The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Integrated management of Neonatal and Childhood illness among Infants of 0 to...Dhruvendra Pandey
Integrated management of Neonatal and Childhood illness among Infants of 0 to 2 months, Difference between IMCI and IMNCI, Objective, Elements, Management of Diarrhea, Bacterial Infections, Jaundice, Hypothermia, Feeding problem, counseling of mothers, followup
Poshan Abhiyaan is a programme started by Indian government to eradicate malnutrition. It is started in 2018 on 8th of March on the occasion of International Womens Day.
Integrated management of Neonatal and Childhood illness among Infants of 0 to...Dhruvendra Pandey
Integrated management of Neonatal and Childhood illness among Infants of 0 to 2 months, Difference between IMCI and IMNCI, Objective, Elements, Management of Diarrhea, Bacterial Infections, Jaundice, Hypothermia, Feeding problem, counseling of mothers, followup
Poshan Abhiyaan is a programme started by Indian government to eradicate malnutrition. It is started in 2018 on 8th of March on the occasion of International Womens Day.
under 5 mortality, most common causes for under 5 mortality, the situation in India, situation in other parts of the world and schemes by Indian government to overcome this problem
Launched by the ministry of health & family welfare, government of India, under the national health mission.
It envisages Child Health Screening and Early Intervention Services
In 2011 to reduce neonatal mortality government of India launched Home based new born care program based on Gadchirolli model of SEARCH. This presentation will tell about how the program is enrolling in our country.
(Kangaroo Mother Care) Kangaroo Mother Care is an affordable alternative technology that addresses the needs of low birth weight infants. The kangaroo Mother Care position where in the baby is held against the mother's chest on skin to skin contact provides all the basic requirements for newborn survival.
Integrated child development services (icds) 2021Noddy Prabhat
Integrated child development services
1. introduction of icds.
2. describe the objectives of icds.
3. explain beneficiary of icds.
4. enumerate of icds team.
5. discuss the role of the health department.
6. elaborate the services under icds.
7. focuses of major achievement of icds .
8. Conclusion.
9. Bibliography.
Factors Influencing Immunization Coverage among Children 12- 23 Months of Age...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
under 5 mortality, most common causes for under 5 mortality, the situation in India, situation in other parts of the world and schemes by Indian government to overcome this problem
Launched by the ministry of health & family welfare, government of India, under the national health mission.
It envisages Child Health Screening and Early Intervention Services
In 2011 to reduce neonatal mortality government of India launched Home based new born care program based on Gadchirolli model of SEARCH. This presentation will tell about how the program is enrolling in our country.
(Kangaroo Mother Care) Kangaroo Mother Care is an affordable alternative technology that addresses the needs of low birth weight infants. The kangaroo Mother Care position where in the baby is held against the mother's chest on skin to skin contact provides all the basic requirements for newborn survival.
Integrated child development services (icds) 2021Noddy Prabhat
Integrated child development services
1. introduction of icds.
2. describe the objectives of icds.
3. explain beneficiary of icds.
4. enumerate of icds team.
5. discuss the role of the health department.
6. elaborate the services under icds.
7. focuses of major achievement of icds .
8. Conclusion.
9. Bibliography.
Factors Influencing Immunization Coverage among Children 12- 23 Months of Age...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Knowledge and Practice of Immunization amongst the care-givers of 12-23 month...iosrjce
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Can you please go over the power point you’ve provided & make sureTawnaDelatorrejs
Can you please go over the power point you’ve provided & make sure these 3 corrections required are successfully completed please? If you can add in more cited references please.
13
Assessing Current Approaches to Childhood Immunizations
Department of Psychology, Grand Canyon University
PSY-550: Research Methods
Dr. Shari Schwartz
May 19, 2021
Introduction
Immunization is the process in which an individual is protected against disease, and it is done via vaccination. On the other hand, vaccination is the action of a vaccine being introduced into the body to produce immunity to a particular disease. A vaccine is a product that arouses the immune system of an individual, thus the production of immunity to a particular disease. The immunity thus protects the individual from that disease. Immunity is the protection from a disease that is infectious. Child immunization is the primary public health approach in the reduction of child mortality and morbidity. Assessment of the current approaches that are linked to the immunization of a child is essential. Globally, primary immunization is estimated to prevent approximately 2.5 million childhood deaths annually from tetanus, diphtheria, measles, and pertussis (Dube et al., 2013). Immunization succession is always accompanied by rejection of public health practices, and reasons for these have never been straightforward. Some of the motivations are religious, scientific, or even political. To reduce the incidence and prevalence of vaccine-preventable diseases, vaccination programs depend on a high uptake level. Vaccination offers protection for vaccinated individuals. When there are high vaccination coverage rates, the indirect protection rate is stimulated for the overall community (Dube et al., 2013).Literature Review
Despite this massive use, immunization coverage in countries still developing has been reported to be still low. If mothers were educated on the importance of these vaccine services to their children, all the children would receive immunization as per the Expanded Program on the Immunization schedule, hence preventing mortality and morbidity. According to Thapar et al., in 2014, approximately an 18.7million children could not get the third dose of the Diphtheria-Pertussis-Tetanus (DPT3) vaccine. The total percentage of children who are one year and below and have to receive their dosses of DPT3 vaccine is seen as a proxy indicator regarding full immunization. The DPT3 estimates assess the health system performance and measure the immunization program effectiveness regarding service delivery. These strategies are thus used in the implementation of strategies for the elimination and eradication of diseases. According to Thapar et al., the global coverage for DPT1 and DPT3 was 90% and 86%, respectively, while that of measles first dose at 86%.
The above estimates thus do not replicate the seen differences in vaccine coverage. The coverage of DPT1 and DPT3 varied ...
13 Assessing Current Approaches to Childhood ImmunizatioChantellPantoja184
13
Assessing Current Approaches to Childhood Immunizations
Department of Psychology, Grand Canyon University
PSY-550: Research Methods
Dr. Shari Schwartz
May 19, 2021
Introduction
Immunization is the process in which an individual is protected against disease, and it is done via vaccination. On the other hand, vaccination is the action of a vaccine being introduced into the body to produce immunity to a particular disease. A vaccine is a product that arouses the immune system of an individual, thus the production of immunity to a particular disease. The immunity thus protects the individual from that disease. Immunity is the protection from a disease that is infectious. Child immunization is the primary public health approach in the reduction of child mortality and morbidity. Assessment of the current approaches that are linked to the immunization of a child is essential. Globally, primary immunization is estimated to prevent approximately 2.5 million childhood deaths annually from tetanus, diphtheria, measles, and pertussis (Dube et al., 2013). Immunization succession is always accompanied by rejection of public health practices, and reasons for these have never been straightforward. Some of the motivations are religious, scientific, or even political. To reduce the incidence and prevalence of vaccine-preventable diseases, vaccination programs depend on a high uptake level. Vaccination offers protection for vaccinated individuals. When there are high vaccination coverage rates, the indirect protection rate is stimulated for the overall community (Dube et al., 2013).Literature Review
Despite this massive use, immunization coverage in countries still developing has been reported to be still low. If mothers were educated on the importance of these vaccine services to their children, all the children would receive immunization as per the Expanded Program on the Immunization schedule, hence preventing mortality and morbidity. According to Thapar et al., in 2014, approximately an 18.7million children could not get the third dose of the Diphtheria-Pertussis-Tetanus (DPT3) vaccine. The total percentage of children who are one year and below and have to receive their dosses of DPT3 vaccine is seen as a proxy indicator regarding full immunization. The DPT3 estimates assess the health system performance and measure the immunization program effectiveness regarding service delivery. These strategies are thus used in the implementation of strategies for the elimination and eradication of diseases. According to Thapar et al., the global coverage for DPT1 and DPT3 was 90% and 86%, respectively, while that of measles first dose at 86%.
The above estimates thus do not replicate the seen differences in vaccine coverage. The coverage of DPT1 and DPT3 varied from 84% and 76% in Africa and 97% and 94% in the European countries. In India, the routine has been lower than in the rest of the countries. Following the 2013 outbreak in Israel, many paren ...
13 Assessing Current Approaches to Childhood ImmunizatioCicelyBourqueju
13
Assessing Current Approaches to Childhood Immunizations
Department of Psychology, Grand Canyon University
PSY-550: Research Methods
Dr. Shari Schwartz
May 19, 2021
Introduction
Immunization is the process in which an individual is protected against disease, and it is done via vaccination. On the other hand, vaccination is the action of a vaccine being introduced into the body to produce immunity to a particular disease. A vaccine is a product that arouses the immune system of an individual, thus the production of immunity to a particular disease. The immunity thus protects the individual from that disease. Immunity is the protection from a disease that is infectious. Child immunization is the primary public health approach in the reduction of child mortality and morbidity. Assessment of the current approaches that are linked to the immunization of a child is essential. Globally, primary immunization is estimated to prevent approximately 2.5 million childhood deaths annually from tetanus, diphtheria, measles, and pertussis (Dube et al., 2013). Immunization succession is always accompanied by rejection of public health practices, and reasons for these have never been straightforward. Some of the motivations are religious, scientific, or even political. To reduce the incidence and prevalence of vaccine-preventable diseases, vaccination programs depend on a high uptake level. Vaccination offers protection for vaccinated individuals. When there are high vaccination coverage rates, the indirect protection rate is stimulated for the overall community (Dube et al., 2013).Literature Review
Despite this massive use, immunization coverage in countries still developing has been reported to be still low. If mothers were educated on the importance of these vaccine services to their children, all the children would receive immunization as per the Expanded Program on the Immunization schedule, hence preventing mortality and morbidity. According to Thapar et al., in 2014, approximately an 18.7million children could not get the third dose of the Diphtheria-Pertussis-Tetanus (DPT3) vaccine. The total percentage of children who are one year and below and have to receive their dosses of DPT3 vaccine is seen as a proxy indicator regarding full immunization. The DPT3 estimates assess the health system performance and measure the immunization program effectiveness regarding service delivery. These strategies are thus used in the implementation of strategies for the elimination and eradication of diseases. According to Thapar et al., the global coverage for DPT1 and DPT3 was 90% and 86%, respectively, while that of measles first dose at 86%.
The above estimates thus do not replicate the seen differences in vaccine coverage. The coverage of DPT1 and DPT3 varied from 84% and 76% in Africa and 97% and 94% in the European countries. In India, the routine has been lower than in the rest of the countries. Following the 2013 outbreak in Israel, many paren ...
Running head RESEARCH PAPER15RESEARCH PAPERDo.docxtoltonkendal
Running head: RESEARCH PAPER 1
5
RESEARCH PAPER
Do the Benefits of Vaccination Outweigh Risks?
Yolanda Godbee
Columbia Southern University
Body Paragraphs Revision
Introduction
There have been arguments on whether the benefits of vaccination outweigh the risks. Many religious groups and non-governmental organizations have been on the front line in condemning vaccination. Most of these groups argue that vaccination does not only prevent children from contracting some diseases but also have their long-term side effects. Some of the religious groups have come out to claim that vaccination is used by some of the governments as a birth control method since it has effects on the hormones responsible for the formation of the fetus. However, the claims have not been substantiated (Sears, 2011). The groups have not rested their case there; some have access to resources, and they say they have conducted tests on some of the polio vaccines, and they found out that they affect most of the female children. They believe that the vaccine causes hormonal imbalance and therefore interfering with the normal process of conceiving and giving birth.
Vaccination prevents the children from contracting diseases as they develop. Vaccinations given to children at tender ages help then strengthen their immunity thus preventing a lot of diseases from infecting them. According to Sears (2011), the government of United States has championed for the vaccination to all children to help them grow healthy. The government champions the vaccination for children because of the enormous health benefits. Other countries like Australia, United Kingdom and Sweden are also championing for disease prevention in children and the society in general through vaccination. The spirit has been spread to other parts of the world like in Africa where last year the number of the vaccinated children increased by 37% in just two years. The move has not only seen many children being prevented from risky illnesses, but the society has also responded positively to the issue of immunization. Prevention of diseases is not the only benefit of vaccination.
Vaccination has also helped various countries to strengthen their economies in a significant way. Some diseases like Ebola, measles, polio and small pox can now be controlled through vaccination thus making people healthier and stronger to build the economy of their countries. This is evident in the 20th century when these diseases were killer diseases and governments spent lots of money in treating them hence making the economy weaker in the process. Evidently, recent research that was conducted by the Union of Doctors states that the number of people who died of polio and measles has drastically dropped and that is because vaccination has been embraced by many nations (Sears, 2011). As compared to the 20th century, the 21st century has seen most countries develop economically as more people are freed from these diseases throu ...
SOCIO-CULTURAL AND BEHAVIORAL FACTORS INFLUENCING CHILDHOOD IMMUNIZATION PR...GABRIEL JEREMIAH ORUIKOR
Abstract: Background: Immunization is one of the most cost-effective interventions with proven strategies to reach
the vulnerable populations. It is also a proven tool for controlling and eliminating life threatening infectious diseases.
It also prevents illness, disability and deaths from vaccine preventable diseases averting estimated 2-3 million deaths
each year.
Method: A descriptive survey research design was adopted, one hundred 100 nursing mothers were used for the
study. The instruments used for the study was a self-structured questionnaire. Simple random sampling technique
was used to select the sample for the study. Data collected were analysed using frequency, counts and percentage
table for demographic information.
Result: The findings of the study revealed that behaviour/attitude of healthcare workers and lack of enough
information were determinants of incomplete routine immunization, while life style, religion and belief were not
determinants of incomplete routine immunization. However, level of education, distance to health facility, life style,
religion and belief were jointly determinants of incomplete routine immunization among nursing mothers in Jericho
specialist hospital.
Conclusion: Based on the findings of the study; it is therefore recommended that State Government and
Philanthropists should assist in building more health care facilities close to the communities for easy accessibility.
Effort should be geared towards public campaign using local dialect to encourage them to complete routine
immunization. In addition, community mobilization should be strengthening especially among nursing mothers to
be fully informed about the merits of completing the routine immunization and to avert childhood morbidity and
mortality in our society.
Maternal Immunization with Tdap Vaccine Dr. Sharda Jain Lifecare Centre
Maternal
Immunization
with Tdap Vaccine
Agenda
Pertussis:Key facts & Epidemiology
Who is at risk?
Source of Pertussis infection
What is Tdap vaccine?
Recommendations for Maternal Immunization with Tdap vaccine
Safety data on Maternal Immunisation with Tdap vaccine
Summary
Running head PERCEIVED BENEFITS AND BARRIES ON MMR VACCINE 1 .docxtodd581
Running head: PERCEIVED BENEFITS AND BARRIES ON MMR VACCINE 1
Perceived Benefits and Barriers about the MMR Vaccine among the Parents of a Pediatric
Population in South Florida
Florida International University
PERCEIVED BENEFITS AND BARRIES ON MMR VACCINE 2
Background
According to the Center for Disease Control and Prevention (CDC), about 1 in 4 people
in the United States will be hospitalized and one out of every 1,000 people with measles will
develop brain swelling that could lead to brain damage. Given the possible severity when
obtaining Measles, the CDC recommends to protect children against measles by obtaining a
vaccine that provides enduring insurance against all strains of measles (Measles, 2018). The
Measles, Mumps, and Rubella vaccine (MMR) is administered in two doses in order to prevent
an individual from obtaining one of those diseases. The first dose was given to children when
they are about 13 months old, which offers 90 to 95% protection against those diseases. The
second dose increases those protection odds to become 99%, which is administered before a
child turns five years old. In order for the vaccine to be immune in our system, we need to
achieve at least 95% of immunity to those diseases (Gardner, 2010).
Side effects of MMR vaccine
There is for all intents and purposes no medication without reactions. Gentle symptoms of MMR
vaccine include the following: fever, mild rash, and swelling of the glands in the cheeks or neck.
Moderate reactions include: febrile seizures, brief joint inflammation, and impermanent
thrombocytopenia. Serious side effects of MMR vaccine are amazingly uncommon, but can
include serious allergic responses. Other serious side effects are rare to the point that it is
difficult to recognize whether they are caused by the vaccine, which includes: deafness, long-
term seizures, coma, lowered consciousness, and lasting brain damage (Mahmić-Kaknjo, 2017).
PERCEIVED BENEFITS AND BARRIES ON MMR VACCINE 3
Barriers
Obtaining immunization has been viewed as one of the best general wellbeing accomplishments
of the twentieth century for their job in killing smallpox and controlling polio, measles, rubella,
and different irresistible ailments in the United States. Regardless of their adequacy in
forestalling and destroying illness, routine youth vaccine take-up remains problematic. Parent
refusal of immunizations has added to flare-ups of vaccine preventable infections, for example,
measles and pertussis (Maglione, 2014). Late episodes of measles in the United Kingdom and
United States have awoken reestablished worry about vaccination dismissal. The rate of
vaccination take-up has fallen. Individuals' view of vaccine protection and effectiveness has
appeared to be an imperative factor for immunization take-up that, in the meantime, can spread
between people (Medus, 2014).
Research has shown that guardians' frames of mind .
Similar to Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization (20)
Congenital Agenesis Of The Corpus Callosum With Intracerebral Lipoma And Fron...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
“Hemodynamic and recovery profile with Dexmedetomidine and Fentanyl in intrac...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Correlation of Estrogen and Progesterone Receptor expression in Breast Canceriosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Analytical Study of Urine Samples for Epidemiology of Urinary Tract Infection...iosrphr_editor
The current study was carried out in District Abbottabad aimed to determine the common urinary
tract infections in local community to determine the epidemiology of significant diseases in asymptomatic patients
of renal disorder. In this study a total of 1000 urine samples were examined during 3rd February to 1st April 2015
from patients attending Ayub Teaching Hospital Abbottabad by using dipstick and microscopic analysis of urine.
There were 638 females and 362 males patients examined during this period. The range of age groups is between
1.5 years to 80 years. Results of this study was reported as Pyuria 11%, Proteinuria 21.1%, Hematuria 10.4%,
Epithelial Cells 8.2%, pH 7.8 %, Granular casts 7.3%, Triple phosphate 6.6%, Calcium oxalate 6.4%, Glycosuria
6.3%, Bacteria 6.2% and mucous 4.1%. This study concludes that routing urinalysis should be performed for all
individuals to diagnose the asymptomatic diseases that will help in simple therapeutic measurements as urinalysis
is a simple step to determine the root of Urinary tract disorders.
Chest sonography images in neonatal r.d.s. And proposed gradingiosrphr_editor
BACKGROUND : Lung sonography has been used to monitor the patients of R.D.S. in
N.I.C.U. in recent times.
AIMS : To Describe and Grade the changes of R.D.S. by lung sonography.
SETTING & DESIGN : Tertiary care institutional set up in a rural medical college.
STUDY DURATION : September 2014 to May 2015. Follow-up variable, upto 2 weeks.
PROSPECTIVE, ANALYTICAL STUDY.
MATERIALS AND METHODS -This was a single institute study approved by the institutional ethics
committee. Prior informed consent was obtained from the parents. 100 consecutive patients admitted in
N.I.C.U. WITH gestational age < 36 weeks with respiratory complaints were enrolled. Chest x-ray was
obtained within few hours of admission and lung sonography was performed within 24 hours. Follow – up
sonography was performed as and when necessary. Sonography image was graded and correlated with chest
xray and clinical picture
The Comprehensive Review on Fat Soluble Vitaminsiosrphr_editor
This review article deals with brief description of fat soluble vitamins with figures and tables
showing statistical analytical data duly quoting the references wherever necessary. The word “soluble” actually
means “able to be dissolved.” Whether a vitamin is classified as 'fat-soluble' or 'water-soluble' has to do with
how the vitamin is absorbed, stored and removed from the body. Vitamins are tiny organic compounds with a
huge impact on the health and well-being of the body. The body needs a small amount of fat soluble vitamins in
order to stay in optimal health. Fat soluble vitamins play an important role in keeping the body healthy and
functioning from immune system and muscle and heart function, easy flow and clotting of blood as well as eye
health. They are critical to health and wellness–particularly reproductive health and wellness. Low-fat, no-fat
and vegan diets are woefully lacking in fat soluble vitamins. However a diet based on traditional foods can
naturally provide these vitamins. Science is still learning about many of the functions of vitamins. "Too much
vitamin A, D, or K can lead to increased levels that are unhealthy and can cause serious health consequences.
Diseased conditions leading to decreased fat absorption leads to decreased absorption of vitamins. The fatsoluble
vitamins work most safely and effectively when obtained them from natural foods within the context of a
diet rich in all their synergistic partners. If fat soluble vitamins are stored for lengthy time they generate threat
for toxicity than water soluble vitamins and such situation even aggravated, provided they are consumed in
excess. Vitamin products, above the legal limits are not considered food supplements and must be registered as
prescription or non-prescription (over-the-counter drugs) due to their potential side effects. Vitamin A and E
supplements do not provide health benefits for healthy individuals, instead they may enhance mortality, and it is
held proved that beta-carotene supplements can be harmful to smokers
Sulphasalazine Induced Toxic Epidermal Necrolysis A Case Reportiosrphr_editor
Toxic Epidermal Necrolysis (TEN) is a rare and life threatening mucocutaneous reaction
characterized by extensive necrosis and detachment of epidermis. The Worldwide incidence of TEN is 0.9 to 1.4
per million populations per year [1]. Here we have discussed a case of Toxic Epidermal Necrolysis secondary
to Sulfasalazine managed with fluid replacement, analgesics, anti-infective therapy aggressive nutritional
support and intravenous high dose steroid therapy.
Keywords- Toxic Epidermal Necrolysis, Sulfasalazine
Evaluation the efficacy of IVIgG in treatment of Hemolytic Disease of Newborniosrphr_editor
Hemolytic disease of newborn (HDN) is an important cause of hyperbilirubinemia in the
neonatal period,and delayed diagnosis and treatment may lead to permanent brain damage. Traditional
neonatal treatment of HDN is intensive phototherapy and exchange transfusion.Intravenous
immunoglobulin(IVIgG) has been introduced as an alternative therapy to exchange transfusion. This study was
conducted to assess the effect of IVIG in HDN .
FIBROLIPOMATOUS HAMARTOMA OF ULNAR NERVE: A RARE CASE REPORT.iosrphr_editor
Nervous fibrolipomatous hamartoma is said to be a rare tumor-like condition involving the peripheral
nerves,in which the epineurium and perineurium are enlarged and distorted by excess of fatty and fibrous tissue
s that infiltrate between and around nerve boundaries. The median nerve is more likely to develop a hamartoma
than other nerves with a predilection for the carpal tunnel.
A fibrolipomatous hamartoma – is a rare, benign, congenital lesion most commonly found in the median nerve,
usually at the level of the wrist or hand.
We report a case of this rare condition in ulnar nerve.
SELF MEDICATION PRACTICES FOR ORAL HEALTH PROBLEMS AMONG DENTAL PATIENTS IN B...iosrphr_editor
Introduction: Self‑ medication is commonly practiced all over the world. Self-medication is defined as the use
of medication by a patient on his own initiative or on the advice of a pharmacist or a lay person instead of
consulting a medical practitioner. The present study was aimed to estimate the prevalence of self-medication for
oral health problems among dental patients in Bengaluru city; to identify triggering factors that could influence
self-medication practices; to identify sources of medications used; to identify sources of information about
medications used; and to identify reasons for self-medication.Study Design: A Cross sectional Study.Methods:A
survey was conducted among 175 subjects among dental patients in Bengaluru city. Data were collected
through a specially designed proforma using a closed‑ ended, self‑ administered questionnaire containing 15
questions, in five sections.
Results: The prevalence of
Clinico-haematological Profile of Falciparum Malaria in a Rural Hospital of T...iosrphr_editor
Aim: To study the clinico-haematological profile malaria in a rural hospital of Tripura.
Material and methods: A cross-sectional hospital-based study was done from at Kulai District
Hospital,Tripura. This hospital based cross sectional study was done on 60 confirmed cases of falciparum
malaria (either by peripheral smear or rapid diagnostic test) admitted in Kulai District Hospital. A case sheet
proforma was prepared and data (demographic profile,clinical feature, investigation, treatment, and
complication) from all indoor patients was collected and analyzed.
Result: Out of 60 patients, 40(66.6%) were males and 20 (33.4%) were females. Most of the patients were
between the age group 21-40 years with the highest prevalence between the age group of 21-30. Fever was the
most common symptom. Anemia was present in 42(70%) patients, out of which 6(10%) patients had severe
anemia. Thrombocytopenia was present in 36(60%) patients.Abnormal liver function tests were observed in
26(43.3%) subjects while abnormal kidney function tests were observed in16(26.6%) patients. All the 60
patients received Artemisinin based antimalarial drugs.
Conclusion: Early detection, prompt management, and adequate supportive therapy may reduce mortality due
to falciparum cerebral malaria.
Indonesian Wild Ginger (Zingiber sp) Extract: Antibacterial Activity against ...iosrphr_editor
Lempuyang gajah (Zingiber zerumbet (L.) Smith), lempuyang pahit (Zingiber amaricans BL.), and
lempuyang wangi (Zingiber aromaticum Vahl.) are used as traditional medicine (jamu) in Indonesia. It is also
used for treatment of microbial infections, helps to increase appetite and stimulate digestion in chickens.
Information on their uses are available, but only limited in the scientific data on their bioactivity. The study was
conducted on the antibacterial effect of organic extracts of these plants with Mycoplasma gallisepticum as the
agent of chronic respiratory disease in chickens. Juice and extracts of fresh and dried rhizome are evaluated
through the disc diffusion assay and minimum inhibitory concentration. Oxytetracyclin (30 µg) are used as
standards. All extracts are individually exhibited as antibacterial activity against Mycoplasma gallisepticum (7
± 0.11 mm to 21 ± 0.86 mm). The minimum inhibitory concentration (MIC) determination of plants extracts are
ranged from 7.8 mg/ml to 31.2 mg/ml. The preliminary results suggested promising antibacterial properties of
wild ginger from Indonesia, and probably could be used in management of chronic respiratory disease in
chickens.
A case of allergy and food sensitivity: the nasunin, natural color of eggplantiosrphr_editor
Abstract: Allergies and food sensitivities can both be considered as "adverse reactions individualistic" to food.
Are pathological and individual forms because they affect a few individuals in way rather serious; immediate
or delayed reactions occur instead with simple effects histamine, or, in severe cases with respiratory and
anaphylactic shock
The eggplant (Solanum melongena L.) is known to cause food allergies in some Asian countries, but detailed
studies on allergies caused by eggplant are lacking, however, it was highlighted the presence of allergens in
edible parts of eggplant with preponderance in the peel .
The purpose of this study was to propose an extraction method rapid, efficient and cost of natural dye from
waste products from the food industry, such as the peels of eggplant, from which it was extracted, isolated and
purified the nasunin,a colored molecule in red-fuchsia.
Nasusin was tested on 58 patients to evaluate the potential sensitizing effect on the skin. The results demonstrate
that allergenic effects are negligible and therefore the nasunin can be used as a colorant in various industrial
sectors with a certain safety margin
Complete NMR Assignment of MogrosidesII A2, II E andIII A1Isolated from Luo H...iosrphr_editor
NMR analysis allowed complete assignments of three known mogrol glycosides, Mogroside IIA2 (1),
II E (2)and IIIA1 (3), isolated from the extracts of Luo Han Guo. Herein, complete 1H and 13C NMR
assignmentsof all threemogrosidesare described based on NMR experiments (1H NMR, 13C NMR, COSY,
HSQC-DEPT, HMBC, NOESY and 1DTOCSY) and mass spectral data.
Nanoemulsion and Nanoemulgel as a Topical Formulationiosrphr_editor
: Nanoemulsion is referred type of emulsion with uniform and extremely small droplet size in the range
of 20-200 nm. Nanoemulsion provides numerous advantages over other carrier such as polymeric nanoparticle
and liposomes, including low cost preparation procedure, high hydrophilic and lipophilic drug loading system
to enhance the longer shelf live upon preserving the therapeutic agents. Incorporating the preparation of
nanoemulsion with hydrogel matrix to produce nanoemulgel exhibited by the two separate systems that forming
it. Nanoemulgel possesses the properties of thixotropic, non-greasy, effortlessly spreadable, easily be removed,
emollient, not staining, soluble in water, longer shelf life, bio-friendly, translucent and agreeable appearance.
Pharmacokinetics of High-Dose Methotrexate in Egyptian Children with Acute Ly...iosrphr_editor
Aim:Since several factors have been shown to influence the clearance of methotrexate, the purpose of this study
was to identify potential relationships between patient covariates and the methotrexate clearance estimates and
deduce a pharmacokinetic model for the estimation of methotrexate clearance in Egyptian pediatric ALL
patients that may help dosage adjustment and achieve target steady-state plasma concentrations in a similar
sittings.
Patients and methods: A total of 94 pediatric patients with B-cell ALL, of whom 70 were the studied population
and 24 were the test population, were treated with four courses of HDMTX doses 2.5 gm/m2
(low-risk arm) or 5
gm/m2
(standard-/high-risk arm) given every other week by intermittent intravenous infusions over 24 hours as
a part of their treatment protocol. Patients were monitored for the 24 hour MTX concentration and the systemic
methotrexate clearance was calculated for each methotrexate dose
Epidemiology of Tuberculosis (TB) in Albania 1998-2009iosrphr_editor
Abstract : In Albania, many people erroneously think that tuberculosis (TB) is a disease of the past-an illness
that no longer constitutes a public health threat. Surveillance is an integral part of tuberculosis (TB) control.
Albania has a highTB notification rate and there are doubts about underreporting. The evolution of the
incidence of tuberculosis is presented, together with more detailed figures over the period 1998-2009. These
figures were obtained by the monthly forms (called 14/Sh) compared with the individual notification data.
Objective: To examine the distribution and sources of increased tuberculosis (TB) morbidity and reporting
system deficiencies in the Albania from 1998 through 2009. Metodology: The study is descriptive one conductet
during the period 1998-2009. The statistical analysis is based on data reported from regional level (regional
epidemiological departments) to the central level (Public Health Institute). Results: The main findings were:
discordance between the collected data (individual form) and reported data (monthly form); tuberculosis
incidence rate shows little oscillations which ranges from 6.67 to 9.2 cases/100.000 population; 50% of the
regions show a lack of information on the confirmation of diagnosis and laboratory examination type used for
confirmation. Conclusion: TB disease in high-risk populations where it is difficult to detect, diagnose, and treat;
limitations of current control measures and the need for new tests and treatments, including an effective
vaccine; improving information system, regulation of individual form and personnel training.
Total Phenol and Antioxidant from Seed and Peel of Ripe and Unripe of Indones...iosrphr_editor
Study on total phenol and antioxidantactivity ofsugar apple fruits of various solvent, part of fruits, and level of ripening. Solvent extraction used were 80% (v/v) methanol, 50% (v/v) acetone, boiling water, and 50% (v/v) ethanol. Part of fruits thatbeen used for samples were seed and peel which are normally by products of sugar apple processing, level of ripening were unripe, and ripe sugar apple fruits. Total phenol was determined by Folin-ciocalteau method. Total antioxidant was quantified by 1,1-diphenyl-2-picrylhydrazyl(DPPH) method.Therewas a difference in type of solvent, part of fruits, and level of ripeningon total phenol and antioxidant concentration of sugar apple fruits. Seeds have higher total phenol concentration than peels of this fruits. Unripe sugar apple fruits have higher total phenol and antioxidant than ripe fruit. The best solvent for phenol extraction was ethanol 50%butthe best solvent for antioxidant extraction was acetone 50%.
A Review on Step-by-Step Analytical Method Validationiosrphr_editor
When analytical method is utilized to generate results about the characteristics of drug related samples it is essential that the results are trustworthy. They may be utilized as the basis for decisions relating to administering the drug to patients. Analytical method validation required during drug development and manufacturing and these analytical methods are fit for their intended purpose. To comply with the requirements of GMP pharmaceutical industries should have an overall validation policy which documents how validation will be performed. The purpose of this validation is to show that processes involved in the development and manufacture of drug, production and analytical testing can be performed in an effective and reproducible manner. This review article provides guidance on how to perform validation characteristics for the analytical method which are utilized in pharmaceutical analysis.
A Cross Sectional Study of Ethnic Differences in Occurrence and Severity of A...iosrphr_editor
Non-steroidal anti-inflammatory drugs are the most widely used "over the counter" medication all over the world despite their complications in different major organs. Present studies envisaged for knowing the occurrence and severity of adverse drug reactions from NSAIDs in different ethnic communities of Sikkim. A cross sectional study was undertaken in the medicine outpatients department of a secondary and tertiary care hospital. The patients belonging to Nepalese, Bhutias, Lepchas ethnic communities and others community (settlers from other parts of India) were included to analyzed the data based on the age and gender, ethnicity and ADRs, drugs and ADRs. Severity assessment was done using Hartwing and Siegel scale and causality assessment by Naranjo scale. Total 109 cases of ADRs, predominating in female were detected. Nepalese were the most affected and Gastrointestinal tract (GIT) being the most affected organ in them. Diclofenac showed maximum number of ADRs in all the communities. Maximum number of cases occurred on single day use (40.36%) of drugs. All the cases were belonging to the "possible category" and the maximum being the mild (72.48%) in nature. It is advisable to consider the ethnic/racial differences equally with other factors, to improve the safety and efficacy of a drug.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization
1. IOSR Journal Of Pharmacy
(e)-ISSN: 2250-3013, (p)-ISSN: 2319-4219
www.iosrphr.org Volume 5, Issue 6 (June 2015), PP. 34-45
34
Assessment of Knowledge, Attitudes and Practices of Mothers in
Jos North Regarding Immunization
*1
Chris-Otubor, G.O., 2
Dangiwa, D.A., 3
Ior, L.D, 1
Anukam, N.C.
1
Department of Pharmaceutics And Pharmaceutical Technology,
2
Department of Clinical Pharmacy,
3
Department of Pharmacology, Faculty of Pharmaceutical Sciences, University Of Jos, Plateau State, Nigeria.
ABSTRACT: Background: The knowledge of mothers on immunization- a public health intervention that has
greatly reduced mortality and morbidity globally- is very vital as they play a great role in child care. Their
ability to have the right knowledge will enhance their practice and attitude towards immunization. This study
was set to assess the knowledge, attitude and practice of mothers as regards immunization and the influence of
socio demographic characteristics on immunizable children.
Method:
A household multi-stage sampling 48-item questionnaire study design was modified and adopted.
Mothers with children born between 26th
September 2011 and 26th
September 2012 were targeted. Records of
children that visited the immunization unit in the month of August 2012 were also studied.
Results:
The number of respondents who participated in the study was 232. Though only 2.6% had excellent
knowledge on vaccine preventable diseases, 89.6% had an overall good knowledge while 5.2% each had fair
and poor knowledge. Less than 60% reported for vaccination at the stipulated time and less than 3% had
negative attitude towards immunization. The education of the mother, marital status, religion, geopolitical zone
and her and/or the father of the child been immunized as children significantly influenced their knowledge
(p<0.05). The records of 513 children that visited the clinic for the first time in April 2012 also revealed that
only 23.4% completed their immunization schedule revealing poor practice by mothers. These findings call for
health promotion.
Conclusion:
It is therefore suggested that proper health education and health promotion interventions be taken as measures to
improve knowledge, attitude and practice of mothers towards immunization as a disease prevention tool.
KEYWORDS: Knowledge, attitude, practices, mothers, child immunization
I. INTRODUCTION
What is immunization? The World Health Organization (WHO) has defined immunization as the
process whereby a person is made immune or resistant to an infectious disease, typically by the administration
of a vaccine. These vaccines help to stimulate the body‟s own immune system to protect the person against
subsequent infection or disease (WHO, 2013). Immunization therefore depicts the ability to develop immunity.
Immunity being the state of having sufficient biological defenses to avoid infection, disease, or other unwanted
biological invasion (Gherardi, 1989). Immunity also depicts the capability of the body to resist harmful
microbes from gaining access into it.
Immunization is one of the most successful and cost effective public health interventions in the
constant effort of human beings against diseases that affect our wellbeing. Immunization has prevented more
deaths in the past years than any other health intervention globally (Awosika, 2012). WHO (2013) also stated
that immunization is a proven tool for controlling and eliminating life-threatening infectious disease and has
been estimated to alleviate 2 to 3 million deaths each year. WHO (2013 ) further stated that although global
vaccination coverage is holding steady but an estimated 22 million infants worldwide are still missing out on
basic vaccines. The report on global vaccination coverage showed that the proportion of the world‟s children
who receive recommended vaccines has remained steady for the past few years giving an instance that the
percentage of infants fully vaccinated against diphtheria-tetanus-pertussis (DTP3) was 83% in 2011, 84% in
2010 and 83% in 2009.
2. Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization
35
Every year more than 10 million children in low- and middle-income countries die before they reach
their fifth birthdays. Most die because they do not access effective interventions that would combat common and
preventable childhood illnesses (Lee, 2003).Vaccine preventable diseases remain the most common cause of
childhood mortality with an estimated three million deaths each year (Odusanya et al., 2008). They also
observed that uptake of vaccination services is dependent not only on provision of these services but also on
other factors including knowledge and attitude of mothers, density of health workers, accessibility to
vaccination clinics and availability of safe needles and syringes.
Kapoor and Vyas (2010) had stated that although immunization is one of the most effective, safest and
efficient Public Health Interventions, and that its impact on childhood morbidity and mortality has been great,
its full potential was yet to be reached. Through proven strategies, immunization has been made accessible to
even the most hard-to-reach and vulnerable populations since it involves clearly targeted groups (WHO, 2013).
When immunization rates are high, it is much less likely a pathogen will be carried and transmitted from person
to person. Declines in vaccination rates allow diseases to emerge in the population again. A case in point is the
fact that Measles is now endemic in the United Kingdom, after vaccination rates dropped below 80% (Awosika,
2012). In Nigeria in 2001, unfounded fears of the polio vaccine led to a drop in vaccination rates and re-
emergence of infection, and the spread of polio to ten other countries (Awosika, 2012).
It has been reported that in 1958 there were 763,094 cases of measles and 552 deaths in the United
States (Orenstein et al., 2004; CDC, 2008). With the introduction of new vaccines, the number of cases dropped
to fewer than 150 per year having a median value of 56 (CDC, 2008). In early 2008, it was also reported that
there were only 64 suspected cases of measles. Out of these 64 infections, 54 cases were associated with
importation from another country, although only 13% were actually acquired outside of the United States; 63 of
these 64 individuals either had never been vaccinated against measles, or were uncertain whether they had been
vaccinated (CDC, 2008).
In response to challenges in global immunization, WHO and the United Nations International
Children‟s Emergency Fund (UNICEF) set up the Global Immunization Vision and Strategy (GIVS) in 2003
(GIVS, 2005). The chief goal of GIVS is primarily to reduce illness and death due to vaccine-preventable
diseases by at least two-thirds by 2015 or earlier. The Task Force on Immunization in Africa (TFI) recognized
from the outset the need for high vaccination coverage to counter the disproportionate burden from vaccine-
preventable diseases in the African Region, and therefore set challenging goals for 2001–2005. These goals
aimed to ensure that the immunization performance of the African Region caught up with other regions‟
performance.
Siddiqi et al., (2010) concluded that mothers‟ knowledge about Expanded Program on immunization
(EPI) vaccination in peri-urban Karachi was quite low and not associated with their children‟s EPI coverage.
Mothers‟ educational status, however, was significantly associated with child‟s coverage. This finding depicted
a better health seeking behavior of a more educated mother. According to Angelilio et al., (1999), several
studies on the immunization status of children have been published in various countries at different times, and
comparisons with these studies are interesting but must be made cautiously. They also stated that since many
factors may influence vaccination coverage, important differences should be taken into account, such as
prevalence of vaccine-preventable diseases, availability of vaccination centers, level of knowledge and
information about vaccination, and different methods used to measure immunization status.
In Nigeria, the National Primary Health Care Development Agency has a National Immunization
Policy that was revised in 2009. Included within this policy is the Immunization Schedule which is designed to
include all children 0-1 year who shall receive one dose of (Bacille-Calmette Guerin) BCG against tuberculosis,
one dose of Yellow Fever vaccine, 3 doses of Diphtheria, Pertussis, Tetanus (DPT), 3 doses of Haemophilus
influenza (Hib) vaccines, 3 doses of Hepatitis B vaccines 4 doses of (Oral Poliomyelitis Vaccine) OPV and one
dose of Measles vaccine before the age of one.
3. Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization
36
Table 1 Immunization Schedule for Vaccines used in Nigeria
Contact Minimum
Target age
of child
Type of Vaccine Dosage Route of
administration
Site
1st
At Birth BCG 0.05ml Intra dermal Right Upper Arm
OPV0 2 drops Oral Mouth
2nd
6 weeks Pentavalent1(DPT,
HBV and Hib)
0.5ml Intramuscular Antero-lateral
aspect of thigh
OPV1 2 drops Oral Mouth
3rd
10 weeks Pentavalent2(DPT,
HBV and Hib)
0.5ml Intramuscular Antero-lateral
aspect of thigh
OPV2 2 drops Oral Mouth
4th
14 weeks Pentavalent3(DPT,
HBV and Hib)
0.5ml Intramuscular Antero-lateral
aspect of thigh
OPV3 2 drops Oral Mouth
5th
9 months Measles 0.5ml Subcutaneous Left Upper Arm
Yellow fever 0.5ml Subcutaneous Left Upper Arm
Sourced from National Primary Health Care Development Agency (NPHCDA, 2009)
II. METHOD
A household multi-stage sampling questionnaire study design was employed in various localities
within Jos North Local Government Area. The coverage survey of the Expanded Programme on Immunization
(EPI) under the World Health Organization which was revised in 1991 (WHO, 1991), was modified and
employed. Various communities were visited and the questionnaires were administered to mothers or caregivers
that had children that fell within the study population.
As a way of intervention, during the course of the filling of the questionnaires mothers that lacked
adequate knowledge were educated and a little flier was designed for distribution to women to enhance their
knowledge as regards the immunization schedule. This served as a form of health promotion.
The records of the month of August 2012 at the immunization centre in the Ministry of Health Jos were
also studied and the information required extracted.
The research focused on mothers and caregivers with children aged between 12-23 months. Children
born between 26th
September 2011 and 26th
September 2012 were considered.
A four-sectioned semi-structured questionnaire was used to collect data from mothers/ caregivers. The
first section comprised of questions relating to the demographic data while the second, third and fourth section
dealt with questions relating to knowledge, practices and attitude of mothers/ caregivers respectively. Each
question was constructed as adapted from the EPI coverage survey (WHO, 2011). Copies of the instrument were
also handed over to researchers for validation. Structured interview was used for patients with low literacy level
especially those who cannot read and/or write. This was to ensure coverage of as many mothers as possible.
In order to ensure a wide coverage of the study population, research assistants were selected and
trained to fill the research instruments as well as to interpret information found on the child immunization cards.
Questionnaires were pretested to observe response of mothers and ascertain the appropriateness of the questions.
A minimum of seven mothers were visited in various wards of Jos North metropolis, thereby generating
responses that would represent a higher percentage of the entire population.
Descriptive analysis was utilized for data analysis which involves the use of frequency distribution and
percentage. Data was collated, entered and analyzed using Chi-square with the aid of SPSS software version 16
Chicago, Illinois.
Ethical clearance was gotten from the Institutional Health Research Ethical Committee of the Jos
University Teaching Hospital before the collection of the data. The consent of the respondents was sought
before the administration of the questionnaires. Data collected were treated with utmost confidentiality.
4. Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization
37
III. RESULTS
Three hundred and fifty-five, 48-item questionnaires were distributed to the respondents through
trained research assistants between 26th
September and 25th
October 2013. Two hundred and thirty two were
correctly filled and returned by the time of analysis. Sixty-four were improperly filled, forty-four returned late
and fifteen are yet to be returned as at the time of compilation. Thus the response rate was 65.4%.
The survey of children that reported for immunization at the epidemiologic unit of the Ministry of
Health in Jos in the month of August 2012 revealed that five hundred and seventeen children (517) visited the
unit out of which two hundred and fifty-six (256) were males and two hundred and fifty-seven (257) were
females. The sexes of four (4) children were not recorded so they were eliminated from the study.
I. Results from survey of mothers in Jos north
The figure below shows that out of a total of 232 questionnaires that were returned correctly filled, more males
(51.3%) than females (48.7%) were sampled.
Fig 1: Distribution of sampled children by sex
Table 2 depicts that the mothers were largely between the ages of 25-30years (44.4%) which is the reproductive
period for most women. Only about 4% were above 40 years of age.
Table 2 Distribution of the age of mothers sampled
Age Frequency Percentage
<25 49 21.1
25-30 103 44.4
31-40 71 30.6
>40 9 3.9
Total 232 100.0
Table 3 shows that almost 93% of the mothers were married while the remaining percentages were single,
separated, divorced or widowed.
Table 3 Marital Status of the mothers
status Frequency Percentage
Single/separated/divorced/widowed 17 7.3
married 215 92.7
Total 232 100.0
Table 4 revealed that most of the mothers have had some form of secondary education, this accounted for over
56%. However, 3.9% never had any formal education.
48.70%51.30%
Female
Male
5. Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization
38
aTable 4 Mothers’ education
Table 5
portray
ed that
a large
majorit
y of
mothers were from the north central (75.4%) geopolitical zone of Nigeria. Other women represented other zones
as follows; north-west (3.0%), north-east (3.4%), south-west (7.3%) and south-east (10.8%). South-south were
not represented in the study.
Table 5 Distribution of mothers by their geopolitical zones
Zone Frequency Percentage
North-central 175 75.4
North-west 7 3.0
North-east 8 3.4
South-south 0 0
South-west 17 7.3
South-east 25 10.8
Total 232 100.0
Table 6 showed that almost 93% of sampled mothers were Christians as compared to 7.3% that were Muslims.
Table 6 Religion of mothers surveyed
Religion Frequency Percentage
Christianity 215 92.7
Islam 17 7.3
Total 232 100.0
Table 7 portrayed that most women were into business/trading (52.1%), 23.7% were not in any paid
employment (housewives), 13.8% were civil servants, and 5.2% each were students or workers in corporate
organizations.
Table 7 Mothers’ occupation
Occupation Frequency Percentage
Housewife 55 23.7
Business/trading 121 52.1
Civil servant 32 13.8
Corporate organization 12 5.2
student 12 5.2
Total 232 100.0
In Fig 2 it was observed that majority (83.6%) of mothers were immunized as children but 6.0% were not.
Unlike mothers, 60.3% of fathers were immunized as children and 5.2% were not.
Education Frequency Percentage
Primary 28 12.1
Secondary 131 56.5
Tertiary 64 27.6
None 9 3.9
Total 232 100.0
6. Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization
39
Fig 2: History of parental immunization at infancy
Table 8 revealed that overall; most mothers were able to give correct answers to questions on immunization and
were generally able to identify vaccine preventable diseases. Only 6 mothers (2.6%) however showed excellent
knowledge on the vaccine preventable diseases and were able to identify that malaria and HIV were not vaccine
preventable diseases in Nigeria currently.
Table 8 Assessment of Knowledge
Yes
N (%)
No
N (%)
I don’t know
N (%)
Heard about immunization 230 (99.2) 1(0.4) 1 (0.4)
Immunization prevents childhood disease 218 (94.0) 5 (2.2) 9 (3.9)
It stops children from developing properly 10 (4.3) 207 (89.2) 15 (6.5)
Vaccine preventable diseases catered for in Nigeria
Tuberculosis 184 (79.3) 12 (5.2) 36 (15.5)
Malaria 136 (58.6) 55 (23.7) 41 (17.7)
Diphtheria 105 (45.3) 24 (10.3) 103 (44.4)
Pertussis 114 (49.1) 19 (8.2) 99 (42.7)
HIV 61 (26.3) 118 (50.9) 53(22.8)
Measles 203 (87.5) 15(6.5) 14 (6.0)
Influenza 113 (48.7) 44(19.0) 75 (32.3)
Poliomyelitis 213 (91.8) 8 (3.4) 11 (4.7)
Hepatitis 187 (80.6) 20 (8.6) 25 (10.8)
Tetanus 182 (78.4) 22 (9.5) 28 (12.1)
Yellow fever 202 (87.1) 8 (3.4) 22 (9.5)
Table 9 summarized the outcomes of Table 3.7 by scoring and categorizing them into three. The first group was
rated “good” when the mothers scored between 8 and 14 questions correctly. The second group was rated “fair”
if they scored between 5 and 7 points while the third group was rated “poor” if they scored less than 5 points.
The overall knowledge of sampled women was good as almost 90% had a good knowledge of immunization
even though an equal percentage of 5.2 had fair and poor knowledge respectively.
Table 9 Cumulative assessment of knowledge
Knowledge Frequency Percentage
Good 208 89.6
Fair 12 5.2
poor 12 5.2
Total 232 100.0
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
Yes No I Don’t know
83.60%
6.00%
10.30%
60.30%
5.20%
34.50%
mothers
fathers
7. Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization
40
Table 10 classified the children and their level of immunization depicting the practice of their mothers. In terms
of receiving the vaccine at the stipulated time; for BCG, those that had taken it by two weeks fell into this group
along with those that had taken the other vaccines within one month of the due date.
About 56.0%, 40.5% and 39.7% mothers vaccinated their children within the stipulated time for BCG,
DPT and hepatitis vaccines respectively. Over 30% were said to be immunized against each of the diseases but,
there was no record in the form of immunization cards available to prove it. There were also cases of incomplete
dosage for DPT (7.8%), hepatitis (9.9%) and OPV (8.6%). However, some children were not presented for
vaccination at all; yellow fever had the highest prevalence (10.7%) while BCG was the lowest (2.2%).
Table 10 Assessments of practices
Vaccine A B C D E
BCG 130 (56.0) 27 (11.6) 70 (30.2) - 5(2.2)
DPT 94 (40.5) 41(17.7) 72 (31.0) 18 (7.8) 7 (3.0)
Hepatitis 92 (39.7) 35 (15.1) 75 (32.3) 23 (9.9) 7 (3.0)
OPV 93 (40.1) 37 (15.9) 75 (32.3) 20 (8.6) 7 (3.0)
Measles 116 (50.0) 18 (7.8) 76 (32.8) - 22 (9.5)
Yellow fever 112 (48.3) 19 (8.2) 76 (32.8) - 25 (10.7)
Note: DPT and Hepatitis were taken as single vaccines or as in PENTA
Key:
A- Vaccinated at the stipulated time
B- Vaccinated but not at the stipulated time
C- Mothers history
D- Incomplete doses
E- Not vaccinated
Table 11 portrayed that the level of education was significantly associated with how knowledgeable mothers
were on immunization and vaccine preventable diseases, the higher the level of education, the higher the
knowledge. Other factors that significantly associated with knowledge were marital status, geopolitical zone,
religion, mothers being immunized as children as well as fathers.
Table 11 Influence of socio demographic characteristics on knowledge
Characteristics knowledge Chi-square p-value
Good
n=208
Fair
n=12
Poor
n=12
Sex 0.486 0.784
Female 100(88.5%) 7 (6.2%) 6 (5.3%)
Male 108 (90.8%) 5 (4.2%) 6(5.0%)
Mothers age 3.722 0.714
<25 42 (85.7%) 3(6.1%) 4(8.2%)
25-30 94(91.3%) 4(3.9%) 5(4.9%)
31-40 64(90.1%) 5(7.0%) 2(2.8%)
>40 8(88.9%) 0 (0.0%) 1(11.1%)
Mothers Marital Status 14.766 0.001*
Single/separated/divorced/
widowed (64.7%) 4(23.5%) 2 (11.8%)
married 197 (91.6%) 8 (3.7%) 10 (4.7%)
Mothers Education 22.846 0.001*
None 6 (66.7%) 0 (.0%) 3 (33.3%)
Primary 22(78.6%) 4(14.3%) 2(7.1%)
Secondary 120 (91.6%) 7 (5.3%) 4 (3.1%)
Tertiary 60 (93.8%) 1 (1.6%) 3 (4.7%)
Geopolitical Zone 46.747 0.000*
North-central 160 (91.4%) 8 (4.6%) 7 (4.0%)
North-west 2 (28.6%) 1 (14.3%) 4 (57.1%)
North-east 6 (75.0%) 1 (12.5%) 1 (12.5%)
South-south
8. Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization
41
South-west 17 (100.0%) 0 (0.0%) 0 (0.0%)
South-east 23 (92.0%) 2 (8.0%) 0 (.0%)
Mother‟s Occupation 14.540 0.069
Housewife 44 (80.0%) 3 (5.5%) 8 (14.5%)
Business/trading 110 (91.7%) 7 (5.8%) 3 (2.5%)
Civil servant 30 (93.8%) 1 (3.1%) 1 (3.1%)
Corporate organization 12 (100.0%) 0 ( 0.0%) 0 (0.0%)
student 12 (92.3%) 1 (7.7%) 0 (0.0%)
Religion 24.324 0.000*
Christianity 198 (92.1%) 10 (4.7%) 7 (3.3%)
Islam 10 (58.8%) 2 (11.8%) 5 (29.4%)
Mother‟s immunized 31.933 0.000*
Yes 179 (92.3%) 9 (4.6%) 6 (3.1%)
No 7 (50.0%) 2 (14.3%) 5 (35.7%)
I don’t know 22 (91.7%) 1 (4.2%) 1 (4.2%)
Father‟s immunized 27.757 0.000*
Yes 134 (95.7%) 3 (2.1%) 3 (2.1%)
No 6 (50.0%) 3 (25.0%) 3 (25.0%)
I don’t know 68 (85.0%) 6 (7.5%) 6 (7.5%)
Birth order 5.532 0.699
1st
70(93.3%) 3 (4.0%) 2 (2.7%)
2nd
61 (91.2%) 2 (2.9%) 4 (6.0%)
3rd
42 (85.7%) 3 (6.1%) 4 (8.2%)
4th
13 (86.7%) 1 (6.7%) 1 (6.7%)
>4th
21 (84.0%) 3 (12.0%) 1 (4.0%)
*P<0.05
Table 12 shows several reasons identified by mothers for negative attitude toward immunization. Prominent
among these were mothers‟ busy schedule and family issues (2.7% each). Some mothers also blamed it on
strikes and lack of money.
Table 12 Reasons for negative attitude toward immunization
Reason Frequency Percentage
Mother was too busy 6 2.7
There was a family problem 6 2.7
The vaccine was not available 5 2.3
The time for immunization was not convenient 3 1.3
I postponed going until another time 3 1.3
The child was ill-was brought but not immunized 3 1.3
The child was ill-was not brought 3 1.3
Wasn’t aware of the need for a second or third dose 3 1.3
don’t believe in the vaccine 2 0.9
Was not aware of the need for immunization. 2 0.9
Heard bad things about immunization 2 0.9
Did not know the place and time for immunization 1 0.4
Long queue and waiting time 1 0.4
Strike (industrial action by health workers) 1 0.4
Lack of money 1 0.4
Total 42 18.5
II. Records of August 2012 at the epidemiologic unit
Table 13 showed that only 23.4% of children that had their first immunization in the unit returned for
the subsequent immunizations until they completed the schedule. The remaining (76.6%) did not show up at the
unit to complete the immunization schedule indicting that non-adherence to the immunization schedule was
clearly visible.
9. Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization
42
Table 13 Children that completed or did not complete their immunization schedule at the unit
Sex Completed Did not complete Total
N (%) N (%) N (%)
Male 57(11.1) 199(38.8) 256(49.9)
Female 63(12.3) 194(37.8) 257(50.1)
Total 120(23.4) 393(76.6) 513(100)
IV. DISCUSSION
Knowledge of mothers on immunization
The study which was an analytical epidemiology seeking for determinants of health-related outcomes
which are the factors that often increase or decrease a person‟s risk to a specific health outcome- which in this
study is immunization- revealed that a high percentage (99.2%) of mothers reported that they have heard about
immunization. About 90% also reported that they knew that vaccines are meant to prevent childhood diseases
rather than cause harm to the children. This knowledge therefore accounts for the overall „good‟ knowledge
rated among the sampled women (89.6%). It was alarming however that only 2.6% of the mothers had excellent
knowledge about all the vaccine preventable diseases (VPDs) children are immunized for. This discovery calls
for targeted information, education and communication.
While more than 90% knew about poliomyelitis- which one can easily attribute to the continual door-
to-door immunization and the constant jingles being aired on television and radio- less than 50% knew about
influenza, diphtheria and pertussis. Tetanus, tuberculosis, hepatitis and yellow fever were also readily identified
by about 80% of the women. Angelillo et al., (1999) also reported similarly that only 20% knew that pertussis,
measles, mumps, and rubella were diseases that are vaccine-preventable in children while carrying out a survey
in Italy.
Poor knowledge of mothers on VPDs is detrimental in achieving a high percentage of coverage during
immunization. When mothers are not properly educated with regards to the diseases their children are meant to
be immunized against, they may not realize the necessity of the vaccines. One of the Millennium Developmental
Goals (MDGs) is to reduce child mortality. This would not be achieved significantly if mothers are not aware of
these VPDs. This lack of knowledge also extends to the appropriate time for each vaccine to be taken.
Just as a vast population has been sensitized with regards to poliomyelitis, other diseases should also be
given a similar enlightenment. Such enlightenment is bound to urge mothers to present their wards for
immunization. This requires health promotion in the form of health education where persuasive communication
could be utilized in passing the information on by gaining the attention of the people, relaying the message in
such a manner that the content would be comprehended and accepted by the people.
Attitude of mothers towards immunization
Only a small percentage of women (less than 3%) gave reasons for their failure in availing their
children for immunization. The most popular reasons given were „mother being too busy‟ and „there was a
family problem‟. The least reasons given by mothers were „Did not know the place and time for immunization‟,
„long queue and waiting time‟, „Strike (industrial action by health workers)‟ and „Lack of money‟. The
unavailability of vaccines as a reason for not being immunized was given by only 2.3% of women. Most of the
reasons proffered by the women only show the lack of education on the part of women. If mothers were better
educated on the importance of immunization and the need for it to be taken at the right time, they probably
would not have excuses for not showing up for immunization. Proper information needs to be passed on to the
women. It is also important to note that „Lack of money‟ should not so much as be an issue in Jos North because
the government has provided a facility that is very reliable and the services offered in the facility is free
including the vaccines given. This further stresses the fact that ignorance is a major reason for mothers not
immunizing their children. Health education must be utilized to promote health protection through vaccination
in order to prevent these childhood killer diseases.
Practice of mothers as regards immunization
In terms of showing up for immunization at the right time (within one month of the expected date) it
was observed that almost 60% of mothers brought their children promptly for the first immunization- BCG. This
high turnout could be attributed to the fact that women who give birth in hospitals, clinics or maternity homes
are usually given this vaccine immediately or advised to go to approved centers. Antai (2009) had also stated
that the proportion of mothers that delivered in a hospital setting is a predictor of child immunization uptake.
Further noting that hospital delivery is one of the most important preventive measures against maternal and
10. Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization
43
child health outcomes, and an important determinant of full immunization. It has also been observed (during
data collection and brief interviews at the child immunization unit) that mothers that have their babies at home
often are not aware of the vaccines or turn up very late for the vaccines especially if they begin to suspect ill
health in their children.
For DPT, Hepatitis and OPV, a slight drop to a lower rate (about 40%) was observed which may not be
unconnected to mothers not being aware of the actual date they are expected to return for another vaccine. There
was however another hike in turn up (up to 50%) observed for yellow fever and measles. A smaller percentage
(less than 20%) was generally observed to turn up late for the vaccines while less than 10% were either not
vaccinated or had incomplete doses. Considering those that were immunized at the stipulated time and those
who were immunized late, it will be observed that only about 60% of children were recorded within these
groups. This shows that though there is a seemingly good knowledge about immunization among mothers, their
being available for these vaccines does not reflect this knowledge. The survey of the records at the
epidemiologic unit showed that less than 25% of children who had their first immunization at the unit had
returned to complete their full course of vaccination. Dropouts were observed at various levels of schedule.
Many reasons could be postulated for this high rate of dropout such as moving to another area, changing the
place used for immunization, death of the child or ignorance on the part of the mother. Health education is
greatly required in this regard.
It must also be stated that just as the EPI coverage survey of WHO (2009) noted that although routine
reports from health centers also provide important information about immunization coverage, immunization
coverage estimates based on health centre records may be inaccurate or misleading. It was observed while going
through the records that omissions were sometimes inevitable probably as a result of high turnout of women for
immunization of their children leading to work pressure on the staff.
These findings are similar to that of Sadoh & Eregie (2009) in Benin, Nigeria who reported that the
uptake of vaccines was the highest for BCG, OPV0, and Hepatitis at birth having a percentage rate of 89.5%,
96.7%, and 93.8% respectively having studied the records of a clinic. They however noticed that uptake was the
lowest for measles and yellow fever vaccines having percentage rates of 57.6% and 57.2% respectively.
Though over 30% of women claimed to have immunized their children, no concrete evidence was
presented as to how promptly this was done or the completeness of the schedule for such children. Inappropriate
immunization of children generally leads to the spread of vaccine preventable diseases which would result in
increased morbidity and mortality were they could have been prevented. Sadoh and Eregie (2009) commented in
this regard stating that to achieve maximal protection against vaccine-preventable diseases, a child should
receive all immunizations within recommended intervals.
One of the health indicators of achieving reduction in child mortality is to increase the proportion of
one year olds that have been immunized against measles. From this study, only 50% of the children were
immunized promptly against measles and 9.5% were yet to be immunized even after one year of age.
Influence of socio demographic characteristics on knowledge
Some demographic factors were observed to have significant effects on the knowledge of mothers. One
of such factors was marital status of the mothers. Married women were observed to have a significantly higher
knowledge of immunization (p=0.001) than their single/divorced/widowed or separated counterparts. This is
unlike the study conducted by Odusanya et al., (2008) were the marital status of the mother was not found to
significantly affect their level of knowledge on immunization. The marital status of a mother may enhance her
knowledge in the sense that those that are married may have more access to education compared to those that
are single mothers who may generally have more responsibility and would tend to put aside education in order
to seek for a means to cater for their children. The supportive role of their partners may also enhance her
knowledge if both partners jointly seek for ways to better the health status of their offspring.
The level of education of mothers was observed to be very significant (p=0.001) to their knowledge on
immunization. The higher the level of education of the mother, the greater their knowledge on immunization.
This has been similarly reported by Angellilo et al., (1999) and Odusanya et al., (2008) who stated that the level
of knowledge about mandatory vaccinations for infants correlated significantly with level of education. This
expected because those with higher educational standards would have greater ability to process information
generally than those who are not.
11. Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization
44
The geopolitical zone of the mother also significantly (p=0.000) affected their level of knowledge on
immunization. Those from the south-west had the highest rate (100%) compared to those from the north-west
who had the least (28.6%) rate of people with good knowledge and the highest rate (57.1%) with poor
knowledge. The states that fall into the north-west are Jigawa, Kaduna, Kano, Katsina, Kebbi, Sokoto and
Zamfara states. This finding may not be unconnected to the earlier report by the Nigeria Demographic and
Health Survey (NDHS 2003) which noted that widespread inequities persist in immunization coverage to the
disadvantage of children of parents in the lowest socio-economic quintile, parents with no education and parents
in the rural areas, especially in the northern region of the country as reported by Aina & Ejembi (2013). The
wide spread of information that vaccines served as contraceptives may have resulted in this poor knowledge and
practice by mothers from this zone. The religion of the mother was also observed to have a significant effect
(p=0.000) on the knowledge of the mothers. This finding may also be linked to the geopolitical zone since
certain religions are more acceptable in zones. A higher percentage (92.1%) among the Christian women had
good knowledge compared to the Muslims (58.8%). The practice of „purdah‟ where the women are not
permitted to freely come into the society, serves as a form of restriction that hinders their access to relevant
information. To overcome this challenge imams and other Islamic leaders must be enlightened on the need of
immunization as a disease prevention exercise. Church leaders and traditional rulers should also be properly
informed. The fact that the mother and/or father were immunized as children also significantly (p=0.000) affect
their knowledge on immunization.
V. CONCLUSION
Within the limits of this study it can be said that though there seems to be a high level of knowledge
among mothers in Jos North generally, this knowledge is not reflected in their practices. Knowledge of mothers
in Jos North was also found to be significantly affected by education, marital status, religion, geopolitical zone
and the mother and/or father been immunized as a child. Health promotion in the form of health education is
still lacking in some areas making adherence to the immunization schedule a challenge for some mothers. There
is a need to properly counsel them on disease prevention and health protection. Some mothers were observed to
still have negative attitudes towards immunization which calls for periodic health promotion and education.
VI. CONTRIBUTION TO KNOWLEDGE
This study has established that there is a high knowledge of immunization among mothers in Jos North
which is evident among mothers with children born between 26th
of September 2011 and 26th
September 2012.
Knowledge of mothers in Jos North was also found to be significantly affected by education, marital status,
religion, geopolitical zone and the mother and/or father been immunized as a child. This knowledge however
did not translate into practice since some mothers did not complete the immunization schedule. A case study of
the month of August 2012 also showed that among the mothers who visited the epidemiologic unit for
immunization only a few mothers completed the full schedule for their children emphasizing non-adherence.
Generally, only a few women had negative attitudes towards immunization.
VII. RECOMMENDATIONS
There will be a need to create more jingles on air in English and other dialects to promote
knowledge on the immunization schedule and the various vaccines that should be taken.
Fliers and billboards with relevant information on immunization should be produced and widely
distributed.
Traditional birth attendants in various localities should be reached and educated on immunization
as a disease prevention and health protection tool. Health protection in the area of preventing
sepsis during child birth through tetanus toxoid vaccines can be taught also.
Pharmacists especially those in public health and community can take up the challenge and
educate the women through public health activities centered on health promotion.
The Government should make it mandatory for children to present their immunization cards before
being admitted into public and private schools.
Similar studies should be conducted in various local governments, published and the results
forwarded to their Chairmen for action.
Areas that have poor access roads should be considered and given adequate attention to ensure
better coverage.
Suggestions for further study
Studies that are focused on the individual wards in Jos North will greatly provide specific information as regards
what is obtainable within the wards and enable interventions that are focused and purposeful in these wards.
12. Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization
45
VIII. ACKNOWLEDGEMENT
The authors accept hereby acknowledge the Ministry of Health, Plateau State, Nigeria for their
willingness to grant us access to their records.
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