Parental Acceptance of Human Papilloma Virus Vaccine for Their Pre-Pubertal and Teenage Daughters

Objective: To determine the factors influencing parental acceptance of the HPV vaccine for their pre-pubertal (age group 9-14 years) daughters.Design: Cross sectional study.Setting: Four primary schools within Langata constituency in Nairobi County in June 2010.Subject: Girls in Standard five to eight were selected for the study. A self explanatory one page questionnaire was given out to take to their mothers/guardian and returned in one week. Fifty mothers were then randomly selected from the returned questionnaires and an in depth telephone interview was conducted. The data entry and coding was done and analysed using SPSS version 15.Results: In this study 68% of parents/guardians accepted that vaccination should be done but only 58% agreed that their daughters should be vaccinated, majority of the respondents were females, (women 82% and men 18 %). This observed difference across the genders was not statistically significant p=0.078. The level of education of the respondent (nil 2.7%, primary 6.6%, college /university 47.7% secondary 45.7%) the observed difference across the educational levels of agreeing to vaccination was not statistically significant p=0.898. The knowledge/awareness on cervical cancer and its relationship to HPV infection correlated with the level of education was found to have been statistically significant. The parents recommended age of vaccination was 11-13 year (58%). Parent/guardians suggested age of vaccination and HPV vaccine acceptance was significant correlated with the vaccination acceptance by the parents p=0.009. This study has shown that the recommended age of vaccination by parents is 11-13years age group which was similar to findings done in many countries.Conclusion: There was poor knowledge on the relationship between HPV infection and cervical cancer. The acceptable age of vaccine administration was 11-13 year

Patient Education and counselling for promoting adherence to treatment for tuberculosis (Review)

Geneeskunde en GesondheidswetenskappeSentrum vir Bewysgebaseerde GesonheidsorgPlease help us populate SUNScholar with the post print version of this article. It can be e-mailed to: [email protected]

Reminder systems and late patient tracers in the diagnosis and management of tuberculosis

Background Reminder systems and late patient tracers as strategies to improve patients' adherence to tuberculosis screening, diagnosis, and treatment are used in some countries, but their effectiveness has not previously been systematically reviewed. Objectives To assess the effects of reminder systems and late patient tracers on completion of diagnostics, commencement of treatment in people referred for curative or prophylactic treatment of tuberculosis, completion of treatment in people starting curative or prophylactic treatment for tuberculosis, and cure in people being treated for active tuberculosis. Search strategy We searched the Cochrane Infectious Diseases Group Specialized Register ( June 2008), Cochrane Effective Practice and Organization of Care Group Specialized Register ( April 2007), CENTRAL ( The Cochrane Library 2008, Issue 2), MEDLINE ( 1966 to June 2008), EMBASE ( 1974 to June 2008), LILACS ( 1982 to June 2008), CINAHL ( 1982 to June 2008), SCI-EXPANDED ( 1945 to June 2008), SSCI ( 1956 to June 2008), mRCT ( June 2008), Indian Journal of Tuberculosis ( 1983 to June 2008), and reference lists. We also contacted researchers working in the field. Selection criteria Randomized controlled trials (RCTs), including cluster RCTs and quasi-RCTs, and controlled before-and-after studies comparing any reminders or late patient tracers with no or other kinds of reminders or late patient tracers. We included people in any setting who require treatment for tuberculosis or require prophylaxis against tuberculosis and are referred to tuberculosis diagnostic or screening services. Data collection and analysis Two authors independently assessed trial risk of bias and extracted data. Nometa-analysis could be undertaken due to the heterogeneity of interventions across trials. Main results Nine trials involving 5257 participants met the inclusion criteria. Three assessed the use of late patient tracers, and six assessed reminder systems. Late patient tracers ( home visit and letter) were shown to be beneficial in increasing adherence to tuberculosis treatment compared with no late patient tracer. The results from almost all the reminder trials, except one, show benefits of different types of reminders compared to no reminder on adherence to tuberculosis clinic appointments. Authors' conclusions The included trials show significantly better outcomes among those tuberculosis patients for which late patient tracers and reminders are used. Studies of good quality ( large and with rigorous study design) are needed to decide the most effective late patient tracer actions and reminders in different settings. Future studies of reminders in chemoprophylaxis and treatment settings would be useful

Barriers to treatment adherence for individuals with latent tuberculosis infection: a systematic search and narrative synthesis of the literature

We investigated the rates of initiation and completion of treatment for latent TB infection (LTBI), factors explaining nonadherence and interventions to improve treatment adherence in countries with low TB incidence.A systematic search was performed in PubMed and Embase. All included articles were assessed for risk of bias. A narrative synthesis of the results was conducted.There were 54 studies included in this review. The proportion of people initiating treatment varied from 24% to 98% and the proportion of people completing treatment varied from 19% to 90%. The main barriers to adherence included the fear or experience of adverse effects, long duration of treatment, financial barriers, lack of transport to clinics (for patients), and insufficient resources for LTBI control. While interventions like peer counseling, incentives, and culturally specific case management have been used to improve adherence, the proportion of people who initiate and complete LTBI treatment still remains low.To further improve treatment and LTBI control and to fulfill the World Health Organization goal of eliminating TB in low-incidence countries, greater priority should be given to the use of treatment regimens involving shorter durations and fewer adverse effects, like the 3-month regimen of weekly rifapentine plus isoniazid, supported by innovative patient education and incentive strategies