ASSESSING THE UPTAKE OF MENINGITIS TYPE A VACCINE AMONG INDIVIDUALS IN KOBOKO MUNICIPALITY, KOBOKO DISTRICT.

Introduction: The introduction of the polysaccharide serogroup A vaccine in the African meningitis belt has led to a reduction in the occurrence of the epidemic meningitis disease caused by the Neisseria Meningitides serogroup A. The January 2017 mass meningitis vaccination campaign conducted in the Eastern, Northern and North Western (West Nile) districts of Uganda that are within the meningitis belt was to create herd immunity. This study assesses the uptake of polysaccharide serogroup A vaccine among individuals age 1 to 29 years in Koboko municipality, Koboko district.

Background: vaccination contributes greatly to the fight against of bacterial meningitis disease. There are four meningococcal meningitis vaccines currently in use, in January 2017 the polysaccharide meningococcal serogroup A vaccine was used due to the high periodicity of Neisseria Meningitides serogroup A in the African meningitis belt. The MoH and WHO initiated targeted mass vaccination of individuals’ age 1 – 29 years due to their vulnerability to create herd immunity with an aim of reaching up to 80% (MoH) and 95% of the target population (WHO). The containment of meningococcal meningitis epidemic required mass vaccination and public awareness as key strategies in the control and prevention of meningococcal meningitis disease.

Methods: A descriptive cross-sectional survey involving 435 study respondents and 20 local leaders from two municipality divisions of Koboko South and North was used in this study. Multi-stage sampling procedure was used to select the division out of three and then six wards (Mengo, Appa, Abele, Triangle, Teremunga and Ombaci) were randomly selected by simple random sampling from the two division. Structured questionnaires were administered to the 435 study respondent through consent to generate quantitative data and 20 key informant guides administered to local leaders to generate qualitative data. The quantitative data was entered and analysed using SPSS software to determine the significant association and influence of the factors that had impacted on the uptake of the meningitis type A vaccine. Pearson chi-squares test, p-values and odd ratios were generated to quantify the level of significance and influence of multiple variables on vaccine uptake. The qualitative data was triangulated and deduction made on the leader views on the factors influencing the polysaccharide meningococcal meningitis type A vaccine uptake.

Results: The survey indicated that the vaccination coverage was at 88.7%, those who had not completed primary education were 4.86 times more likely to go for vaccination p-0.00, OR = 4.86; 95% (2.09 - 11.32), compared to those who had completed higher level. furthermore those who knew the signs and symptoms of meningitis disease as stiff neck were 11.08 times more likely to go for vaccination p-0.02, OR = 11.08; 95% CI (1.46 – 83.65), compared to those who knew other signs and symptoms. The study respondents who knew the importance of vaccinating against meningitis disease were 0.06 times more likely to go for vaccination P-0.01, OR = 0.06; 95% CI (0.01 - 0.44) than those who don’t know. Furthermore the respondents who stated that vaccine causes abnormality were 0.15 times less likely to go for vaccination p-0.00, OR = 0.15 at 95% CI: (0.04 - 0.55) unlike those who belief in God’s protection. Sharing information with friends and peers on the meningitis type A mass vaccination campaign was 47.93 time more likely to influence individuals to go for vaccination p-0.00, OR = 47.93 at 95% CI (11.46- 200.45).

Conclusion: The mass meningitis vaccination campaign was able to achieve the MoH target of 80% coverage but fall short of the WHO recommendation of 95% which would had been achieved with intense sensitisation activities as it had significant influence on individual to get vaccinated leading to sharing of information within friends and peers.

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