Hussain R. Usman|Mohammad H. Rahbar|Sibylle Kristensen|Sten H. Vermund|Russell S. Kirby|Faiza Habib|Eric Chamot
Randomized controlled trial to improve childhood immunization adherence in rural Pakistan: redesigned immunization card and maternal education
University of Alabama at Birmingham|University of Alabama at Birmingham|Vanderbilt University|University of South Florida|Aga Khan University|University of Alabama at Birmingham
summary objective substantial dropout first dose diphtheriatetanuspertussis dtp1 3rd dose dtp dtp3 immunization recorded pakistan conducted randomized controlled trial assess effects providing substantially redesigned immunization card centrebased education interventions together dtp3 completion six rural expanded programme immunization epi centres pakistan methods motherchild pairs enrolled dtp1 randomized four study groups redesigned card centrebased education combined intervention standard care child followed 90 days record dates dtp2 dtp3 visits study outcome dtp3 completion end followup period study group results enrolled 378 motherchild pairs redesigned card group 376 centrebased education group 374 combined intervention group 378 standard care group end followup 39 children standard care group completed dtp3 compared significantly higher proportion children completed dtp3 redesigned card group 66 crude risk ratio rr 17 95 ci 15 20 centrebased education group 61 rr 15 95 ci 13 18 combined intervention group 67 rr 17 95 ci 14 20 conclusions improved immunization card alone education mothers alone together effective increasing followup immunization visits study underscores potential study interventions public health impact necessitates evaluation complete epi schedule large scale epi system