ABSTRACT
To assess the causes of low tetanus toxoid (TT) vaccination coverage in pregnant women a mixture of quantitative and qualitative methods were adopted at the community, primary health care delivery and management levels in Lahore district, Pakistan. Out of a random sample of 362 women who had delivered during the previous 3 months, 87% recalled receiving 2 doses of TT. The main reasons for non-vaccination were poor knowledge about the importance of TT (32% of women) or the place and time to get vaccinated (18%). According to the managers and primary health care medical officers, the main reasons for low coverage were lack of awareness about the importance of vaccination among the public and misconceptions about TT vaccination (e.g. that it was a contraceptive).
Subject(s)
Attitude of Health Personnel , Health Knowledge, Attitudes, Practice , Patient Acceptance of Health Care/psychology , Pregnant Women/psychology , Tetanus Toxoid , Vaccination/psychology , Adolescent , Adult , Awareness , Causality , Cross-Sectional Studies , Educational Status , Female , Focus Groups , Health Care Surveys , Humans , Middle Aged , Pakistan , Patient Acceptance of Health Care/statistics & numerical data , Pregnancy , Prenatal Care/statistics & numerical data , Qualitative Research , Residence Characteristics , Socioeconomic Factors , Surveys and Questionnaires , Vaccination/statistics & numerical dataABSTRACT
To assess the causes of low tetanus toxoid [TT] vaccination coverage in pregnant women a mixture of quantitative and qualitative methods were adopted at the community, primary health care delivery and management levels in Lahore district, Pakistan. Out of a random sample of 362 women who had delivered during the previous 3 months, 87% recalled receiving 2 doses of TT. The main reasons for non-vaccination were poor knowledge about the importance of TT [32% of women] or the place and time to get vaccinated [18%]. According to the managers and primary health care medical officers, the main reasons for low coverage were lack of awareness about the importance of vaccination among the public and misconceptions about TT vaccination [e.g. that it was a contraceptive]
Subject(s)
Pregnancy , Immunization , Health Knowledge, Attitudes, Practice , Surveys and Questionnaires , Prenatal Care , Primary Health Care , Awareness , Tetanus ToxoidABSTRACT
Osteonecrosis of the knee comprises two separate disorders, primary spontaneous osteonecrosis which is often a self-limiting condition and secondary osteonecrosis which is associated with risk factors and a poor prognosis. In a series of 61 knees (38 patients) we analysed secondary osteonecrosis of the knee treated by a new technique using multiple small percutaneous 3 mm drillings. Total knee replacement was avoided in 59 knees (97%) at a mean follow-up of 3 years (2 to 4). Of the 61 knees, 56 (92%) had a successful clinical outcome, defined as a Knee Society score greater than 80 points. The procedure was successful in all 24 knees with small lesions compared with 32 of 37 knees (86%) with large lesions. All the procedures were performed as day cases and there were no complications. This technique appears to have a low morbidity, relieves symptoms and delays more invasive surgery.
