Background:
Immune-Mediated Inflammatory Diseases (IMIDs) are a group of disorders characterized by altered immune regulation causing chronic inflammation in target organs or organ systems. Patients with IMIDs are at an increased risk of infectious diseases. Examples of IMIDs include Rheumatoid arthritis (RA), the spondyloarthritis (SpA) disease spectrum, connective tissue disorders, cutaneous inflammatory conditions (including psoriasis and atopic dermatitis), inflammatory bowel disease (IBD), asthma and autoimmune neurological diseases such as multiple sclerosis. Children with immune-mediated inflammatory disorders (IMIDs) are at increased risk of infections and would therefore derive great benefit from preventive measures such as vaccination.
Broad Objective
This project aimed to increase awareness of the need for the inclusion of essential additional vaccines in the care package for paediatric patients with IMIDs attending care in two tertiary hospitals in Nairobi. Further, we aimed to perform a structured assessment and intervention for immunization status to ensure that those who need the vaccines were offered the opportunity to receive them. We also planned to develop 3 tools for use by health workers and caregivers of children with IMIDs:
i) Immunization status Checklist
ii) Vaccination Educational tool for Caregivers of children with IMIDs
iii) Vaccination Educational tool for Health workers managing children with IMIDs
Methodology
We conducted a study among caregivers of children with IMIDs to determine their knowledge, attitude towards and uptake of vaccinations as a means to ensure better health for their children. The study recruited primary caregivers of patients with IMIDs attending the dermatology, nephrology, and rheumatology clinics at the Kenyatta National Hospital and Gertrude’s Children’s Hospital. Ethical approval for the study was obtained from the Kenyatta National Hospital – University of Nairobi Ethics Review Committee.
Results
A total of 103 primary caregivers to patients with IMIDs were recruited into the study, 90- from the KNH and 13 from Gertrude’s children’s hospital. Only 25 index participants had received additional vaccines outside the routine EPI immunization schedule. 82/103 primary caregivers affirmed their willingness to have their child receive the incentive vaccine. Among the 82 who were willing to have the children vaccinated, 66 received the vaccine while the rest failed to get the vaccine for varying reasons including the state of the patient (12 who were sick or admitted in hospital had the vaccination deferred). Two participants did not receive the vaccine because the primary caregiver was not available to give consent or authorize administration of the vaccine. Two others missed due to unfavorable clinic operation times.
Three tools for use by health workers and caregivers of children with IMIDs were developed.
Conclusion
Vaccine hesitancy is a major threat to attainment of optimal care outcomes even among patients with IMIDs. Therefore, greater emphasis should be put on health education for caregivers and patients to inform them of the benefits of immunization to ensure these children get maximum benefit from currently available and future vaccines.
Dr. Elizabeth Kiragu is a Paediatric Allergy Specialist and full time faculty based at the Aga Khan University Hospital, Nairobi. She attended the University of Nairobi and for her undergraduate degree and her Masters in Paediatrics and Child Health. She completed a 2-year Paediatric Allergy fellowship at the University of Cape Town. Dr. Kiragu has established comprehensive allergy services within the Paediatric Department of Aga Khan University Hospital, Nairobi. She has a special interest in food allergies, urticaria, asthma and allergy advocacy. She is committed towards advancing allergy care in Kenya at primary care level via presenting on a wide variety of topics at various National and Regional Conferences/Symposiums.
DR. JOY MUYONGA
DR. JUSTUS MAINGI SIMBA MBChB, PhD.
Dr. Barnabas Kigen
DR. JUSTUS MAINGI SIMBA MBChB, PhD.
Dr. Caren Ito Emadau
DR. JUSTUS MAINGI SIMBA MBChB, PhD.
Affiliation: Machakos County
Fred Were is Professor of Paediatrics and Child Health specializing in Newborn Medicine. He presently holds portfolios of; Dean School of Medicine University of Nairobi (UON), Acting Principal College of Health Sciences (UON), Adjunct Professor of Newborn Medicine at the Aga Khan University (East Africa) and Executive Director/Chief Researcher of The Kenya Paediatric Research Consortium a wing of the Kenya Paediatric Association.
Njeri Wahome delights in all things administration. With over 20 years of experience in operations management in the development sector, Njeri as hands-on experience in strategic planning, financial management, human resources management, administration and logistics planning. She has experience providing technical assistance to NGOs on institutional strengthening for growth and sustainability.
Thomas Ngwiri is Head Clinician at Gertrude’s Children’s Hospital since February 2010. He is also Director of the Paediatric endocrinology training centre for Africa (PETCA) – Nairobi which trains paediatricians from sub-Saharan Africa in the field of diabetes and other endocrine disorders. He has been a member of the Kenya Paediatric association executive since 2010 and is the immediate former National Chair of the association.
Dr. Lawrence Okong’o Owino is a lecturer at the department of paediatrics and child health at the University of Nairobi. He is also a consultant paediatrician at the Kenyatta National hospital as well as a consultant paediatrician and rheumatologist for all the major hospitals in Nairobi. He is a pioneer paediatric rheumatologist. His research interests are in the field of musculoskeletal health and immunizations. He has published papers in peer reviewed journals focussing mainly on childhood rheumatic disorders.
MBChB (UoN), MMed (UoN) M.Phil-MCH (UCT)). Dr Osano is a Lecturer in the Department of Paediatrics and Child Health, School of Medicine, University of Nairobi, a consultant Paediatrician cardiologist at Kenyatta National Hospital. He has been the Program Coordinator for the NIH MEPI grant awarded to the University of Nairobi: Strengthening Maternal Newborn Child Health Research Training in Kenya. He has special interest in Maternal Child Health.
Dr. Joe Mbuthia is a graduate of the University of Oxford, with a specialty in Paediatric Infectious Diseases. He is an honorary Lecturer at the Department of Paediatrics and Child health, University of Nairobi as well as a Senior Technical Advisor to the HIV programme – Kenya Paediatric Research Consortium.
Dr. David Githanga is an accomplished medical professional with over 37 years of clinical practice experience. He holds a fellowship of the royal college of physicians of Edinburg (2021, a PhD in Medical Immunology from the University of Nairobi. (2019), Masters in public Health from the University of London (2010), He qualified in paediatric cardiology from the Royal Hospital for sick Children in Glasgow UK (1993), A Diplomate in Child Environmental Health from Athens Greece (2005, a Master’s degree in pediatrics from the University of Nairobi (1990) having obtained his MB,chB from the same University in 1984. Over the years he has demonstrated leadership capability and strategic thinking that has been instrumental in spearheading the growth, development and integration of the Kenya Pediatric Association (KPA) where he served in executive positions for a total period of 19 years.
Dr. Doris M.W. Kinuthia is medical professional with expertise in paediatrics and adolescent medicine, nephrology and HIV. She graduated from the University of Nairobi with medical qualifications MB.Ch.B and M.Med in Paediatrics. She has Certificates in Tropical medicine and Immunology from the same University. She did her fellowship in Paediatric Nephrology at the hospital for Sick Children in Great Ormond Street, London.U.K. She has a post graduate diploma and Master of Business Administration from Sunderland University U.K.
Denish Osodo works at Safaricom Limited as the Internal Audit Director. He has wide and deep experience in Accounting and Audit with along progressive career in Assurance, Governance and Risk Services.
Dr. Makeba Shiroya Wandabwa is a Paediatrician and Public Health Specialist, with a strong health systems background having worked in various capacities to develop child health policies and guidelines, implement and monitor high impact child health interventions at the international, national, sub national and community levels. She has provided technical, strategic, evaluation and operational support for RMNCAH/HIVAIDS health programs funded by USAID, DFID, Global Fund and World Health Organization.
Dr. Kibore received her bachelor’s degree in medicine and her master’s degree in Pediatrics and Child Health both from the University of Nairobi, Kenya, she then went on and completed a Master’s degree in Public Health from the University of Washington, USA.
Denish Osodo works at Safaricom Limited as the Internal Audit Director. He has wide and deep experience in Assurance, Governance and Risk Services. Prior to joining Safaricom, he worked at PricewaterhouseCoopers (PwC) for several years, offering audit and business advisory services to Companies in different industries during his stints in Kenya and United Kingdom offices. He left PwC as a Director in the Risk Assurance Services team focusing on the provision of Internal Audit and business Controls Advisory Services to clients across Africa.
AFFILIATIONS: Department of Paediatrics and Child health, University of Nairobi.
AFFILIATIONS: Aga Khan University Nairobi, Kenya.
AFFILIATIONS:
AFFILIATION: Medical services Nairobi City County
AFFILIATIONS: Aga Khan University Hospital
AFFILIATIONS: Department of Paediatrics and Child Health, Kenyatta University.
AFFILIATIONS: Gertrudes Childrens Hospital