Couverture vaccinale des enfants d'âge pré-scolaire admis au centre hospitalier de Cayenne en 2017

Abstract : Vaccination is a major health concern in the world, particularly for newborns who are most vulnerable to diseases that could effectively be prevented. Ensuring vaccination in French Guiana is of utmost importance due to high demographic growth and limited access to healthcare. This limited access to healthcare is a result from relatively high isolation and precariousness. The purpose of this study was to describe the vaccination coverage (VC) of children under the age of 3 in Cayenne, French Guiana, and determine the factors that might influence whether or not people receive vaccinations and the causes of vaccine refusal. This is an epidemiologic, descriptive, observational, retrospective, transversal and single-center study, performed in Cayenne from 1st January to 1st May 2017. All children below pre-school age that were attended for at Cayenne hospital during this time have been included in this study. Children with no health record i.e. heath book were not integrated in this study. Data collection was done through a questionnaire that doctors had to fill within the pediatric hospital unit, during pediatric consultations as well as in the pediatric emergency department. The VC was estimated by the proportion of people with complete immunization for 13 vaccines (among which four are mandatory). The relation between immunization status and socio-economic factors has been analyzed in a hierarchical mixed and ordered regression model. We have studied 184 questionnaires. The Vaccination Cover was 70% for pentavalent vaccine (diphtheria, tetanus, poliomyelitis, hib, and ca). However, the VC was 46% for yellow fever. For recommended vaccines, VC was 70% for hepatitis B, 50% for MMR vaccine and pneumococcus. VC was 7% for meningitis. There was no correlation between the child’s care arrangement, birth location or socio-professional category of the parents and the vaccination status. The main reasons behind non-vaccination for all vaccines are transport issues e.g. high isolation ant the fact that not all attending physicians propose the vaccine to their patients. There was a shortage of BCG vaccines. As a matter of fact, French Guiana has a positive opinion when it comes to vaccines, very few parents refuse the vaccination of their child. In order to improve the vaccination cover in the first few years of a child’s life, there is a strong need to promote vaccination notably though media campaigns, aiming to incentivize the parents to get their children vaccinated. Furthermore, it might be useful to organize continuous medical trainings for health professionals to increase their awareness and make them familiar with the vaccination calendar again. The vaccination cover for children under the age of 3 years is very mediocre in French Guiana, and several measures need to be implemented to improve its status.
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Master Thesis
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Cécile Marre. Couverture vaccinale des enfants d'âge pré-scolaire admis au centre hospitalier de Cayenne en 2017. Médecine humaine et pathologie. 2018. ⟨dumas-02052590⟩

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