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Original Article • Rev. Saúde Pública 55 • 2021 • https://doi.org/10.11606/s1518-8787.2021055003478 copy

Attitude and perception towards vaccination against poliomyelitis in Peshawar, Pakistan

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

This research aimed to quantitatively assess the general public's awareness, attitude and perception of polio and its vaccination in Peshawar KPK, Pakistan.

METHODS:

We conducted a survey-based study to understand the surge in polio cases from 2015 to 2019 in the Peshawar city of the Khyber Pakhtunkhwa (KPK), Pakistan. A pre-tested questionnaire-based study was conducted in 2019 to assess the attitude and general perception of residents of Peshawar KPK towards polio vaccination.

RESULTS:

Out of 241 country-wide polio cases, 63 (26.1%) polio cases were reported in Peshawar city from 2015–2019. The questionnaire revealed that individuals between 18–30 years of age had sufficient knowledge (65.1%) about polio. Male and female participants had equal awareness (~ 43%). Participants with higher education (45.9%), those with better financial status (49.5%), individuals with children < 5 years of age (46.4%), and those who had experience of a polio patient (63.1%) had better knowledge. Participants inhabiting the central city were better aware (50.5%) of polio than individuals living in the outskirts.

CONCLUSION:

The data indicated that poor knowledge and negative attitudes of people towards polio vaccination are the main causes of the polio eradication program's failure. Moreover, religious beliefs, unchecked migration between the Pak-Afghan border, and lack of knowledge about polio vaccination are identified as critical barriers to polio eradication.

DESCRIPTORS:
Poliomyelitis, prevention & control; Poliovirus Vaccines; Vaccination Refusal; Vaccination Coverage; Health Knowledge, Attitudes, Practice

Year	No. of Patients	Sex		Mean age at disease onset (in months)	Partially vaccinated patients (%)	Serotypes (%)
Year	No. of Patients	Male (%)	Female (%)	Mean age at disease onset (in months)		1	2	3
2015	8	3 (37.5%)	5 (62.5 %)	20	5 (62.5 %)	8 (100%)	–	–
2016	9	4 (44.5%)	5 (55.5 %)	15	5 (55.5 %)	8 (88 %)	–	1 (12%)
2017	8	3 (37.5%)	5 (62.5 %)	07	4 (50 %)	8 (100%)	–	–
2018	28	12 (42.9%)	16 (57.1 %)	13.4	15 (53.5 %)	28 (100%)	–	–
2019	10	5 (50.0%)	5 (50.0 %)	12.1	2 (20.0 %)	10 (100%)	–	–

No. of doses/age in months	Partially vaccinated (n = 31)					Unvaccinated (n = 32)	Completely vaccinated (n = 60)
No. of doses/age in months	1^st dose	2^nd dose	3^rd dose	More than 3 doses	Total no. of cases received vaccination	No. of cases received Zero doses	No. of cases received all doses
01–12 months	02	02	06	00	10	21	20
13–24 months	02	01	08	00	11	10	15
24–36 months	02	01	02	01	06	0	15
37–48 months	02	01	01	00	04	01	10
Total	31					32	60

Variables		total no.	Knowledge (%)		OR (95%CI)	p
Variables		total no.	Poor	Good	OR (95%CI)	p
Age (years)
	18–30	149	52 (34.9 %)	97 (65.1 %)	0.9911 (0.9032–1.087)	0.8486
	31–40	99	62 (62.6 %)	37 (37.4 %)	0.9955 (0.8592–1.154)	0.9518
	41–50	65	31 (47.7 %)	34 (52.3 %)	0.9127 (0.7722–1.073)	0.272
	51–60	41	34 (82.9 %)	07 (17.1 %)	0.8775 (0.6306–1.173)	0.3949
	> 60	30	27 (90.0 %)	03 (10.0 %)	0.9612 (0.7182–1.176)	0.733
Gender
	Female	225	128 (56.9 %)	97 (43.1 %)	1.019 (0.9289–1.117)	0.6945
	Male	159	90 (56.6 %)	69 (43.4 %)	0.9787 (0.8772–1.091)	0.6981
Qualification
Uneducated		72	53 (73.6 %)	19 (26.4 %)	1.031 (0.8600–1.239)	0.7401
	Primary	58	38 (65.5 %)	20 (34.5 %)	1.099 (0.9063–1.344)	0.3381
	Secondary	106	64 (60.4 %)	42 (39.6 %)	0.987 (0.8612–1.131)	0.8542
	Religious	87	53 (60.9 %)	34 (39.1 %)	1.006 (0.8646–1.171)	0.9352
Graduate		61	33 (54.1 %)	28 (45.9 %)	0.9099 (0.7589–1.083)	0.2939
Employment status
	Unemployed	168	113 (67.3 %)	55 (32.7 %)	1.027 (0.9173–1.150)	0.6463
	Paid-employed	115	67 (58.3 %)	48 (41.7 %)	0.9634 (0.8432–1.099)	0.5794
	Self-employed	101	63 (62.4 %)	38 (37.6 %)	0.9693 (0.8403–1.116)	0.665
Monthly Income (PKR)
	< 10,000–20,000	168	113 (67.3 %)	55 (32.7 %)	1.034 (0.9248–1.157)	0.5559
	< 30,000–50,000	115	67 (58.3 %)	48 (41.7 %)	1.006 (0.8846–1.145)	0.9233
	> 50,000	101	51 (50.5 %)	50 (49.5 %)	1.013 (0.8843–1.161)	0.8502
Marital status
	Single	41	16 (39.0 %)	25 (61.0 %)	1.134 (0.9126–1.431)	0.2662
	Married	343	96 (28.0 %)	246 (72.0 %)	0.9984 (0.9197–1.084)	0.9688
Participants having children < 5 years of age
	No	171	104 (60.8 %)	67 (39.2 %)	1.005 (0.9027–1.119)	0.9276
	Yes	215	116 (54.0 %)	99 (46.0 %)	1.003 (0.9126–1.102)	0.9564
Past experience with polio patients
	No	243	167 (68.8 %)	76 (31.2 %)	0.9827 (0.8938–1.080)	0.7159
	Yes	141	52 (36.9 %)	89 (63.1 %)	1.006 (0.8923–1.134)	0.9278
Residence
Peshawar outskirts		291	189 (65.0 %)	102 (35.0 %)	0.9998 (0.9192–1.087)	0.9965
Peshawar city		93	46 (49.5 %)	47 (50.5 %)	0.813 (0.6948–0.9412)	0.0071

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