Download Table 1

Knowledge & Attitudes
about Diphtheria Vaccination in 2012
of Naresuan University Hospital’s Medical Personnel
Kanyarat Jongpitakrat, Tipkamol Prajsuchanai
Advisors: Bodin Bootthum, MD; Suwit Leartkajonsin, MD.
Magnitude of problem (1)
•
Diphtheria is one of vaccine preventable diseases that
have been well controlled by high coverage of
vaccination in children.
•
However, since 2010-2012 diphtheria outbreaks occurred
more frequently in Thailand.
•
The recent data (6th December 2012 ) showed that the total
number of diphtheria cases is 40, 4 of these died.
Department of disease control . Ministry of public health, Thailand, 2012
Magnitude of problem (2)
•
The Ministry of Public Health then stated the policy to
give vaccine to medical personnel in the epidemic area.
(goal of vaccine coverage = 90%)
•
Infectious Control Committee of Naresuan University
Hospital then arranged to give vaccination for personnel
in November, 2012.
•
Only 47.28% of medical personnel were participated.
Objectives
•
Primary objective
 To determine knowledge and attitudes about diphtheria
and diphtheria vaccination among Naresuan University
Hospital’s medical personnel.
•
Secondary objectives
 To explore the reasons why medical personnel did not
intend to be vaccinated.
 To assess the prevalence of the problem and the factors
associated with the immunization
Methodology (1)
•
•
•
Cross-sectional study
Analytic study
Questionnaire
Methodology (2)
•
Step1 : Proportional Stratified Sampling
Occupations
Physician
Nurse
Pharmacist
Practical nurse
Nurse aid
Medical technologist
Medical student
Total
•
No. of
Population
201
292
20
3
165
18
28
727
Proportion
27.65
40.17
2.75
0.41
22.70
2.48
3.85
100
No. of
Samples
33
48
3
1
27
3
5
120
Step 2 : Simple Randomized Sampling
RESULT
110
Medical Personnel
2 respondents
answered half of
the questions
58 vaccinated
(53.70%)
50 not yet
vaccinated
(46.30%)
Table 1 : Baseline data (1)
Baseline data
No. of medical
personnel (N%)
1) Gender
male
female
20 (18.52)
88 (81.48)
2) Age
< 20 years
20 – 30 years
31 – 40 years
41 – 50 years
> 5o years
2 (1.85)
65 (60.19)
40 (37.04)
1 (0.93)
0 (0)
Table 1 : Baseline data (2)
Baseline data
No. of medical
personnel (N%)
3) Profession
Physician *
Nurse *
Pharmacist
Practical nurse
Nurse aid *
Medical technologist
Medical student
19 (17.59)
49 (45.37)
4 (3.70)
1 (0.93)
27 (25.00)
3 (2.78)
5 (4.63)
4) Working experience
< 5 years
5-10 years
> 10 years
55 (50.93)
39 (36.11)
14 (12.96)
Table 1 : Baseline data (3)
Baseline data
5) Perception of the news
Yes
No
No. of medical personnel
(N%)
92 (85.19)
16 (14.81)
6) The way to receive the news
(92 people perceived)
Television
Radio
Newspaper
Internet
Medical Colleagues
Hospital
66 (71.74)
5 (5.43)
18 (19.57)
46 (50.00)
50 (54.35)
64 (69.57)
Table 1 : baseline data (4)
Baseline data
9) Vaccination in last one year
dT
Tdap
Have not yet been vaccinated
10) The reasons cited by those
who did not receive vaccination
(N:50)
Ignorance of the news
Fear of side effects
Lack of time
Fear of pain
Fear of expenses
No. of medical personnel
(N%)
26 (24.07)
32 (29.63)
50 (46.30)
23 (46.00)
9 (18.00)
13 (26.00)
5 (10.00)
13 (26.00)
The reasons they said no to vaccination
(N=50)
50
45
46
40
35
30
26
25
26
18
20
15
10
10
5
0
Ignorance of
the news
Fear of side
effects
Lack of time
Fear of pain
Fear of
expenses
Table 2. Univariate analysis
Variable
Experience
<5 yr*
5-10 yr
>10 yr
Perception
of news
yes
no*
OR
p-value
30(54.55)
12(30.77)
2.70
0.02*
6(42.86)
8(57.14)
0.90
0.86
56(60.87)
2(12.50)
36(39.13)
14(87.50)
10.89
0.02*
Vaccination
Nonvaccination
N(%)
N(%)
25(45.45)
27(69.23)
Baseline data No.4
Working experiences
35
30
25
54.55%
45.45%
69.23%
vaccination
20
15
30.77%
10
57.14 %
42.86%
5
0
<5 years
5-10 years
> 10 years
nonvaccination
Baseline data No.5
Perception of news
60
60.87%
50
40
39.13%
30
20
87.50%
10
12.50%
0
yes
no
vaccination
non-vaccination
Table 3: knowledge about diphtheria and vaccination (1)
Questions
Correct
(N%)
Incorrect
(N%)
P-value
(n=108)
1. Diphtheria can be prevented by vaccination
101 (93.52)
7 (6.48)
0.552
2. Diphtheria is an acute infectious disease of the
respiratory system.
99 (91.67)
9 (8.33)
0.201
3. Diphtheria can cause fever,
cough, sore throat, and difficult
swallowing.
95
(87.96)
13
(12.04)
0.077
*
4. The main complications of diphtheria are airway
obstruction, myocarditis, and neuropathy.
98 (90.74)
10 (9.26)
0.362
5. Diphtheria spreads when an infected person coughs
or sneezes.
96 (88.89)
12 (11.11)
0.785
6. It can’t be spread by handling used tissues or by
drinking from a glass used by an infected person.
67 (62.04)
41 (37.96)
0.685
7. Diphtheria only occurs in children.
99 (91.67)
9 (8.33)
0.561
Table 3: knowledge about diphtheria and vaccination (2)
Questions
Correct
(N%)
Incorrect
(N%)
P-value
(n=108)
8. Antibiotics can prevent diphtheria.
84 (77.78)
24 (22.22)
0.959
9. Virus causes diphtheria.
51 (47.22)
57 (52.78)
0.881
10. Prevention of diphtheria infection in children is to be
fully vaccinated three doses.
11. The booster is not required in the person who already
received diphtheria vaccine since childhood.
20 (18.52)
88 (81.48)
0.713
83 (76.85)
25 (23.15)
0.267
12. Immunodeficiency is not the risk of
diphtheria infection.
87
(80.56)
21
(19.44)
0.021*
13. Side effects of the vaccine are
swelling and redness at the injection
site. Vaccine can also cause severe
allergy.
72
(66.67)
36
(33.33)
0.029*
14. Anyone who have fever shouldn’t receive vaccine.
91 (84.26)
17 (15.74)
0.645
15. As you are the medical personnel, should you get
vaccination when there is an outbreak of diphtheria?
Mean = 11.537 (SD=2.28)
103 (95.37)
5 (4.63)
0.122
vaccination
11.74
Nonvaccination
11.3
0.159
T-test
Knowledge No.3:
Diphtheria can cause fever, cough, sore throat, difficult swallowing.
correct
incorrect
Vaccination
Non-vaccination
P-value = 0.077, OR = 2.96
Knowledge No.13:
Side effects of vaccine are swelling and redness at the injection site.
Vaccine also cause severe allergy.
right
wrong
Vaccination
Non-vaccination
P-value = 0.029, OR = 2.47
Table 5: Attitudes about diphtheria and vaccination (1)
Questions
N%
P-value
(n=108)
agree
not sure
disagree
1.Healthy people cannot get diphtheria infection.
23 (21.30)
22 (20.37)
63
(58.33)
0.137
2. Diphtheria is not around us. We think we won’t get
infected.
13 (12.04)
21 (19.44)
74
(68.52)
0.937
3. Diphtheria is a disease that can be prevented.
95 (87.96)
9 (8.33)
4 (3.70)
0.380
4. Diphtheria is not a serious disease that can cause death.
9 (8.33)
28 (25.93)
71
(65.74)
0.289
5. Vaccinations are needed in young children. Adults do not
need to be vaccinated against diphtheria.
7 (6.54)
14 (13.08)
86
(80.37)
0.330
6. Everyone should be vaccinated
against diphtheria because it spreads
easily.
82
(75.93)
17
(15.74)
9
(8.33)
0.081*
7. If there is diphtheria infected young
children at your house, everyone who
lived in that house should get
vaccinated to protect themselves.
77
(71.30)
25
(23.15)
6
(5.56)
0.038*
Table 5: Attitudes about diphtheria and vaccination (2)
Questions
agree
not sure
disagree
P-value
(n=108)
8. Diphtheria vaccine has serious side effects.
17 (15.74)
33 (30.56 )
58 (46.30)
0.427
9. There should have free vaccination against
diphtheria to the medical personnel.
96 (88.89)
10 (9.26 )
2
(1.85)
0.216
10. Getting into an epidemic area without
protection is a risk factor to have diphtheria
infection.
84 (77.78)
16 (14.81)
8
(7.41)
0.424
11. If a medical personnel
encourages you to receive
vaccination, you will get
vaccinated.
N%
71
28
9
0.020
(85.19) (12.04) (2.78)
*
12. The medical personnel should be the ones who
educate people how to protect themselves.
94 (87.04)
13 (12.04)
1
(0.93 )
0.337
13. Medical personnel have more risk to have
diphtheria infection, they should receive vaccine.
91 (84.26)
15 (13.89 )
2
(1.85 )
0.833
14. Everyone should be participated in preventing
an outbreak of diphtheria.
98 (90.74 )
10 (9.26)
0
(0)
0.278
Attitude No.6
Everyone should be vaccinated against diphtheria
because it easily spreads.
Agree
Disagree
Not sure
Vaccination
Non-vaccination
P-value = 0.038, OR = 2.97
Attitude No.11
If a medical personnel encourages you to receive vaccination,
you will get vaccinated.
Agree
Disagree
Not sure
Vaccination
Non-vaccination
P-value = 0.020
Conclusion
•
The medical personnel who had more knowledge and good
attitude to the diphtheria vaccination would rather decide to
receive a vaccination than the others.
•
The perception of news and working experiences were also
related to the vaccination.
•
Therefore, institutional diphtheria vaccination campaigns
should focus on the awareness of medical personnel and
new recommendations for diphtheria vaccination.
Thank You