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

RESUMO

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.


Assuntos
Adolescente , Criança , Análise por Conglomerados , Estudos de Viabilidade , Feminino , Humanos , Programas de Imunização/organização & administração , Masculino , Vacinação em Massa , Polissacarídeos Bacterianos/efeitos adversos , Serviços de Saúde Escolar/organização & administração , Método Simples-Cego , Febre Tifoide/prevenção & controle , Vacinas Tíficas-Paratíficas/efeitos adversos , Vietnã
2.
J Health Popul Nutr ; 2004 Sep; 22(3): 240-5
Artigo em Inglês | IMSEAR | ID: sea-799

RESUMO

Despite the availability of at least two licensed typhoid fever vaccines--injectable sub-unit Vi polysaccharide vaccine and live, oral Ty21a vaccine--for the last decade, these vaccines have not been widely introduced in public-health programmes in countries endemic for typhoid fever. The goal of the multidisciplinary DOMI (Diseases of the Most Impoverished) typhoid fever programme is to generate policy-relevant data to support public decision-making regarding the introduction of Vi polysaccharide typhoid fever immunization programmes in China, Viet Nam, Pakistan, India, Bangladesh, and Indonesia. Through epidemiological studies, the DOMI Programme is generating these data and is offering a model for the accelerated, rational introduction of new vaccines into health programmes in low-income countries. Practical and specific examples of the role of epidemiology are described in this paper. These examples cover: (a) selection of available typhoid fever vaccines to be introduced in the programme, (b) generation of policy-relevant data, (c) providing the 'backbone' for the implementation of other multidisciplinary projects, and (d) generation of unexpected but useful information relevant for the introduction of vaccines. Epidemiological studies contribute to all stages of development of vaccine evaluation and introduction.


Assuntos
Ásia/epidemiologia , Vacinas Bacterianas , Efeitos Psicossociais da Doença , Países em Desenvolvimento/economia , Estudos Epidemiológicos , Humanos , Programas de Imunização/organização & administração , Polissacarídeos Bacterianos/administração & dosagem , Salmonella typhi/imunologia , Febre Tifoide/economia , Vacinas Tíficas-Paratíficas/administração & dosagem , Vacinas Atenuadas , Vacinas de Produtos Inativados
3.
J Health Popul Nutr ; 2004 Jun; 22(2): 139-49
Artigo em Inglês | IMSEAR | ID: sea-872

RESUMO

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.


Assuntos
Adulto , Idoso , Atenção à Saúde , Diarreia/epidemiologia , Feminino , Pesquisas sobre Atenção à Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Razão de Chances , Vigilância da População , Pobreza , Prevalência , Fatores de Risco , Classe Social , Vietnã/epidemiologia
4.
J Health Popul Nutr ; 2004 Jun; 22(2): 150-8
Artigo em Inglês | IMSEAR | ID: sea-559

RESUMO

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.


Assuntos
Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Disenteria Bacilar/epidemiologia , Feminino , Pesquisas sobre Atenção à Saúde , Promoção da Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Vigilância da População , Saúde Pública , Fatores de Risco , Fatores Sexuais , Vacinas contra Shigella/administração & dosagem , Vietnã/epidemiologia
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