Browsing by Author "Cameron, Neil"

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    The acceptability of three vaccine injections given to infants during a single clinic visit in South Africa
    (BioMed Central, 2016) Tabana, Hanani; Dudley, Lilian; Knight, Stephen; Cameron, Neil; Mahomed, Hassan; Goliath, Charlyn; Eggers, Rudolf; Wiysonge, Charles S.
    ENGLISH SUMMARY : Background: The Expanded Programme on Immunisation (EPI) has increased the number of antigens and injections administered at one visit. There are concerns that more injections at a single immunisation visit could decrease vaccination coverage. We assessed the acceptability and acceptance of three vaccine injections at a single immunisation visit by caregivers and vaccinators in South Africa. Methods: A mixed methods exploratory study of caregivers and vaccinators at clinics in two provinces of South Africa was conducted. Quantitative and qualitative data were collected using questionnaires as well as observations of the administration of three-injection vaccination sessions. Results: The sample comprised 229 caregivers and 98 vaccinators. Caregivers were satisfied with the vaccinators’ care (97 %) and their infants receiving immunisation injections (93 %). However, many caregivers, (86 %) also felt that three or more injections were excessive at one visit. Caregivers had limited knowledge of actual vaccines provided, and reasons for three injections. Although vaccinators recognised the importance of informing caregivers about vaccination, they only did this sometimes. Overall, acceptance of three injections was high, with 97 % of caregivers expressing willingness to bring their infant for three injections again in future visits despite concerns about the pain and discomfort that the infant experienced. Many (55 %) vaccinators expressed concern about giving three injections in one immunisation visit. However, in 122 (95 %) observed three-injection vaccination sessions, the vaccinators administered all required vaccinations for that visit. The remaining seven vaccinations were not completed because of vaccine stock-outs. Conclusions: We found high acceptance by caregivers and vaccinators of three injections. Caregivers’ poor understanding of reasons for three injections resulted from limited information sharing by vaccinators for caregivers. Acceptability of three injections may be improved through enhanced vaccinator-caregiver communication, and improved management of infants’ pain. Vaccinator training should include evidence-informed ways of communicating with caregivers and reducing injection pain. Strategies to improve acceptance and acceptability of three injections should be rigorously evaluated as part of EPI’s expansion in resource-limited countries.
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    First do no harm
    (Health and Medical Publishing Group (HMPG), 2007-11) Cameron, Neil
    To the Editor: Should an organisation representing a profession with a millennia-old tradition of Primum non nocere (First do no harm) place itself in an alliance that makes it difficult to speak out against actions which break one of the basic tenets of medical and human ethics?
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    Is the Western Cape at risk of an outbreak of preventable childhood diseases? : lessons from an evaluation of routine immunisation coverage
    (Health and Medical Publishing Group (HMPG), 2008) Corrigall, Joanne; Coetzee, David; Cameron, Neil
    Objective. To determine the routine immunisation coverage rates in children aged 12-23 months in the Western Cape. Design. Cross-sectional Household Survey using an adaptation of the '30 by 7' cluster survey technique. Setting. Households across the Western Cape. Subjects. A total of 3 705 caregivers of children aged 12-23 months who had been living in the Western Cape for at least 6 months. Outcome measures. Vaccination status (1 = fully vaccinated; 0 = partially vaccinated) as recorded on a Road-to-Health card or by history. Reasons for not vaccinating were established from a questionnaire. Results. The immunisation coverage was 76.8% for vaccines due by 9 months and 53.2% for those due by 18 months. The reasons given for not being immunised were clinic-related factors (47%), lack of information (27%), caregiver being unable to attend the clinic (23%), and lack of motivation (14%). Of the clinic factors cited, the two commonest ones were missed opportunities (34%) and being told by clinic staff to return another time (20%). Conclusion. While the coverage indicates that a great deal of good work is being done, the coverage is insufficient to prevent outbreaks of measles and other common childhood conditions, including polio. The coverage is too low to consider not running periodic mass campaigns for measles and polio. It will need to be sustainably improved before introducing rubella vaccine as part of the Expanded Programme on Immunisations (EPI) schedule. The reasons given by caregivers for their children not being immunised are valuable pointers as to where interventions should be focused.