Electronic Theses and Dissertations (Masters)

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Browsing Electronic Theses and Dissertations (Masters) by School "Pathology"

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    Maternal vaccination in South Africa: timing and completeness
    (2024) Bourne, Julia
    Maternal immunisation is an invaluable public health measure that protects not only the mother, but also the foetus and new-born infant against a host of diseases; and is recommended by both the World Health Organisation (WHO) and South African national health authorities. Pregnancy induces a heightened state of immune system vulnerability, leaving women more susceptible to severe influenza outcomes, whilst neonatal tetanus has a fatality rate of between 80-100% in the absence of medical intervention. Maternal immunisation against influenza and tetanus has been successfully utilised as a public health strategy across the globe to uphold maternal and neonatal health. Maintaining coverage is imperative for both diseases as influenza strains change seasonally and tetanus cannot be eliminated, highlighting the importance of continued maternal immunisation. This study aimed to describe the uptake of both influenza and tetanus vaccinations during pregnancy, the completion of the tetanus vaccination schedule and the timing of both influenza and tetanus immunisation within South African antenatal care facilities. In addition, this study described clinical and demographic factors affecting maternal immunisation uptake. Clinical and demographic data were collected in a parent study and were retrospectively analysed in this study using the statistical software Stata. Influenza vaccination uptake within the sampled population was found to be 16.62% (806/4851). The odds of influenza vaccination were significantly higher in women aged 21-30 years, and women with six or more ANC visits. Metro East Cape Town site in the Western Cape outperformed Gauteng sites, with significantly increased odds of influenza vaccination amongst women frequenting that site. Appropriate influenza immunisation: defined as immunisation occurring during the period of either 01/04/2017-31/07/2017 or 01/04/2018-30/06/2018, occurred in 74.86% (530/708) of the cohort. Women who were alcohol users were significantly more likely to receive an influenza vaccine – yet this may be explained by the Metro East site which had the higher influenza coverage having the highest prevalence of alcohol use during pregnancy. Of 7105 women, 7031 (98.96%) received at least one dose of tetanus toxoid vaccine (TTV). Of these women, 39.24% (2759) received one dose; 51.06% (3590) received two doses and 9.70% (682) received the recommended three doses of TTV in their index pregnancy. Tetanus schedule completion was significantly more likely in women ≤20 years, and those who presented for their booking antenatal care (ANC) visit in the first trimester. In addition, women with more than three visits had an increased likelihood of TTV schedule completion. The odds of TTV schedule completion were decreased by negatively parity and gravidity, values over one and less than six, and greater than one respectively. Women with hypertension were significantly less likely to receive three TTV doses compared to women without hypertension. Julia Bourne MSc(Vaccinology) Research Report: Version 2.0 v Tetanus immunisation schedule adherence prevalence was 0.60% (4/670) in women with three doses and 90.34% (3209/3552) in women with two. Improvements may be made in South African maternal immunisation coverage, with this study supporting the idea of targeted educational campaigns and a revision of the maternal immunisation schedule to include the tetanus, diphtheria & acellular pertussis vaccine instead of the tetanus toxoid vaccine.
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    Understanding barriers and motivators of Covid-19 vaccine uptake among young people in Soweto, South Africa
    (2024) Nkhata, Bernadette
    The SARS-CoV-2 novel human coronavirus is the cause of coronavirus disease (Covid-19) Covid19 is coupled with common symptoms such as fever or chills, dry cough, and tiredness. Less common symptoms include muscle or body aches, the new loss of taste or loss of infection. Vaccines are the most effective public health intervention that could protect individuals and the community from the severity of Covid-19. Several vaccine candidates have shown good safety and efficacy during recent randomized clinical trials, and seven of which have been rolled out to different African counties with over 1 million doses administered. In south Africa there has been a low uptake of the Covid-19 vaccine particularly among the youth, despite studies showing positive attitudes towards vaccination. The youth play an important role in the pandemic as they are a crucial source for the spread of the virus to more vulnerable populations. Understanding the barriers and motivations towards vaccine uptake in this population group will assist in implementing interventions targeted specifically for the youth. Aim The aim of this study is to understand the barriers and motivations towards vaccine uptake among the youth aged 18-35 in Soweto, South Africa. Methodology This is a qualitative exploratory study approach employing focus group discussions. Eight focus group discussions with both male and female participants between the ages of 18 and 35 took place in two study sites, Themb’Elihle and Meadowlands South Africa. A total of 62 participants were enrolled in the study. The Health Belief Model theoretical framework served as a guide for this investigation. Themes were developed through thematic qualitative analysis and the data collected was examined and interpreted with the use of qualitative software ATLAS.ti. Results The study found that young adults do experience barriers and motivations that determine their decision to get vaccinated against Covid-19 or not. Misinformation was among the strongest barriers to vaccination. The spread of rumors and conspiracies of the vaccines left participants feeling scared to be vaccinated. This led to the lack of trust in health care professionals, and the lack of trust in governmental authorities leading the vaccines rollout. Motivation to vaccinate came as a result of the need to protect themselves and loved ones. Participants were also willing to vaccinate as a means to reintegrate back into society and to access basic means that were previously restricted due to the Covid-19 pandemic. Conclusion The results of this study demonstrate that motivations and barriers that young adults in Soweto, South Africa encounter have a significant impact on their decision to get immunized. Policymakers are encouraged to look into the challenges faced by this group, with a focus on how social media can be used as a useful tool for reaching out to young adults and spreading correct information.