Effect of vaccine reminder and tracker bracelets on routine childhood immunization coverage and timeliness in urban Pakistan (2017-18): a randomized controlled trial.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Health Promotion/*statistics & numerical data ; Immunization Programs/*statistics & numerical data ; Measles Vaccine/*administration & dosage ; Patient Compliance/*statistics & numerical data ; Reminder Systems/*statistics & numerical data; Child ; Child, Preschool ; Female ; Humans ; Immunization ; Infant ; Male ; Measles/prevention & control ; Pakistan ; Research Design ; Vaccination/statistics & numerical data ; Vaccination Coverage
    • Abstract:
      Background: Inability to track children's vaccination history coupled with parents' lack of awareness of vaccination due dates compounds the problem of low immunization coverage and timeliness in developing countries. We evaluated the impact of two types of silicone immunization reminder bracelets for children in improving immunization coverage and timeliness of Pentavalent-3 and the Measles-1 vaccines.
      Methods: Children < 3 months were enrolled in either of the 2 intervention groups (Alma Sana Bracelet Group and Star Bracelet Group) or the Control group. Children in the intervention groups were provided the two different bracelets at the time of recruitment. Each time the child visited the immunization center, a hole was perforated in the silicone bracelet to denote vaccine administration. Each child was followed up till administration of Measles-1 vaccine or till 12 months of age (if they did not come to the center for vaccination). Data was analyzed using the intention-to-treat population between groups. The unadjusted and adjusted Risk Ratios (RR) and 95% confidence interval (CI) for Pentavalent-3 and Measles-1 coverage at 12 months of age were estimated through bivariate and multivariate analysis. Time-to-Pentavalent-3 and Measles-1 immunization curves were calculated using the Kaplan-Meier method.
      Results: A total of 1,445 children were enrolled in the study between July 19, 2017 and October 10, 2017. Baseline characteristics among the three groups were similar. Up-to-date coverage for the Pentavalent-3 /Measles-1 vaccine at 12 months of age was 84.6%/72.0%, 85.4%/70.5% and 83.0%/68.5% in Alma Sana Bracelet group, Star Bracelet group and Control group respectively but the differences were not statistically significant. In the multivariate analysis, neither the Alma Sana bracelet (adjusted RR = 1.01; 95% CI: 0.96-1.06), (adjusted RR: 1.05; 95% CI: 0.97-1.13) nor the Star bracelet (adjusted RR = 1.01; 95% CI: 0.96-1.06) (adjusted RR: 1.03; 95% CI: 0.95-1.11) was significantly associated with Pentavalent-3 vaccination or Measles-1 vaccination.
      Conclusion: Although we did not observe any significant impact of the bracelets on improved immunization coverage and timeliness, our findings add to the existing literature on innovative, low cost reminders for health and make several suggestions for enhancing practical implementation of these tools.
      Trial Registration: ClinicalTrials.gov NCT03310762 . Retrospectively Registered on October 16, 2017.
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    • Contributed Indexing:
      Keywords: Immunization coverage and timeliness; Immunization reminders; Silicone bracelets
    • Molecular Sequence:
      ClinicalTrials.gov NCT03310762
    • Accession Number:
      0 (Measles Vaccine)
    • Publication Date:
      Date Created: 20200713 Date Completed: 20201102 Latest Revision: 20201102
    • Publication Date:
      20240105
    • Accession Number:
      PMC7353686
    • Accession Number:
      10.1186/s12889-020-09088-4
    • Accession Number:
      32652969