage rates of immunization services.

Keywords:
caregivers knowledge attitudes practices predictors polio vaccination eradication

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Progress towards Polio Eradication-Worldwide, 2013-2014. Available from: https://www.cdc.gov/MMWr/preview/mmwrhtml/mm6321a4.htm. Accessed on 15th August 2017.
[2]	Progress towards Polio Eradication-Worldwide, 2013-2014. Available from: https://www.cdc.gov/MMWr/preview/mmwrhtml/mm6321a4.htm. Accessed on 15th August 2017.
[3]	Why polio is back. Available from: http://www.vox.com/2014/5/7/5688112/why-polio-is-on-the-rise-again. Accessed on 02nd September 2017.
[4]	Why polio is back. Available from: http://www.vox.com/2014/5/7/5688112/why-polio-is-on-the-rise-again. Accessed on 02nd September 2017.
[5]	How many people have polio today worldwide? Available from: http://www.answers.com/Q/How_many_people_have_polio_today_worldwide. Accessed on 05th September 2017.
[6]	How many people have polio today worldwide? Available from: http://www.answers.com/Q/How_many_people_have_polio_today_worldwide. Accessed on 05th September 2017.
[7]	GPEI, Eradicating the Last 1% of Polio Is Deadly but Essential, Available from: http://www.newsweek.com/2014/12/05/last-stand-against-polio-287862.html. Accessed on 10th September 2017.
[8]	GPEI, Eradicating the Last 1% of Polio Is Deadly but Essential, Available from: http://www.newsweek.com/2014/12/05/last-stand-against-polio-287862.html. Accessed on 10th September 2017.
[9]	WHO, Current Status of routine immunization and polio eradication in the African Region: Challenges and recommendations. 2010 Aug. Report No.: 60.
[10]	WHO, Current Status of routine immunization and polio eradication in the African Region: Challenges and recommendations. 2010 Aug. Report No.: 60.
[11]	CDC Global Health - Polio - Updates on CDC’s Polio Eradication Efforts - October 17, 2014. Available from: http://www.cdc.gov/polio/updates/index.htm. Accessed on 10th September 2017.
[12]	CDC Global Health - Polio - Updates on CDC’s Polio Eradication Efforts - October 17, 2014. Available from: http://www.cdc.gov/polio/updates/index.htm. Accessed on 10th September 2017.
[13]	Northwest Region (Cameroon), Available from: https://en.wikipedia.org/w/index.php?title=Northwest_Region_(Cameroon)&oldid=781496771. Accessed on 15th September 2017WHO, HOH. Active surveillance of Acute Flaccid Paralysis in Cameroon 2001.
[14]	Northwest Region (Cameroon), Available from: https://en.wikipedia.org/w/index.php?title=Northwest_Region_(Ca meroon)&oldid=781496771. Accessed on 15th September 2017WHO, HOH. Active surveillance of Acute Flaccid Paralysis in Cameroon 2001.
[15]	Kumbo East Health District, District Validation Data Management Tool (DVDMT). Kumbo East Health District Service; 2015. Available at the Kumbo East District Health Service. Accessed on 10th August 2017.
[16]	Kumbo East Health District, District Validation Data Management Tool (DVDMT). Kumbo East Health District Service; 2015. Available at the Kumbo East District Health Service. Accessed on 10th August 2017.
[17]	Mbuh R, polio eradication, Update on situation in Cameroon. MINSANTE; 2014.
[18]	Mbuh R, polio eradication, Update on situation in Cameroon. MINSANTE; 2014.
[19]	Qualit_res__smpl_size_consid.doc. Available from: https://my.laureate.net/Faculty/docs/Faculty%20Documents/qualit_res__smpl_size_consid.doc. Accessed on 18th May 2017
[20]	Qualit_res__smpl_size_consid.doc. Available from: https://my.laureate.net/Faculty/docs/Faculty%20Documents/qualit_res__smpl_size_consid.doc. Accessed on 18th May 2017
[21]	Saeed, H., Azhar, S., Syed, Akash. and Khalid, S, Polio and its vaccination: A cross Sectional study of knowledge, attitude and perception of general public in district Abbottabad and Mansehra Khyber, Pakistan. Anti-infective Agents, 2018, 16 (7) 22-31.
[22]	Saeed, H., Azhar, S., Syed, Akash. and Khalid, S, Polio and its vaccination: A cross Sectional study of knowledge, attitude and perception of general public in district Abbottabad and Mansehra Khyber, Pakistan. Anti-infective Agents, 2018, 16 (7): 22-31.
[23]	Khan, M.U., Ahmad, A., Aqeel, T., Salman, S., Ibrahim, Q., Idrees, J. and Khan, M.U, “Knowledge, attitudes and perceptions towards polio immunization among residents of two highly affected regions of Pakistan”, BMC Public Health, 2015, 15(1): 1.
[24]	Khan, M.U., Ahmad, A., Aqeel, T., Salman, S., Ibrahim, Q., Idrees, J. and Khan, M.U, “Knowledge, attitudes and perceptions towards polio immunization among residents of two highly affected regions of Pakistan”, BMC Public Health, 2015, 15(1), 1.
[25]	Ogwumike, O.O., Kaka, B. and Adeniyi, A.F, “Children with paralytic poliomyelitis: A cross-sectional study of knowledge, attitudes and beliefs of parents in Zamfara state, Nigeria”, BMC Public Health, 2012, 12(1), 1.
[26]	Ogwumike, O.O., Kaka, B. and Adeniyi, A.F, “Children with paralytic poliomyelitis: A cross-sectional study of knowledge, attitudes and beliefs of parents in Zamfara state, Nigeria”, BMC Public Health, 2012, 12(1): 1.
[27]	Dehli, N.A, Critical leap to polio eradication in India, United Nations children’s fund, Regional office for South Asia, 2003.
[28]	Dehli, N.A, Critical leap to polio eradication in India, United Nations children’s fund, Regional office for South Asia, 2003.
[29]	Aj Jabbar A, Religious leaders as partners in polio eradication (NWFP/FATA). In Technical Advisory group in poliomyelitis eradication in Afghanistan and Pakistan, Cairo 2008.
[30]	Aj Jabbar A, Religious leaders as partners in polio eradication (NWFP/FATA). In Technical Advisory group in poliomyelitis eradication in Afghanistan and Pakistan, Cairo 2008.
[31]	WHO, Poliomyelitis: intensification of the global eradication initiative. Geneva, Switzerland; 2013.
[32]	WHO, Poliomyelitis: intensification of the global eradication initiative. Geneva, Switzerland; 2013.
[33]	Alina g.,Emmon R., Abeer S.,Mohammed U.A., Sobia N.,Arslan M., Umar h., Marvi B., and Saad S, Knowledge ,attitudes and Practices regarding the Oral polio vaccine in Slum area of Karachi.
[34]	Alina g.,Emmon R., Abeer S.,Mohammed U.A., Sobia N.,Arslan M., Umar h., Marvi B., and Saad S, Knowledge ,attitudes and Practices regarding the Oral polio vaccine in Slum area of Karachi.
[35]	Center for Diseases Control and Prevention, Progress towards Poliomyelitis Eradication-Afgahnistan and Pakistan, 2011-2012.
[36]	Center for Diseases Control and Prevention, Progress towards Poliomyelitis Eradication-Afgahnistan and Pakistan, 2011-2012.
[37]	Center for Diseases Control and Prevention, Polio in Somalia, Kenya, Ethiopia, Jan 2014.
[38]	Center for Diseases Control and Prevention, Polio in Somalia, Kenya, Ethiopia, 2014.
[39]	Joseph, N., Subba, S.H., Nelliyanil, M., Kotian, S.M, and Haridath, A.C.A, “Study of knowledge and attitude towards pulse polio immunization in semi urban areas of South India, Australas”, Med. J.,2011,4(2): 81.
[40]	Joseph, N., Subba, S.H., Nelliyanil, M., Kotian, S.M, and Haridath, A.C.A, “Study of knowledge and attitude towards pulse polio immunization in semi urban areas of South India, Australas”, Med. J.,2011,4(2,81).
[41]	Sparrow A, Syria’s Polio Epidemic: The Suppressed Truth, New York; 2014.
[42]	Sparrow A, Syria’s Polio Epidemic: The Suppressed Truth, New York; 2014.
[43]	Masaharu M., Somthana D., Kayako S., Kencoh T., Outavong P., Anonh X, and Chushi K, “Factors affecting routine immunization coverage among children aged 12-59 months in Lao PDR after regional polio eradication in Western Pacific Region”, http://www.biosciencetrends.com 2007.
[44]	Masaharu M., Somthana D., Kayako S., Kencoh T., Outavong P., Anonh X, and Chushi K, “Factors affecting routine immunization coverage among children aged 12-59 months in Lao PDR after regional polio eradication in Western Pacific Region”, http://www.biosciencetrends.com 2007.
[45]	UNICEF, Promotion of routine immunization in Uganda-What National and District Leaders need to do, 2012.
[46]	UNICEF, Promotion of routine immunization in Uganda-What National and District Leaders need to do, 2012.
[47]	WHO, Current Status of Routine Immunization and Polio Eradication in the African Region; Challenges and Recommendations, Regional Committee for Africa, 2010. [Sixtieth Session].
[48]	WHO, Current Status of Routine Immunization and Polio Eradication in the African Region; Challenges and Recommendations, Regional Committee for Africa, 2010. [Sixtieth Session].