Utilization and Accessibility of Healthcare on Pemba Island, Tanzania: Implications for Health Outcomes and Disease Surveillance for Typhoid Fever

Kaljee, Linda; Pach, Alfred; Thriemer, Kamala; Ley, Benedikt; Ali, Said M.; Jiddawi, Mohamed Saleh; Puri, Mahesh; Seidlein, Lorenz von; Deen, Jacqueline; Ochiai, R. Leon; Wierzba, Thomas F.; Clemens, John D.

doi:10.4269/ajtmh.2012.12-0288

Cited by 12 publications

(7 citation statements)

References 19 publications

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“…Such a perspective is culture-specific, as research in other settings indicate strong beliefs in external factors in disease cause and treatment efficacy. 20 This self-knowledge was also reflected in discussions of susceptibility to influenza and pneumonia. Respondents described themselves as having 'weak immune systems' or alternatively as 'healthy' and 'never or seldom getting sick'.…”

Section: Discussionmentioning

confidence: 94%

“You need to be an advocate for yourself”: Factors associated with decision-making regarding influenza and pneumococcal vaccine use among US older adults from within a large metropolitan health system

Kaljee

Kilgore

Prentiss

et al. 2017

Human Vaccines & Immunotherapeutics

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In the United States, influenza and pneumonia account significantly to emergency room use and hospitalization of adults >65 y. The Centers for Disease Control and Prevention recommends use of the annual influenza vaccine and 2 pneumococcal vaccines for older adults to decrease risks of morbidity and mortality. However, actual vaccine up-take is estimated at 61.3% for pneumococcal vaccines and 65% for influenza vaccine in the 2013-2014 season. Vaccine up-take is affected by multiple socio-cultural and economic factors including general healthcare access and utilization, social networks and norms, communication with health providers and health information sources, as well as perceptions related to vaccines and targeted diseases. In this study, 8 focus group discussions (total N = 48) were conducted with adults 65+ years living in urban and suburban communities in the Detroit Metropolitan Area. The research objective was to increase understanding of barriers and facilitators to vaccine up-take in this age cohort within the context of general healthcare availability and accessibility, social networks, information sources, and personal perceptions of diseases and vaccines. The data suggest the need to integrate broader health care service experiences, concepts of knowledge of one's own well-being and vulnerabilities, and self-advocacy as factors associated with older adults' vaccine-use decisions. These data also support recognition of multiple levels of vaccine acceptance which can be disease specific. Implications include potential for increasing vaccine up-take through general improvement in health care delivery and services, as well as specific vaccine-focused patient and provider education programs.

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Section: Discussionmentioning

confidence: 94%

“You need to be an advocate for yourself”: Factors associated with decision-making regarding influenza and pneumococcal vaccine use among US older adults from within a large metropolitan health system

Kaljee

Kilgore

Prentiss

et al. 2017

Human Vaccines & Immunotherapeutics

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View full text Add to dashboard Cite

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“…Previous research indicates that strategies of health seeking employed by households in response to an acute illness episode often involve multiple and overlapping efforts. Qualitative research can help to elicit these patterns for specific symptoms and diseases, and provide important healthcare utilization data that can be used to improve surveillance activities and in development of interventions to decrease mortality and morbidity [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Social and Economic Burden Associated With Typhoid Fever in Kathmandu and Surrounding Areas: A Qualitative Study

Kaljee

Pach

Garrett

et al. 2017

The Journal of Infectious Diseases

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Typhoid fever is a significant contributor to infectious disease mortality and morbidity in low- and middle-income countries, particularly in South Asia. With increasing antimicrobial resistance, commonly used treatments are less effective and risks increase for complications and hospitalizations. During an episode of typhoid fever, households experience multiple social and economic costs that are often undocumented. In the current study, qualitative interview data from Kathmandu and surrounding areas provide important insights into the challenges that affect those who contract typhoid fever and their caregivers, families, and communities, as well as insight into prevention and treatment options for health providers and outreach workers. When considering typhoid fever cases confirmed by blood culture, our data reveal delays in healthcare access, financial and time costs burden on households, and the need to increase health literacy. These data also illustrate the impact of limited laboratory diagnostic equipment and tools on healthcare providers’ abilities to distinguish typhoid fever from other febrile conditions and treatment challenges associated with antimicrobial resistance. In light of these findings, there is an urgent need to identify and implement effective preventive measures including vaccination policies and programs focused on at-risk populations and endemic regions such as Nepal.

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“…Understanding healthcare utilization patterns is important for surveillance purposes to ensure that targeted populations are attending research surveillance sites, e.g., hospitals, clinics. 19 However, such patterns may also be useful in terms of outreach efforts for vaccine feasibility studies and public immunization campaigns. At the village level, higher levels of participation were associated with spouse being the sole decision-maker.…”

Section: Discussionmentioning

confidence: 99%

Uptake during an oral cholera vaccine pilot demonstration program, Odisha, India

Kar

Pach

Sah

et al. 2014

Human Vaccines & Immunotherapeutics

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Approximately 30% of reported global cholera cases occur in India. In 2011, a household survey was conducted 4 months after an oral cholera vaccine pilot demonstration project in Odisha India to assess factors associated with vaccine up-take and exposure to a communication and social mobilization campaign. Nine villages were purposefully selected based on socio-demographics and demonstration participation rates. Households were stratified by level of participation and randomly selected. Bivariate and ordered logistic regression analyses were conducted. 517/600 (86%) selected households were surveyed. At the household level, participant compared to non-participant households were more likely to use the local primary health centers for general healthcare (P < 0.001). Similarly, at the village level, higher participation was associated with use of the primary health centers (P < 0.001) and private clinics (p D 0.032). Also at the village level, lower participation was associated with greater perceived availability of effective treatment for cholera (p D 0.013) and higher participation was associated with respondents reporting spouse as the sole decisionmaker for household participation in the study. In terms of pre-vaccination communication, at the household level verbal communication was reported to be more useful than written communication. However written communication was perceived to be more useful by respondents in low-participating villages compared to average-participating villages (p D 0.007) These data on participation in an oral cholera vaccine demonstration program are important in light of the World Health Organization's (WHO) recommendations for pre-emptive use of cholera vaccine among vulnerable populations in endemic settings. Continued research is needed to further delineate barriers to vaccine up-take within and across targeted communities in low-and middle-income countries.

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Utilization and Accessibility of Healthcare on Pemba Island, Tanzania: Implications for Health Outcomes and Disease Surveillance for Typhoid Fever

Cited by 12 publications

References 19 publications

“You need to be an advocate for yourself”: Factors associated with decision-making regarding influenza and pneumococcal vaccine use among US older adults from within a large metropolitan health system

“You need to be an advocate for yourself”: Factors associated with decision-making regarding influenza and pneumococcal vaccine use among US older adults from within a large metropolitan health system

Social and Economic Burden Associated With Typhoid Fever in Kathmandu and Surrounding Areas: A Qualitative Study

Uptake during an oral cholera vaccine pilot demonstration program, Odisha, India

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