Evaluation of interventions to improve timely hepatitis B birth dose vaccination among infants and maternal tetanus vaccination among pregnant women in Nigeria.

Autor: Kanu FA; Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States; The U.S. Public Health Service Commissioned Corps, Atlanta, Georgia, United States. Electronic address: fkanu@cdc.gov., Freeland C; Hepatitis B Foundation, Doylestown, Pennsylvania, United States., Nwokoro UU; Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria; African Field Epidemiology Network, Abuja, Nigeria., Mohammed Y; African Field Epidemiology Network, Abuja, Nigeria; Department of Medical Microbiology and Parasitology, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria., Ikwe H; Global Immunization Division, CDC-Nigeria, Abuja, Nigeria., Uba B; African Field Epidemiology Network, Abuja, Nigeria; National Emergency Routine Immunization Coordination Centre, Abuja, Nigeria., Sandhu H; Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States., An Q; Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States., Asekun A; Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States; Global Immunization Division, CDC-Nigeria, Abuja, Nigeria., Akataobi C; African Field Epidemiology Network, Abuja, Nigeria; National Stop Transmission of Poliomyelitis, Nigeria., Adewole A; African Field Epidemiology Network, Abuja, Nigeria; National Stop Transmission of Poliomyelitis, Nigeria., Fadahunsi R; African Field Epidemiology Network, Abuja, Nigeria; National Stop Transmission of Poliomyelitis, Nigeria., Wisdom M; African Field Epidemiology Network, Abuja, Nigeria; National Stop Transmission of Poliomyelitis, Nigeria., Akudo OL; African Field Epidemiology Network, Abuja, Nigeria; National Stop Transmission of Poliomyelitis, Nigeria., Ugbenyo G; African Field Epidemiology Network, Abuja, Nigeria; National Stop Transmission of Poliomyelitis, Nigeria., Simple E; African Field Epidemiology Network, Abuja, Nigeria; National Stop Transmission of Poliomyelitis, Nigeria., Waziri N; African Field Epidemiology Network, Abuja, Nigeria; National Stop Transmission of Poliomyelitis, Nigeria., Vasumu JJ; Adamawa State Primary Health Care Development Agency, Yola, Adamawa, Nigeria., Bahuli AU; Adamawa State Primary Health Care Development Agency, Yola, Adamawa, Nigeria., Bashir SS; Adamawa State Primary Health Care Development Agency, Yola, Adamawa, Nigeria., Isa A; Adamawa State Primary Health Care Development Agency, Yola, Adamawa, Nigeria., Ugwu G; Department of Obsterics and Gynaecology, College of Medicine, University of Nsukka, Nsukka, Enugu, Nigeria; Enugu State Primary Health Care Development Agency, Enugu, Nigeria., Obi EI; National Emergency Routine Immunization Coordination Centre, Abuja, Nigeria., Binta H; National Emergency Routine Immunization Coordination Centre, Abuja, Nigeria; College of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria., Bassey BO; National Primary Health Care Development Agency, Abuja, Nigeria., Shuaib F; National Primary Health Care Development Agency, Abuja, Nigeria., Bolu O; Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States., Tohme RA; Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States.
Jazyk: angličtina
Zdroj: Vaccine [Vaccine] 2024 Oct 24; Vol. 42 (24), pp. 126222. Date of Electronic Publication: 2024 Aug 27.
DOI: 10.1016/j.vaccine.2024.126222
Abstrakt: Background: Nigeria has the largest number of children infected with hepatitis B virus (HBV) globally and has not yet achieved maternal and neonatal tetanus elimination. In Nigeria, maternal tetanus diphtheria (Td) vaccination is part of antenatal care and hepatitis B birth dose (HepB-BD) vaccination for newborns has been offered since 2004. We implemented interventions targeting healthcare workers (HCWs), community volunteers, and pregnant women attending antenatal care with the goal of improving timely (within 24 hours) HepB-BD vaccination among newborns and Td vaccination coverage among pregnant women.
Methods: We selected 80 public health facilities in Adamawa and Enugu states, with half intervention facilities and half control. Interventions included HCW and community volunteer trainings, engagement of pregnant women, and supportive supervision at facilities. Timely HepB-BD coverage and at least two doses of Td (Td2+) coverage were assessed at baseline before project implementation (January-June 2021) and at endline, one year after implementation (January-June 2022). We held focus group discussions at intervention facilities to discuss intervention strengths, challenges, and improvement opportunities.
Results: Compared to baseline, endline median vaccination coverage increased for timely HepB-BD from 2.6% to 61.8% and for Td2+ from 20.4% to 26.9% in intervention facilities (p < 0.05). In comparison, at endline in control facilities median vaccination coverage for timely HepB-BD was 7.9% (p < 0.0001) and Td2+ coverage was 22.2% (p = 0.14). Focus group discussions revealed that HCWs felt empowered to administer vaccination due to increased knowledge on hepatitis B and tetanus, pregnant women had increased knowledge that led to improved health seeking behaviors including Td vaccination, and transportation support was needed to reach those in far communities.
Conclusion: Targeted interventions significantly increased timely HepB-BD and Td vaccination rates in intervention facilities. Continued support of these successful interventions could help Nigeria reach hepatitis B and maternal and neonatal tetanus elimination goals.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Published by Elsevier Ltd.)
Databáze: MEDLINE
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