A cross sectional survey to evaluate knowledge, attitudes and practices regarding seasonal influenza and influenza vaccination among diabetics in Pretoria, South Africa
CITATION: Olatunbosun, O. D., Esterhuizen, T. M. & Wiysonge, C. S. 2017. A cross sectional survey to evaluate knowledge, attitudes and practices regarding seasonal influenza and influenza vaccination among diabetics in Pretoria, South Africa. Vaccine, 35(47):6375-6386, doi:10.1016/j.vaccine.2017.10.006.
The original publication is available at https://www.journals.elsevier.com/vaccine
Background: In South Africa, inﬂuenza vaccination is recommended to all diabetics. However, vaccinationcoverage among diabetics remains low. Therefore, this study aimed to explore the knowledge, attitudes,and practices among peoplewith diabetes in Pretoria regardingseasonalinﬂuenza and inﬂuenza vaccination.Method: A cross-sectional survey was conducted among type 1 and 2 diabetes mellitus patients whoattended diabetic clinics in two major tertiary hospitals in Pretoria, South Africa from October toDecember 2015. The pilot-tested questionnaire consists of 32 quantitative questions that covered seasonalinﬂuenza and inﬂuenza vaccination in terms of the patient’s demographics, medical history and knowledge,attitudes and practices.Results: A total of 292 completed questionnaires were received with a response rate of 70.0%. Of these, 162participants (55.5%) believed that inﬂuenza is the same as common cold. While 96 (32.9%) participants wereawarethatthey were at higherrisk of complicationsof inﬂuenza,only 86 (29.5%) participantsconsidered vac-cination as an effective means in preventing seriousinﬂuenza-relatedcomplication.Even though 167 (57.2%)participants had heard of the vaccine to prevent inﬂuenza, only 84 (28.8%) participants were previously vac-cinated. Multivariate analysis shows that participants with good attitude score for inﬂuenza vaccinationwere 18.4 times more likely to be vaccinated compared with those with poor attitude score (OR =18.4,95%CI. 5.28–64.10, p = .001). Among those previously vaccinated, advice from their doctors (82/84, 97.6%)was the main factor encouraging vaccination. Top reasons given by participants who had never been vacci-nated before (208/292, 71.2%) include use of alternative protection (107/208, 51.4%) and that vaccination isnot necessary because ﬂu is just a minor illness (93/208, 44.7%).Conclusion: Uptake of seasonal vaccination among diabetics in Pretoria is low. Level of knowledge and per-ception are the main barriers to vaccination. Health care provider’s advice may be an important key predictorof previous inﬂuenza vaccination and they should continue to educate and encourage all diabetics to get vac-cinated for inﬂuenza at least once yearly.