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ORIGINAL ARTICLE
Year : 2020  |  Volume : 9  |  Issue : 1  |  Page : 51-56

Awareness, attitude, and knowledge about pneumococcal infection and vaccination: A survey across North Delhi


Department of Audiology and Speech-Language Pathology, Ashtavakra Institute of Rehabilitation Sciences and Research, New Delhi, India

Date of Submission14-Mar-2019
Date of Decision20-Sep-2019
Date of Acceptance08-Nov-2019
Date of Web Publication13-Jan-2020

Correspondence Address:
Mr. Himanshu Verma
Ashtavakra Institute of Rehabilitation Sciences and Research, PSP Building, Institutional Area, Madhuban Chowk, East Rohini, Sector-14, New Delhi - 110 085
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_13_19

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  Abstract 


INTRODUCTION: Pneumococcal infection is a significant public health problem and leading cause of death among young children in developing countries. In most of the cases, “Streptococcus pneumonia” is the common human pathogenic bacterium. It further increases the risk of otitis media, meningitis, sepsis, paranasal sinuses, and upper respiratory infections. To fight against this condition advanced antibiotic therapies are available, but due to less awareness and knowledge people are unable to access.
AIM: The present study aims to measure the level of awareness and knowledge among the population of North Delhi about pneumococcal infection and vaccination.
MATERIALS AND METHODS: To conduct the survey, questionnaire was developed. The questionnaire consists of 17 questions, which are divided into three sections such as awareness, knowledge, and attitude. A total of 281 (males: 105; females: 176) participants participated in the present survey.
RESULTS: The present study revealed that only 46.02% of females have seen advertisements related to pneumococcal, whereas 60% of males said that they have never seen any advertisement. A total of 43 (40.95%) males and 57 (32.38%) females reported that pneumococcal vaccination (PCV) may help in curing pneumococcal disease; however, only 8.57% males and 19.09% females agreed that PCV can cure the pneumococcal disease. Only 29.89% population knew that pneumococcal can also cause ear infection, whereas only 29.89% were aware of the fact that pneumococcal infection can be fatal for neonates.
CONCLUSION: From the present study, we can conclude that after all the initiatives taken by government, general population still has low level of awareness about the PCV. We suggest that more campaigns, street play, advertisement, and other methods need to introduce to increase the level of awareness.

Keywords: Ear infection, pneumococcal infection, pneumococcal meningitis, pneumococcal vaccination


How to cite this article:
Sharma Y, Jaswal D, Shriwal H, Verma H, Shah J. Awareness, attitude, and knowledge about pneumococcal infection and vaccination: A survey across North Delhi. Int J Health Allied Sci 2020;9:51-6

How to cite this URL:
Sharma Y, Jaswal D, Shriwal H, Verma H, Shah J. Awareness, attitude, and knowledge about pneumococcal infection and vaccination: A survey across North Delhi. Int J Health Allied Sci [serial online] 2020 [cited 2020 Jul 15];9:51-6. Available from: http://www.ijhas.in/text.asp?2020/9/1/51/275645




  Introduction Top


In the present scenario, “National Health Mission” is one of the hot topics around the Indian Population. Due to that, ample of information, warning, and awareness programs are being run by the Indian Government using digital media (example: advertisements). The government is trying to spread awareness among the Indian population about the different vaccination, viruses, their management, and different health policies using advertisements. As per report of the WHO (2011),[1] developing countries are at higher risk of viral or bacterial infections among children and infants. To fight against those issues many Children Immunisation Programmes were recently launched by the Government of India (GOI). Among all other infections, pneumonia is a significant public health problem and leading cause of death among young children in developing countries.[2] According to report of the WHO (2008),[3] about 476,000 children under the age of 5 years die every year due to pneumococcal infection. A recent study reported that about 450 million people are infected per year by pneumococcal infection and approximately 4 million die due to the same. They further stated that majority of pneumonia-related death occur in developing countries, especially in India, China, and Pakistan.[4],[5] Studies also reported that pneumococcal pneumonia is not only the cause of infection in children but also a major cause of morbidity and mortality in elderly population.[6]

Pneumococcal infection is mainly caused by infection with viruses or bacteria. In the majority of cases, “Streptococcus pneumonia” is the common human pathogenic bacterium.[7],[8] In the case of elderly population, bacteria invade the bloodstream or other sterile sites, resulting in invasive pneumococcal disease (i.e., bacteremic pneumonia, meningitis, and sepsis). Pneumococcal infection further leads to or increase the risk of otitis media, meningitis, sepsis, paranasal sinuses, and upper respiratory infections.[9] With advancement in health field vaccinations such as 23 value pneumococcal polysaccharide vaccine is introduced. This vaccination is highly effective in preventing pneumococcal infections and comorbid conditions such as otitis media in children[10],[11],[12] Research suggested that this vaccination achieved a protection rate of 76%–92%[13],[14] However, many studies reported the limited usage of S. pneumonia vaccination in developing countries[15],[16] Xiaodong et al., 2016[17] reported the less awareness and knowledge about the pneumococcal infection and vaccination in the Shanghai population. As we discussed earlier, the GOI is taking many initiatives to aware the general population which may also increase the awareness about vaccination and its benefits. Hence, there is a dearth of studies to measure the level of awareness and knowledge about pneumococcal infection and vaccination in the Indian Scenario.

Aim and objectives

The present study aims to measure the level of awareness and knowledge among the population of North Delhi about the pneumococcal infection and vaccination.

  1. To compare the level of awareness of pneumococcal disease between males and females
  2. To compare the level of awareness of pneumococcal vaccination (PCV) between males and females
  3. To compare the level of attitude toward pneumococcal disease and PCV between males and females
  4. To measure the overall level of awareness, knowledge, and attitude of pneumococcal disease and PCV among the general population
  5. To compare the level of awareness, knowledge, and attitude of pneumococcal disease and PCV based on education level and socioeconomic status.



  Materials and Methods Top


Participants

A total of 281 people were randomly selected from different age groups to complete the questionnaire. The present study consists population from different socioeconomic status and different education levels. Majority of population belongs to the middle-class income group (Rs. 200,000 – Rs. 600,000 P.a.). On the education level, population were divided into two groups (i.e., Group I: XII Grade or below; Group II: Above XII Grade). The present population belongs from both rural and urban areas of North Delhi.

Development of the questionnaire

To conduct the survey, questionnaire was developed. The questionnaire consists of 17 questions which have three options (i.e., yes, no, and may be). The questionnaire assessed the knowledge and attitudes of participants across three broad domains: awareness and knowledge about pneumococcal disease, awareness, and knowledge about PCV, and attitude toward pneumococcal disease and PCV. Awareness and knowledge about the pneumococcal disease section consist of 9 questions, section 2 awareness, and knowledge about PCV consists of three questions, whereas last section contains five questions. The developed questionnaire was validated by two audiologists, one otolaryngologist, and one doctor of medicines. The corrections made by specialist were taken into consideration.

Procedure

Before the collection of data, aim and objectives of the study were explained to all participants and consent forms were filled. The developed questionnaire was also prepared online using Google questionnaire. The link of the questionnaire was sent to the participants as well as hardcopy was also distributed for all those who are unable to fill it online. The form contained 17 questions which helped us in knowing the conditions of PCVs awareness in North Delhi. Every question was compulsory and the participants were asked to fill the complete form, be it online or offline. If participants faced any issue or were unable to understand the question, then explanations were provided by the authors.


  Results Top


Descriptive analysis was performed. Mean standard deviation (SD) and percentile scores were computed. T-test and ANOVA were performed to compare the means between the groups using SPSS 20.00 version software (IBM Corp, 2015).

Demographic result

Among 281 participants, 105 (37.37%) were males with a mean age of 28.54 years and 176 (62.63%) were females with a mean age of 29.67 years. All participants had good physical and mental health while filling the questionnaire.

Level of awareness of pneumococcal disease between males and females

On analysis of data, we found that 58.52% of females have heard about pneumococcal infection, whereas 41.90% of males reported the same. Only 46.02% female population reported that they had seen advertisements related to pneumococcal, whereas 40.90% female population have not. Among 105 males, majority (60%) of them said that they never saw any poster or advertisement related to pneumococcal disease. About 32.95% of female population knew that it can affect old population and 40.90% females were aware that it can cause brain fever, whereas 35.27% reported that they are not aware of this fact. A total of 38.06% female population reported that pneumococcal can cause ear infection, whereas 38.06% were in dilemma. Among 105 males only 17% agreed that pneumococcal can cause infection, as shown in [Table 1].
Table 1: Responses of both groups in Section A

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Comparison of both group responses in section A (i.e., awareness related to pneumococcal disease) was also computed using t-test analysis. On t-test, significant differences (t = 0.00) were found on comparison of responses of males (mean: 1.95; SD: 0.70) and female (mean: 1.81; SD: 0.81) as shown in [Figure 1].
Figure 1: Mean of both groups in Section A (awareness about pneumococcal disease)

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Level of awareness of pneumococcal vaccination between males and females

Among 176 females, 73.29% reported that PCV is necessary for newborns; however, only 13.61% females reported that they had visited hospital with their children for PCV during postpartum period. A total of 17 (16.19%) males reported that they visited to doctor for PCV for their children. A total of 43 (40.95%) males and 57 (32.38%) females reported that PCV may help in curing pneumococcal disease; however, only 8.57% males and 19.09% females agreed that PCV can cure the pneumococcal disease as shown in [Figure 2].
Figure 2: Percentile agreed score of both groups in Section B (awareness about pneumococcal vaccination)

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On comparison of both groups, males (mean: 2.01; SD: 0.74) and females (mean: 1.91; SD: 0.75) SD was not found (t ≥ 0.05), which indicates that both groups had similar responses in this section.

Attitude toward pneumococcal disease and pneumococcal vaccination among males and females

A total of 85.79% females and 71.42% males agreed that children should get proper knowledge at school level about pneumococcal; however, 8.57% of male population was in dilemma, and 17.04% of female population did not agree for the same. Majority of population in both groups (male: 78.09% and females: 86.93%) reported that there is a need to spread awareness about PCV as is done for polio and other vaccination as shown in [Figure 3].
Figure 3: Agreed percentile score of both groups in Section C (attitude towards pneumococcal and pneumococcal vaccination)

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On comparison of both groups, males (mean: 1.45; SD: 0.65) and females (mean: 1.26; SD: 0.54) SD (t = 0.00) were found, as shown in [Figure 4].
Figure 4: Mean values of both groups in Section C (attitude toward pneumococcal and pneumococcal vaccination)

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Overall level of awareness, knowledge, and attitude of pneumococcal disease and pneumococcal vaccination among population

As shown in [Figure 5] and [Figure 6], among the population of 281 participants, 52.31% of people have heard about pneumococcal infection and only 39.50% of them have seen advertisements of the disease in newspapers and television. Only 29.89% population knew that pneumococcal can also cause ear infection, whereas 37.72% were in a dilemma. About 45.06% believed that pneumococcal cannot cause brain fever and only 29.89% were aware of the fact that pneumococcal infection can be fatal for neonates. About 66.54% of the participants reported that PCV is necessary for newborns; however, only 17.08% got their children vaccinated for pneumococcal disease. Among the participants of the study, 84.34% believed that the advertisements shown for the awareness of pneumococcal disease and its vaccination are required. About 18.41% of the people reported that there is no need for the schools to provide knowledge about the pneumococcal disease and PCV and 83.62% believed that people should get more awareness as they have got for Polio and other vaccinations. About 5.69% were in a dilemma whether it should be available at cheap prices or not, whereas 87.54% agreed to the suggestion that it should be available at cheap prices so that everyone can afford PCV.
Figure 5: Percentile score of overall awareness among population about pneumococcal disease

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Figure 6: Percentile score of overall awareness among population about pneumococcal vaccination

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A total of 84.34% population agreed that there is a need to increase advertisements related to pneumococcal disease to spread awareness among the population, whereas 7.11% did not. Majority of population (67.25%) reported that they were not fully aware of pneumococcal infection and its complication and only 14.94% of participants reported that they were fully aware of pneumococcal infection. Most of the participants (80.42%) were in favor of increasing awareness about pneumococcal disease at school level; however, 18.41% disagreed. Majority of participants (83.62%) reported that there is a need to spread awareness about PCV as is done for polio and other vaccination among population of India.

To compare the level of awareness, knowledge, and attitude of pneumococcal disease and pneumococcal vaccination based on education level and socioeconomic status

All participants had a minimum qualification of XII grade as education level; however, majority of population were graduates (89%). Small number (11%) of population consisted Post Graduates, Undergraduates, and various professionals. On statistical analysis, no SD (t ≥ 0.05) was found. Majority of participants belong to middle-class income group (76%); however, 15% belongs to lower-class income group (i.e., annual family income t ≥ 0.05) was found.


  Discussion Top


The present study revealed that most of the participants were unaware, even after so many initiations taken by the GOI to aware general population, about pneumococcal infection, its complication and vaccination through advertisements by using print and digital media. The same conclusion was also made by the study done in Shanghai, China by Xiaodong et al., 2016.[17] Further our result supported by a study done in the Singapore population by How et al. in 2016.[18] It revealed that most of the parents are not aware of PCV and its benefits. The result of the present study was also supported by the study done of Arabian Gulf, 2016, which reported that burden of pneumococcal disease can be reduced by effective vaccination programs in Arabian Gulf countries, but the lack of awareness of PCV among population is a major barrier in implementation of same.[19] The present study indicates that cost of the vaccination is one of the major barriers for the vaccine, and same was supported by the survey done by National Foundation of Infectious Disease (2019).[20] They reported that most of the population believe vaccination has high charges and may also have side effects.

The present study also revealed that participants could develop a good attitude toward PCV after providing the information regarding the benefits of PCV, a complication of pneumococcal disease. Most of the participants reported that awareness among general population must be increased using varieties of other methods such as street plays and by increasing the amount of advertisements related to pneumococcal diseases through print and digital media. Same also reported by How et al.(2016),[18] he reported that number of PCV users increased after counseling related to benefits of PCV by their general physicians. Further our study results supported by study done by Klett-Tammen et al.[21] They reported that most of the population was aware of influenza and tetanus but had least awareness of PCV. They further extended their results and reported that participated participants were ready to learn more about Pneumococcal infection and its vaccination after providing the basic information about the pneumococcal infection and its complications.


  Summary and Conclusion Top


The study was conducted among the population of North Delhi to evaluate the awareness of PCV among the participants. Majority of our participants were females. From the survey, it was concluded that more awareness is needed among the population on account of PCV. Participants are not aware that it can be fatal for neonates as well as for the geriatrics. The fact that pneumococcal can cause hearing loss was not known by a significant amount of participants. This is a preliminary study, and there is need of further extensive studies in future, which can help in spreading awareness among population. The present study limited to only North Delhi population, so there is need to extend the study. This study was not able to include the socioeconomic status and education level intensively as these factors have significant effect on awareness and attitude level, so these need to be included extensively. Further study can also be done to investigate the level of awareness among rural and urban areas.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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