Knowledge, attitudes and perceptions towards polio immunization among residents of two highly affected regions of Pakistan

BackgroundDespite the efforts of national and international organizations, polio has not been eradicated from Pakistan. The prevalence of polio in Pakistan is exceptional in global context. Quetta and Peshawar divisions are amongst the most affected regions hit by polio in Pakistan. This study was carried out to assess the knowledge, attitudes and perceptions towards polio immunization among residents of Quetta and Peshawar divisions in Pakistan.MethodsA descriptive, cross-sectional study involving 768 participants was conducted from August to December, 2014 in Quetta and Peshawar divisions in Pakistan. Multistage sampling technique was used to draw a sample of residents from each division. A pre-tested, self-administered questionnaire was used to collect the data from eligible participants. Descriptive and logistic regression analyses were used to express the results.ResultsA total of 38.8 % participants exhibited good knowledge about polio. Mean knowledge score of the participants was 7.35 ± 2.54 (based on 15 knowledge questions). Older age (p < 0.001), low qualification (p < 0.05), rural locality (p < 0.05) and Quetta division (p < 0.001) were significantly associated with poor knowledge of polio. A large proportion of participants displayed negative attitudes towards polio immunization (84.8 %), with a mean score of 19.19 ± 2.39 (based on 8 attitude statements). Lack of education (p < 0.001) and rural residence (p < 0.001) were significantly associated with the negative attitudes of participants towards polio immunization. False religious beliefs (39.06 %), lack of knowledge (33.7 %), fear of infertility by polio vaccines (32.16 %) and security issues (29.42 %) were reported by the participants as the main barriers towards polio immunization.ConclusionThe findings of this study showed poor knowledge and negative attitudes of participants towards polio immunizations. Religious beliefs and lack of knowledge about polio immunization were reported as the major barriers towards polio immunization.

[1]  C. Dolea,et al.  World Health Organization , 1949, International Organization.

[2]  U. Jajoo,et al.  Annual cluster (pulse) immunization experience in villages near Sevagram, India. , 1985, The Journal of tropical medicine and hygiene.

[3]  Janet Harkness,et al.  Questionnaires in translation , 1998 .

[4]  N. Ahmad,et al.  Immunization coverage in three districts of North West Frontier Province (NWFP). , 1999, JPMA. The Journal of the Pakistan Medical Association.

[5]  F. Mansuri,et al.  Assessment of immunization service in perspective of both the recipients and the providers: a reflection from focus group discussions. , 2003, Journal of Ayub Medical College, Abbottabad : JAMC.

[6]  C. Pandav,et al.  A study of the perception, communication and coverage of pulse polio immunization programme in a Delhi slum. , 2004, Indian journal of public health.

[7]  A. Hyder,et al.  The burden of road traffic injuries in developing countries: the 1st national injury survey of Pakistan. , 2004, Public health.

[8]  J. Fotso International Journal for Equity in Health Open Access Child Health Inequities in Developing Countries: Differences across Urban and Rural Areas , 2022 .

[9]  S. Pocock,et al.  Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration , 2007, PLoS medicine.

[10]  E. Wimmer,et al.  Vaccination against polio should not be stopped , 2007, Nature Reviews Microbiology.

[11]  R. Obregon,et al.  Achieving polio eradication: a review of health communication evidence and lessons learned in India and Pakistan. , 2009, Bulletin of the World Health Organization.

[12]  R. Dellavalle,et al.  Social internet sites as a source of public health information. , 2009, Dermatologic clinics.

[13]  H. Larson,et al.  Lessons from polio eradication , 2011, Nature.

[14]  M. Adil,et al.  Coverage and causes of missed oral polio vaccine in urban and rural areas of Peshawar. , 2011, Journal of Ayub Medical College, Abbottabad : JAMC.

[15]  N. Joseph,et al.  A study of the knowledge and attitude towards pulse polio immunization in semi urban areas of South India. , 2011, The Australasian medical journal.

[16]  M. Adil,et al.  COVERAGE AND CAUSES OF NON IMMUNIZATION IN NATIONAL IMMUNIZATION DAYS FOR POLIO; A CONSUMER AND PROVIDER PERSPECTIVE STUDY IN PESHAWAR , 2011 .

[17]  S. Omer,et al.  Parental perceptions surrounding polio and self-reported non-participation in polio supplementary immunization activities in Karachi, Pakistan: a mixed methods study. , 2012, Bulletin of the World Health Organization.

[18]  O. Ogwumike,et al.  Children with paralytic poliomyelitis: a cross-sectional study of knowledge, attitudes and beliefs of parents in Zamfara state, Nigeria , 2012, BMC Public Health.

[19]  J. Puliyel,et al.  Caution needed in using oral polio vaccine beyond the cold chain: Vaccine vial monitors may be unreliable at high temperatures , 2012, The Indian journal of medical research.

[20]  M. Hassali,et al.  A cross-sectional assessment of knowledge, attitude and practice among Hepatitis-B patients in Quetta, Pakistan , 2013, BMC Public Health.

[21]  M. Nordin The Permissibility of Rotavirus Vaccines - A Personal Perspective , 2013 .

[22]  H. Larson,et al.  Listening to the rumours: What the northern Nigeria polio vaccine boycott can tell us ten years on , 2013, Global public health.

[23]  J. Alexander,et al.  Progress and peril: poliomyelitis eradication efforts in Pakistan, 1994-2013. , 2014, The Journal of infectious diseases.

[24]  M. Dibley,et al.  Determinants of neonatal mortality in Pakistan: secondary analysis of Pakistan Demographic and Health Survey 2006–07 , 2014, BMC Public Health.

[25]  Riaz Anwar Bashir,et al.  POLIO VACCINATION; KNOWLEDGE, ATTITUDE, AND PRACTICE IN DISTRICT ABBOTTABAD, KHYBER PAKHTUNKHWA, PAKISTAN. , 2014 .

[26]  S. El-Kamary,et al.  From Intense Rejection to Advocacy: How Muslim Clerics Were Engaged in a Polio Eradication Initiative in Northern Nigeria , 2014, PLoS medicine.

[27]  Asf,et al.  Determinant Factors for Implementing Polio Eradication Activities under Security Compromised Settings of Pakistan , 2014 .

[28]  S. Taylor Culture and behaviour in mass health interventions: lessons from the global polio eradication initiative , 2015 .