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Community participation in two vaccination trials in slums of Kolkata, India: a multi-level analysis.

Ali M, Sur D, Lopez AL, Kanungo S, Ochiai RL, Manna B, Kim DR, Deen J, Bhattacharya SK, Clemens JD - J Health Popul Nutr (2010)

Bottom Line: A multi-level model was employed in which the individuals were seen nested within the cluster.Communities with predominantly Hindu population, lower percentage of households with an educated household head, or lower percentage of households owning a motorbike had higher participation than their counterparts.At individual scale, higher participation was observed among younger subjects, females, and individuals from households with a household head who had no or minimal education.

View Article: PubMed Central - PubMed

Affiliation: International Vaccine Institute, Seoul, Korea. mali@ivi.int

ABSTRACT
This study aims at understanding the individual and community-level characteristics that influenced participation in two consecutive vaccine trials (typhoid and cholera) in urban slums of Kolkata, India. The study area was divided into 80 geographic clusters (communities), with 59,533 subjects aged > or = 2 years for analysis. A multi-level model was employed in which the individuals were seen nested within the cluster. Rates of participation in both the trials were nearly the same; those who participated in the initial trial were likely to participate in the subsequent cholera vaccine trial. Communities with predominantly Hindu population, lower percentage of households with an educated household head, or lower percentage of households owning a motorbike had higher participation than their counterparts. At individual scale, higher participation was observed among younger subjects, females, and individuals from households with a household head who had no or minimal education. Geographic patterns were also observed in participation in the trials. The results illustrated that participation in the trial was mostly influenced by various individual and community-level factors, which need to be addressed for a successful vaccination campaign.

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Related in: MedlinePlus

Local Bayes smoothing rate (%) of participation in typhoid vaccine, cholera vaccine, and both trials shown in quintile distribution of rates, Kolkata, India
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Figure 1: Local Bayes smoothing rate (%) of participation in typhoid vaccine, cholera vaccine, and both trials shown in quintile distribution of rates, Kolkata, India

Mentions: The study was conducted in urban slum communities in Kolkata, capital of the state of West Bengal. Kolkata, the third largest city in India, has 14 million inhabitants living within an area of 1,450 sq km, making it one of the world's most densely-populated cities. The Kolkata Municipal Corporation consists of 141 civic administrative units called ward, with each ward having an office responsible for public health supervised by a medical officer. The study site comprises two contiguous wards (29 and 30) and encompasses an area of 0.99 sq km. Residents live in homes tightly-spaced together along winding sewage-littered pathways, and they rely on shared toilets and drinking-water (7). Seven referral government hospitals, various traditional practitioners, private medical clinics of qualified and unqualified physicians, and private nursing homes provide healthcare in Kolkata. Five health clinics (Fig.) were set up in the study area for primary care, and cases were referred to the Infectious Diseases Hospital (IDH), which is within a few km from the study site, and B.C. Roy Children Hospital, which is adjacent to the study site.


Community participation in two vaccination trials in slums of Kolkata, India: a multi-level analysis.

Ali M, Sur D, Lopez AL, Kanungo S, Ochiai RL, Manna B, Kim DR, Deen J, Bhattacharya SK, Clemens JD - J Health Popul Nutr (2010)

Local Bayes smoothing rate (%) of participation in typhoid vaccine, cholera vaccine, and both trials shown in quintile distribution of rates, Kolkata, India
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2963767&req=5

Figure 1: Local Bayes smoothing rate (%) of participation in typhoid vaccine, cholera vaccine, and both trials shown in quintile distribution of rates, Kolkata, India
Mentions: The study was conducted in urban slum communities in Kolkata, capital of the state of West Bengal. Kolkata, the third largest city in India, has 14 million inhabitants living within an area of 1,450 sq km, making it one of the world's most densely-populated cities. The Kolkata Municipal Corporation consists of 141 civic administrative units called ward, with each ward having an office responsible for public health supervised by a medical officer. The study site comprises two contiguous wards (29 and 30) and encompasses an area of 0.99 sq km. Residents live in homes tightly-spaced together along winding sewage-littered pathways, and they rely on shared toilets and drinking-water (7). Seven referral government hospitals, various traditional practitioners, private medical clinics of qualified and unqualified physicians, and private nursing homes provide healthcare in Kolkata. Five health clinics (Fig.) were set up in the study area for primary care, and cases were referred to the Infectious Diseases Hospital (IDH), which is within a few km from the study site, and B.C. Roy Children Hospital, which is adjacent to the study site.

Bottom Line: A multi-level model was employed in which the individuals were seen nested within the cluster.Communities with predominantly Hindu population, lower percentage of households with an educated household head, or lower percentage of households owning a motorbike had higher participation than their counterparts.At individual scale, higher participation was observed among younger subjects, females, and individuals from households with a household head who had no or minimal education.

View Article: PubMed Central - PubMed

Affiliation: International Vaccine Institute, Seoul, Korea. mali@ivi.int

ABSTRACT
This study aims at understanding the individual and community-level characteristics that influenced participation in two consecutive vaccine trials (typhoid and cholera) in urban slums of Kolkata, India. The study area was divided into 80 geographic clusters (communities), with 59,533 subjects aged > or = 2 years for analysis. A multi-level model was employed in which the individuals were seen nested within the cluster. Rates of participation in both the trials were nearly the same; those who participated in the initial trial were likely to participate in the subsequent cholera vaccine trial. Communities with predominantly Hindu population, lower percentage of households with an educated household head, or lower percentage of households owning a motorbike had higher participation than their counterparts. At individual scale, higher participation was observed among younger subjects, females, and individuals from households with a household head who had no or minimal education. Geographic patterns were also observed in participation in the trials. The results illustrated that participation in the trial was mostly influenced by various individual and community-level factors, which need to be addressed for a successful vaccination campaign.

Show MeSH
Related in: MedlinePlus