Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar.

<h4>Background</h4>Recent research in two cholera-endemic communities of Zanzibar has shown that a majority (∼94%) of the adult population was willing to receive free oral cholera vaccines (OCVs). Since OCV uptake in the 2009 campaign reached only ∼50% in these communities, an evaluation...

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Autores principales:	Christian Schaetti, Said M Ali, Claire-Lise Chaignat, Ahmed M Khatib, Raymond Hutubessy, Mitchell G Weiss
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7b187caee1624d3ba0828b690e12d45c
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spelling	oai:doaj.org-article:7b187caee1624d3ba0828b690e12d45c2021-11-18T07:11:30ZImproving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar.1932-620310.1371/journal.pone.0041527https://doaj.org/article/7b187caee1624d3ba0828b690e12d45c2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22844489/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Recent research in two cholera-endemic communities of Zanzibar has shown that a majority (∼94%) of the adult population was willing to receive free oral cholera vaccines (OCVs). Since OCV uptake in the 2009 campaign reached only ∼50% in these communities, an evaluation of social and cultural factors and of barriers was conducted to understand this difference for future cholera control planning.<h4>Methodology/principal findings</h4>A random sample of 367 adult peri-urban and rural community residents (46.6% immunized vs. 53.4% unimmunized) was studied with a semi-structured interview that inquired about social and cultural features of cholera depicted in a vignette and barriers to OCV uptake. Symptoms (rectal pain, loose skin only in rural community) and perceived causes (uncovered food, contact with contaminated water) specific for severe diarrhea were associated with uptake. Purchasing drugs from pharmacies to stop diarrhea and vomiting was negatively associated with uptake. Increasing household size, age and previous enteric illness episode were positively related to uptake, the latter only at the rural site. The most prominent barrier to uptake was competing obligations or priorities (reported by 74.5%, identified as most important barrier by 49.5%). Next most prominent barriers were lacking information about the campaign (29.6%, 12.2%), sickness (14.3%, 13.3%) and fear of possible vaccine side effects (15.3%, 5.6%). The majority of unvaccinated respondents requested repetition of the vaccination with free OCVs.<h4>Conclusions/significance</h4>Factors associated with uptake indicated a positive impact of the vaccination campaign and of sensitization activities on vaccine acceptance behavior. Unlike communities opposed to cholera control or settings where public confidence in vaccines is lacking, identified barriers to uptake indicated a good campaign implementation and trust in the health system. Despite prospects and demand for repeating the vaccination, local decision-makers should reconsider how careful logistical arrangements may improve community coverage and thus effectiveness of vaccination campaigns.Christian SchaettiSaid M AliClaire-Lise ChaignatAhmed M KhatibRaymond HutubessyMitchell G WeissPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 7, p e41527 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Christian Schaetti Said M Ali Claire-Lise Chaignat Ahmed M Khatib Raymond Hutubessy Mitchell G Weiss Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar.
description	<h4>Background</h4>Recent research in two cholera-endemic communities of Zanzibar has shown that a majority (∼94%) of the adult population was willing to receive free oral cholera vaccines (OCVs). Since OCV uptake in the 2009 campaign reached only ∼50% in these communities, an evaluation of social and cultural factors and of barriers was conducted to understand this difference for future cholera control planning.<h4>Methodology/principal findings</h4>A random sample of 367 adult peri-urban and rural community residents (46.6% immunized vs. 53.4% unimmunized) was studied with a semi-structured interview that inquired about social and cultural features of cholera depicted in a vignette and barriers to OCV uptake. Symptoms (rectal pain, loose skin only in rural community) and perceived causes (uncovered food, contact with contaminated water) specific for severe diarrhea were associated with uptake. Purchasing drugs from pharmacies to stop diarrhea and vomiting was negatively associated with uptake. Increasing household size, age and previous enteric illness episode were positively related to uptake, the latter only at the rural site. The most prominent barrier to uptake was competing obligations or priorities (reported by 74.5%, identified as most important barrier by 49.5%). Next most prominent barriers were lacking information about the campaign (29.6%, 12.2%), sickness (14.3%, 13.3%) and fear of possible vaccine side effects (15.3%, 5.6%). The majority of unvaccinated respondents requested repetition of the vaccination with free OCVs.<h4>Conclusions/significance</h4>Factors associated with uptake indicated a positive impact of the vaccination campaign and of sensitization activities on vaccine acceptance behavior. Unlike communities opposed to cholera control or settings where public confidence in vaccines is lacking, identified barriers to uptake indicated a good campaign implementation and trust in the health system. Despite prospects and demand for repeating the vaccination, local decision-makers should reconsider how careful logistical arrangements may improve community coverage and thus effectiveness of vaccination campaigns.
format	article
author	Christian Schaetti Said M Ali Claire-Lise Chaignat Ahmed M Khatib Raymond Hutubessy Mitchell G Weiss
author_facet	Christian Schaetti Said M Ali Claire-Lise Chaignat Ahmed M Khatib Raymond Hutubessy Mitchell G Weiss
author_sort	Christian Schaetti
title	Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar.
title_short	Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar.
title_full	Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar.
title_fullStr	Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar.
title_full_unstemmed	Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar.
title_sort	improving community coverage of oral cholera mass vaccination campaigns: lessons learned in zanzibar.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/7b187caee1624d3ba0828b690e12d45c
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Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in Zanzibar.

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