Knowledge, beliefs and practices regarding prevention of bacterial meningitis in Burkina Faso, 5 years after MenAfriVac mass campaigns.

BACKGROUND: To adapt communications concerning vaccine prevention, we studied knowledge, beliefs and practices around meningitis risk and prevention in a young adult population in Burkina Faso in 2016, 5 years after the MenAfriVac® mass campaign and one year before the vaccine's inclusion in the infant immunization schedule. METHODS: In a representative sample of the population aged 15 to 33 years (N = 220) in Bobo-Dioulasso, Burkina Faso, study nurses administered a standardized paper questionnaire consisting of predominantly open questions, collecting information on meningitis risk factors and prevention, and on exposure to dry air and kitchen fire smoke. We identified themes and analyzed their frequency. We created a meningitis knowledge score (range 0 to 4) based on pre-defined best responses and analyzed the determinants of knowledge score levels ≥2 (basic score) and ≥3 (high score) using multivariate logistic regression. RESULTS: Biomedically supported facts and good practices were known by the majority of participants (eg vaccine prevention, 84.5%). Younger women aged 15-20 years had a higher frequency of low scores <2 (17.0%) compared to older women aged 21-33 years (6.3%) and men of both age groups (3.8%). Junior secondary School attendance explained the differences between the two groups of women, the gender gap for the older, but not the young women, and explained score differences among young women. Local understandings and practices for risk and prevention were commonly reported and used (risk from unripe mango consumption and prevention through nasal application of shea nut butter). DISCUSSION: This study shows a gender gap in knowledge of meningitis risk and prevention, largely due to education-level inequalities. Women below 21 years had particularly low levels of knowledge and may need interventions outside schools and perinatal care. Our study suggests a strong adherence to local understandings of and practices around meningitis risk and prevention, which should be taken into account by vaccination promotion

Community engagement and vulnerability in infectious diseases:A systematic review and qualitative analysis of the literature

Background The global response to infectious diseases has seen a renewed interest in the use of community engagement to support research and relief efforts. From a perspective rooted in the social sciences, the concept of vulnerability offers an especially useful analytical frame for pursuing community engagement in a variety of contexts. However, few have closely examined the concept of vulnerability in community engagement efforts, leading to a need to better understand the various theories that underline the connections between the two. Method This literature review searched four databases (covering a total of 537 papers), resulting in 15 studies that analyze community engagement using a framing of vulnerability, broadly defined, in the context of an infectious disease, prioritizing historical and structural context and the many ways of constituting communities. Findings The review identified historical and structural factors such as trust in the health system, history of political marginalization, various forms of racism and discrimination, and other aspects of vulnerability that are part and parcel of the main challenges faced by communities. The review found that studies using vulnerability within community engagement share some important characteristics (e.g., focus on local history and structural factors) and identified a few theoretical avenues from the social sciences which integrate a vulnerability-informed approach in community engagement. Finally, the review proposes an approach that brings together the concepts of vulnerability and community engagement, prioritizing participation, empowerment, and intersectoral collaboration

Vulnerability and One Health assessment approaches for infectious threats from a social science perspective:a systematic scoping review

Vulnerability assessments identify vulnerable groups and can promote effective community engagement in responding to and mitigating destabilising events. This scoping review maps assessments for local-level vulnerabilities in the context of infectious threats. We searched various databases for articles written between 1978 and 2019. Eligible documents assessed local-level vulnerability, focusing on infectious threats and antimicrobial resistance. Since few studies provided this dual focus, we included tools from climate change and disaster risk reduction literature that engaged the community in the assessment. We considered studies using a One Health approach as essential for identifying vulnerability risk factors for zoonotic disease affecting humans. Of the 5390 records, we selected 36 articles for review. This scoping review fills a gap regarding vulnerability assessments by combining insights from various approaches: local-level understandings of vulnerability involving community perspectives; studies of social and ecological factors relevant to exposure; and integrated quantitative and qualitative methods that make generalisations based on direct observation. The findings inform the development of new tools to identify vulnerabilities and their relation to social and natural environments

Understanding and tackling snakebite envenoming with transdisciplinary research

Snakebite envenoming (SBE) is a neglected tropical disease (NTD) of high global impact. The World Health Organization (WHO) estimates 4.5 to 5.4 million people are bitten by snakes annually, resulting in 1.8 to 2.7 million envenomings, 81,000 to 138,000 deaths, and at least 400,000 people suffering from physical or psychological sequelae. SBE mostly affects impoverished rural populations in sub-Saharan Africa, Asia, Latin America, and parts of Oceania, thus fueling a vicious cycle of poverty and illness. SBE not only affects humans, but also domestic animals, including livestock, with negative social and economic consequences. This requires a better understanding of the complex social, cultural, and ecological contexts where SBE occurs, within the conceptual frame of One Health, an integrated approach that recognizes the health of humans, animals, and the environment as closely linked and interdependent. Such complexity demands more integrative approaches for better understanding and confronting this disease. SBE has unique features that make its prevention and control challenging. Unlike many infectious diseases, SBE cannot be eradicated, but its incidence and impact can be reduced through effective programs aimed at better prevention and rapid access to treatment. This in turn demands the engagement of communities to improve the cohabitation of humans, domestic animals, and snakes in rural agroecosystems. In 2019, the WHO launched a strategy for the prevention and control of SBE, aimed at halving the deaths and disabilities caused by this NTD by the year 2030. This strategy is based on 4 pillars, i.e., empower and engage communities; ensure safe, effective treatment; strengthen health systems; and increase partnerships, coordination, and resources. Building on previous ideas and publications, this article discusses and advocates for transdisciplinary research on SBE and for promoting dialogue and collaboration between sectors, particularly by engaging communities affected by SBE at all levels of the research process

Understanding and tackling snakebite envenoming with transdisciplinary research

Snakebite envenoming (SBE) is a neglected tropical disease (NTD) of high global impact. The World Health Organization (WHO) estimates 4.5 to 5.4 million people are bitten by snakes annually, resulting in 1.8 to 2.7 million envenomings, 81,000 to 138,000 deaths, and at least 400,000 people suffering from physical or psychological sequelae. SBE mostly affects impoverished rural populations in sub-Saharan Africa, Asia, Latin America, and parts of Oceania, thus fueling a vicious cycle of poverty and illness. SBE not only affects humans, but also domestic animals, including livestock, with negative social and economic consequences. This requires a better understanding of the complex social, cultural, and ecological contexts where SBE occurs, within the conceptual frame of One Health, an integrated approach that recognizes the health of humans, animals, and the environment as closely linked and interdependent. Such complexity demands more integrative approaches for better understanding and confronting this disease. SBE has unique features that make its prevention and control challenging. Unlike many infectious diseases, SBE cannot be eradicated, but its incidence and impact can be reduced through effective programs aimed at better prevention and rapid access to treatment. This in turn demands the engagement of communities to improve the cohabitation of humans, domestic animals, and snakes in rural agroecosystems. In 2019, the WHO launched a strategy for the prevention and control of SBE, aimed at halving the deaths and disabilities caused by this NTD by the year 2030. This strategy is based on 4 pillars, i.e., empower and engage communities; ensure safe, effective treatment; strengthen health systems; and increase partnerships, coordination, and resources. Building on previous ideas and publications, this article discusses and advocates for transdisciplinary research on SBE and for promoting dialogue and collaboration between sectors, particularly by engaging communities affected by SBE at all levels of the research process

Embracing context: Lessons from designing a dialogue-based intervention to address vaccine hesitancy.

Dialogue with people who are vaccine hesitant has been recommended as a method to increase vaccination uptake. The process of cultivating dialogue is shaped by the context in which it occurs, yet the development of interventions addressing vaccine hesitancy with dialogue often overlooks the role of context and favors relatively fixed solutions. This reflexive paper shares three key lessons related to context for dialogue-based interventions. These lessons emerged during a participatory research project to develop a pilot intervention to create open dialogue among healthcare workers in Belgium about COVID-19 vaccination concerns. Through a mixed methods study consisting of in-depth interviews, focus group discussions, and surveys, we engaged healthcare workers in the design, testing, and evaluation of a digital platform featuring text-based and video-based (face-to-face) interactions. The lessons are: (1) what dialogue means, entails, and requires can vary for a population and context, (2) inherent tension exists between helping participants voice (and overcome) their concerns and exposing them to others' ideas that may exacerbate those concerns, and (3) interactional exchanges (e.g., with peers or experts) that matter to participants may shape the dialogue in terms of its content and form. We suggest that having a discovery-orientation-meaning to work not only inductively and iteratively but also reflexively-is a necessary part of the development of dialogue-based interventions. Our case also sheds light on the influences between: dialogue topic/content, socio-political landscape, population, intervention aim, dialogue form, ethics, researcher position, and types of interactional exchanges

Doubt at the core: Unspoken vaccine hesitancy among healthcare workers.

Funding Information: CG, KP, SD, TK, TN, CVR, LWH report a grant from Fonds Wetenschappelijk Onderzoek (FWO- Research Foundation – Flanders), to conduct social listening of vaccine concerns in Belgium.publishersversionpublishe

Low Immune Response to Hepatitis B Vaccine among Children in Dakar, Senegal

HBV vaccine was introduced into the Expanded Programme on Immunization (EPI) in Senegal and Cameroon in 2005. We conducted a cross-sectional study in both countries to assess the HBV immune protection among children. All consecutive children under 4 years old, hospitalized for any reason between May 2009 and May 2010, with an immunisation card and a complete HBV vaccination, were tested for anti-HBs and anti-HBc. A total of 242 anti-HBc-negative children (128 in Cameroon and 114 in Senegal) were considered in the analysis. The prevalence of children with anti-HBs ≥10 IU/L was higher in Cameroon with 92% (95% CI: 87%–97%) compared to Senegal with 58% (95% CI: 49%–67%), (p<0.001). The response to vaccination in Senegal was lower in 2006–2007 (43%) than in 2008–2009 (65%), (p = 0.028). Our results, although not based on a representative sample of Senegalese or Cameroonian child populations, reveal a significant problem in vaccine response in Senegal. This response problem extends well beyond hepatitis B: the same children who have not developed an immune response to the HBV vaccine are also at risk for diphtheria, tetanus, pertussis (DTwP) and Haemophilus influenzae type b (Hib). Field biological monitoring should be carried out regularly in resource-poor countries to check quality of the vaccine administered