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1.
Southeast Asian J Trop Med Public Health ; 2006 May; 37(3): 515-22
Article Dans Anglais | IMSEAR | ID: sea-30584

Résumé

We report the coverage, safety, and logistics of a school-based typhoid fever immunization campaign that took place in Hue City, central Vietnam; a typhoid fever endemic area. A cluster-randomized evaluation-blinded controlled trial was designed where 68 schools (cluster) were randomly allocated the single dose Vi polysaccharide vaccine (Typherix) or the active control hepatitis A vaccine (Havrix). A safety surveillance system was implemented. A total of 32,267 children were immunized with a coverage of 57.5%. Strong predictors for vaccination were attending primary schools, peri-urban location of the school, and low family income. Human resources were mainly schoolteachers and the campaign was completed in about 1 month. Most adverse events reported were mild. Safe injection and safe sharp-waste disposal practices were followed. A typhoid fever school-based immunization campaign was safe and logistically possible. Coverage was moderate and can be interpreted as the minimum that could have been achievable because individual written informed consent procedures were sought for the first time in Hue City and the trial nature of the campaign. The lessons learned, together with cost-effectiveness results to be obtained by the end of follow-up period, will hopefully accelerate the introduction of Vi typhoid fever vaccine in Vietnam.


Sujets)
Adolescent , Enfant , Analyse de regroupements , Études de faisabilité , Femelle , Humains , Programmes de vaccination/organisation et administration , Mâle , Vaccination de masse , Polyosides bactériens/effets indésirables , Services de santé scolaire/organisation et administration , Méthode en simple aveugle , Fièvre typhoïde/prévention et contrôle , Vaccins antityphoparatyphoïdiques/effets indésirables , Vietnam
2.
J Health Popul Nutr ; 2004 Jun; 22(2): 139-49
Article Dans Anglais | IMSEAR | ID: sea-872

Résumé

To better understand healthcare use for diarrhoea and dysentery in Nha Trang, Viet Nam, qualitative interviews with community residents and dysentery case studies were conducted. Findings were supplemented by a quantitative survey which asked respondents which healthcare provider their household members would use for diarrhoea or dysentery. A clear pattern of healthcare-seeking behaviours among 433 respondents emerged. More than half of the respondents self-treated initially. Medication for initial treatment was purchased from a pharmacy or with medication stored at home. Traditional home treatments were also widely used. If no improvement occurred or the symptoms were perceived to be severe, individuals would visit a healthcare facility. Private medical practitioners are playing a steadily increasing role in the Vietnamese healthcare system. Less than a quarter of diarrhoea patients initially used government healthcare providers at commune health centres, polyclinics, and hospitals, which are the only sources of data for routine public-health statistics. Given these healthcare-use patterns, reported rates could significantly underestimate the real disease burden of dysentery and diarrhoea.


Sujets)
Adulte , Sujet âgé , Prestations des soins de santé , Diarrhée/épidémiologie , Femelle , Enquêtes sur les soins de santé , Accessibilité des services de santé , Humains , Entretiens comme sujet , Mâle , Adulte d'âge moyen , Odds ratio , Surveillance de la population , Pauvreté , Prévalence , Facteurs de risque , Classe sociale , Vietnam/épidémiologie
3.
J Health Popul Nutr ; 2004 Jun; 22(2): 150-8
Article Dans Anglais | IMSEAR | ID: sea-559

Résumé

The acceptability and accessibility of a hypothetical Shigella vaccination campaign was explored. A household survey was conducted with 539 randomly-selected residents of six communes in Nha Trang city of Viet Nam. Four categories of acceptability, such as refusers, low acceptors, acceptors, and high acceptors, were established, Refusers were significantly more likely to be elderly women and were less likely to know the purpose of vaccinations. Low acceptors tended to be male, elderly, and live in urban areas. Low acceptors perceived the disease as less serious and themselves as less vulnerable than acceptors and high acceptors. In terms of accessing vaccination, the commune health centre workers and commune leaders were the preferred sources of information and commune health centres the preferred location for vaccination. Direct verbal information from healthcare providers and audio-visual media were preferred to written information. The respondents expressed a desire for knowledge about the side-effects and efficacy of the vaccine. These findings are significant for targeting specific messages about shigellosis and vaccination to different populations and maximizing informed participation in public-health campaigns.


Sujets)
Adulte , Facteurs âges , Sujet âgé , Sujet âgé de 80 ans ou plus , Dysenterie bacillaire/épidémiologie , Femelle , Enquêtes sur les soins de santé , Promotion de la santé , Accessibilité des services de santé , Humains , Mâle , Adulte d'âge moyen , Acceptation des soins par les patients , Surveillance de la population , Santé publique , Facteurs de risque , Facteurs sexuels , Vaccins anti-shigella/administration et posologie , Vietnam/épidémiologie
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