You are here

  • Home
  • Archive
  • Volume 4, Issue 2
  • Automated phone call and text reminders for childhood immunisations (PRIMM): a randomised controlled trial in Nigeria

Article Text

Article menu

Download PDFPDF

XML
Research
Automated phone call and text reminders for childhood immunisations (PRIMM): a randomised controlled trial in Nigeria
  1. Osayame A Ekhaguere1,
  2. Rosena O Oluwafemi2,
  3. Bolaji Badejoko3,
  4. Lawal O Oyeneyin4,
  5. Azeez Butali5,
  6. Elizabeth D Lowenthal6,
  7. Andrew P Steenhoff7
  1. 1Neonatal-Perinatal Medicine, Department of Pediatrics, Indiana University, Indianapolis, Indiana, United States
  2. 2Department of Pediatrics, Mother and Child Hospital, Akure, Ondo State, Nigeria
  3. 3Department of Pediatrics, Mother and Child Hospital, Ondo Town, Ondo State, Nigeria
  4. 4Department of Obstetrics and Gynecology, Mother and Child Hospital, Ondo Town, Ondo State, Nigeria
  5. 5Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
  6. 6Pediatrics and Epidemiology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  7. 7Division of Infectious Diseases, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
  1. Correspondence to Dr Osayame A Ekhaguere; osaekhag{at}iu.edu

Abstract

Background Sub-Saharan Africa has high under-5 mortality and low childhood immunisation rates. Vaccine-preventable diseases cause one-third of under-5 deaths. Text messaging reminders improve immunisation completion in urban but not rural settings in sub-Saharan Africa. Low adult literacy may account for this difference. The feasibility and impact of combined automated voice and text reminders on immunisation completion in rural sub-Saharan Africa is unknown.

Methods We randomised parturient women at the Mother and Child Hospitals Ondo State, Nigeria, owning a mobile phone and planning for child immunisation at these study sites to receive automated call and text immunisation reminders or standard care. We assessed the completion of the third pentavalent vaccine (Penta-3) at 18 weeks of age, immunisation completion at 12 months and within 1 week of recommended dates. We assessed selected demographic characteristics associated with completing immunisations at 12 months using a generalised binomial linear model with ‘log’ link function. Feasibility was assessed as proportion of reminders received.

Results Each group had 300 mother−baby dyads with similar demographic characteristics. At 18 weeks, 257 (86%) and 244 (81%) (risk ratio (RR) 1.05, 95% CI 0.98 to 1.13; p=0.15) in the intervention and control groups received Penta-3 vaccine. At 12 months, 220 (74%) and 196 (66%) (RR 1.12, 95% CI 1.01 to 1.25; p=0.04) in the intervention and control groups received the measles vaccine. Infants in the intervention group were more likely to receive Penta-3 (84% vs 78%, RR 1.09, 95% CI 1.01 to 1.17; p=0.04), measles (73% vs 65%, RR 1.13, 95% CI 1.02 to 1.26; p=0.02) and all scheduled immunisations collectively (57% vs 47%, RR 1.13, 95% CI 1.02 to 1.26; p=0.01) within 1 week of the recommended date. No demographic character predicted immunisation completion. In the intervention group, 92% and 86% reported receiving a verification reminder and at least one reminder during the study period, respectively.

Conclusion Paired automated call and text reminders significantly improved immunisation completion and timeliness.

Trial registration number NCT02819895.

  • immunisation
  • paediatrics
  • vaccines
  • randomised control trial
  • public Health

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjgh-2018-001232

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • EDL and APS are joint senior authors.

    • Handling editor Seye Abimbola

    • Contributors OAE and AB conceptualised the study. OAE developed the study design, study protocol, performed research assistant training, implemented the project and wrote the first draft. AS and EL provided critical technical assistance in study design, protocol development, project implementation and manuscript review. AS and EL contributed equally as senior authors. ROO and BB were local site PIs. They coordinated all aspects of the study; they provided oversight and supervision of the research assistants. ROO, AB and LO provided administrative assistance for the study and provided critical review of the manuscript.

    • Funding The study was funded by the Thrasher Research Fund (award no. 13813). OAE was awarded a Thrasher Early Career Development Grant as a neonatal-perinatal medicine fellow at the Children's Hospital of Philadelphia. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

    • Disclaimer The funder of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Ethics approval Obtained from the Health Research Ethics Board of the Mother and Child Hospitals, the Ondo State Ministry of Health and the Children’s Hospital of Philadelphia Institutional Review Board.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement All available data can be obtained by contacting the corresponding author. All data requests should be submitted to the corresponding author for consideration. Access to anonymised data may be granted following review.