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Journal Article Ppublish 3 citations

PubMed: 30411430 DOI: 10.1111/jpc.14291

Paediatric immunisation and chemoprophylaxis in a Ugandan sickle cell disease clinic.

J Paediatr Child Health 55(7):795-801

Authors: Chung-Jen Chen, Sabrina Bakeera-Kitaka, Ezekiel Mupere, Philip Kasirye, Deogratias Munube, Richard Idro, Heather Hume, Betsy Pfeffer, Philip LaRussa, Nancy S Green

Affiliations

  • Department of Pediatrics, Columbia University Medical Center, New York, New York, United States.
  • Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda.
  • Department of Pediatrics, University of Montreal, Central University Hospital Saint Justine, Montreal, Quebec, Canada.

Abstract

AIM

We aimed to assess the receipt of recommended care for young children with sickle cell disease (SCD) in a central SCD clinic in Kampala Uganda, focusing on standard vaccination and antibacterial and antimalarial prophylaxis.

METHODS

A cross-sectional assessment of immunisation status and timeliness and prescribed antibacterial and antimalarial prophylaxis was performed in a sample with SCD aged ≤71 months in Mulago Hospital SCD Clinic. Government-issued immunisation cards and clinic-issued visit records for prescribed prophylaxis were reviewed.

RESULTS

Vaccinations were documented by immunisation cards in 104 patients, mean age 31.7 months (range 3-70 months). Only 48 (46.2%) received all doses of each of the four recommended vaccine types, including pneumococcal 10-valent conjugate vaccine (pneumococcal conjugate vaccine (PCV)-10), which became available in 2014. Vaccination completion was associated with younger age and, for polio, maternal employment. PCV-10 series was completed in 54.8% of the sample and in 18.2% of those aged 48-71 months. Of children completing all vaccination types, an average 68.8% were immunised on time, defined as <60 days beyond the recommended age. Only 17 (13.5%) children were both fully and timely vaccinated. In an overlapping sample of 147 children, with a mean age of 38.4 months (4-70 months), 81.6% had ≥1 documented prescription for penicillin and/or antimalarial prophylaxis.

CONCLUSIONS

Standardised vaccination and antibacterial and antimalarial protective measures for young children at this central SCD clinic were incomplete, especially PCV-10 for age ≥24 months, and often late. Child age, but not general maternal demographics, were associated with vaccination and chemoprophylaxis. Clinic-based oversight may improve timely uptake of these preventative measures.

MeSH

Cells, Vaccines, Anemia, Sickle Cell, Child Welfare, Vaccines, Conjugate, Chemoprevention, Vaccination, Aged, Pediatrics, Antimalarials, Child

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