Immunization Status of Pre-School Students in Slums

 

Rathi HB, Bansal AK and PK Shrivastav

Dept. Of Community Medicine, Govt. Medical College, Jagdalpur -494001

 

ABSTRACT:

Immunization status of 555 children were studied in a slum, Out of 555 children 509 (91.4 %) received B.C.G., 452 (84.2 %) and 438 (81.6 %) were immunized with all three doses of D.P.T. and O.P.V. respectively while only 318 (65.8 %) received Measles Vaccine. Regarding drop out rate between 1st and 3rd dose of D.P.T. and O.P.V. were 14.04 % and 3.5 % respectively. On further analysis it has been observed  that Rumors was most leading cause of Non or partial immunization. To combat rumors we have to intensify information, education and communication in the Community.

 

KEY WORDS: Drop out, Immunization.

 

INTRODUCTION:

In developing countries millions of deaths or life long disabilities results from various vaccine preventable diseases in childhood.

 

Immunization programme known as expanded programme in immunization was started by GOI on January 1978 with the objectives of reducing morbidity and mortality due to Diphtheria, Tetanus, Polio, Tuberculosis, Whooping Cough vaccination and against measles was included in 1985-86. The programme with additional imput renamed universal immunization programme (UIP) from November 1985 with the objective to provide children irrespective of caste, creed, colour, and sex against six preventable diseases by immunization them with the available vaccines. Though theoretically and technologically it is feasible but practically it seems to be very difficult task in the face of widely prevalent social and religious prejudices, superstitions, rumors and above all the discriminations on account of sex in the community.

 

OBJECTIVES:

This study was undertaken to assess the immunization of children residing in slums.

 

MATERIALS AND METHODS:

The present study was undertaken in Bhande plot (slum) Nagpur (Maharashtra) from 1st Dec. 1991 to 31st October 1992. The information about the immunization status of children was collected on a pre drawn Proforma from their immunization Cards, interrogating their parents and through examination of subjects for Bacillus Calmate Guerinne (BCG).

 

DROP OUT RATES: - Drop out Rates for DPT and OPV was calculated by using the following formula Bansal et al (2).

 

                              First Dose -Third Dose

                              --------------------------------  X  100

                              First Dose

 

Resons for partial or non immunization:

The Immunization status of the child entered, fully, partially or not immunized as follows.

(a)              Fully Immunized: - Child who received one dose of BCG, there doses of DPT and three doses of OPV.

(b)              Partially Immunized: - Some Immunization have been administered but immunization was not complete.

(c)               Not Immunized: - not even a single dose of any vaccine has been administered. For a partially immunized or non immunized child, the investigator asked an open ended question to a responsible person of the family who was present at the time of survey to tell the most important reason, why the immunization was incomplete or not done. The relevant reply from the respondents recorded in their own words has been categorized in to three headings Bansal et. al. (1-2).

(1)              Lack of Information.

(2)              Lack of motivation.

(3)              Obstacles.

 

OBSERVATION AND DISCUSIIONS:

On analysis of the collected data it has been revealed out of 555, 509 (91.7 %) were inoculated with BCG Vaccines (Table-I).

 

TABLE – I: IMMUNIZATION STATUS OF STUDY SUBJECTS

Type of Vaccine

Vaccinated

Not Vaccinated

BCG

509 (91.4)

46 (8-3)

DPT

1st Dose.

1st and 2nd Dose.

All three Doses.

 

484 (87.3)

470 (85.4)

452 (84.2)

 

70 (12.7)

80 (14.6)

85 (15.8)

OPV

1st Dose.

1st and 2nd Dose.

All three Doses.

 

471(85.0)

459 (83.9)

438 (81.6)

 

83 (15.0)

91 (16.6)

99 (18.4)

MEASLES

318 (65.8)

165 (34.2)

N = 555

Figures in parenthesis indicate percentage.

 

484 were given DPT out of which 85.4 %, had 1st and 2nd Doses and 84.2 % received all the three doses. Similarly out of 555 children revealed 471 (85.0 %) were given first dose OPV, 459 (83.9 %) 1st and 2nd Doses, 438 (81.6 %) were given all three doses. Table further reveals that out of 555 only 318 (65.8 %) subjects were immunized with Measles vaccine. The authors further noticed that immunization coverage for measles and booster dose of triple and OPV was found to be low. Bansal A.K. et. al. (2,4-6) Reported immunization coverage with BCG, DPT and all three doses of DPT were 52.64 %, 83.33 and 53.64 % respectively, which is more or less similar to the finding of the present study.

 

Singh S.P. et al (3) Reported Immunization coverage in urban sums for DPT and OPV was more than 85.0 % while Measles coverage was only 32.1 % which is more or less in accordance of the findings of the present study.

 

DROP OUT:

No matter how well organized a programme; it is very difficult to achieve 100 % coverage of UIP. Drop out rates between 1st and 3rd doses of DPT and OPV were 14.04 % and 3.5 % respectively.

 

Bansal et al (2) In his study reported drop out rate was 8.05 % and 7.7 % for DPT and OPV respectively.

 

Non scientific deep rooted traditions, culture and believes of the community were mainly responsible for partial or non immunization (Table–II). For combating the reasons of partial or non immunization there is a need of creating awareness so there will be change in the behavior pattern of the people.

 

TABLE – II: REASONS FOR PARTIAL OR NON IMMUNIZATION OF CHILDREN

Symptoms

Reasons

Respondents

Lack of Awareness

1.    Lack of knowledge with place and time of immunization.

2.    Lack of knowledge about 2nd and 3rd doses.

3.    Fear of side effects.

4.    Wrong knowledge about indication.

21

 

58

 

98

101

Lack of Motivation

1.    Postponement till another day.

2.    No faith in Immunization.

3.    Rumors.

78

51

110

OBSTACLES

1.    Have to go too far for Immunization.

2.    Timing not convenient.

3.    Vaccinator not available.

4.    Non availability of vaccine.

5.    Child brought but refused for vaccination.

6.    Have to wait for long time.

13

 

49

12

10

38

 

89

 

CONCLUSION:

From above observations and discussions the authors reached to the conclusion that there is still need to intensity the information, education and communication (IEC) in the Community to bring the change in the behavior of community. .

 

REFERENCES:

1.       Bansal A.K. and Chandorkar R.K. (1993) effectiveness of ICDS in child care in Rural and Tribal areas of Chhattisgarh M.P.,; Journal of Ravi Shankar Shukla University, Vol. 6 No.- B (Sciences); 61-65.

2.       Bansal A.K. and Chandorkar R.K. (1997) Immunization Status of Tribal and Non Tribal Children of Raipur district, Madhya Pradesh; Tribal Health Bulletin (ICMR) Vol.-3 No.-2; 12-14.

3.       Singh S.P. et al (1992) A Thrust in under five immunization coverage in an urban slum of Varanasi Indian Journal of Prer. Soni, Medi.; Vol.-23, No.- 1; 37-43.

4.       Bansal A. K. and Chandorkar R. K. (1993) utilization of Health care delivery by Tribal and Non Tribal women of an ICDS Block ; Journal Ravishankar Uni. Vol. 6; No. B (Science) 57-60.

5.       Bansal A.K. and Chandorkar R.K. Impact of I.C.D.S. on morbidity due to Nutritional deficiency Diseases amongst Tribe and non Tribe Children; Research J Science and Tech.;2009: 1(2) ;82-84.

6.       Bansal, A.K., Agarwal Ashok K., and Govila A.K.: status of the girl child amongst Tribe and Non Tribes in the unreached rural India J Ravi Shankar Univ. (1998-99) Vol. 11-12, No. B (Science) 31-36.

 

Received on 14.02.2010

Accepted on 28.02.2010

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Research J. Pharmacology and Pharmacodynamics 2(1): Jan. –Feb. 2010: 57-58