title: Coverage and causes of missed oral polio vaccine in urban and rural areas of Peshawar.
abstract: BACKGROUND
  Poliomyelitis mainly affects children under five years of age. Pakistan is one of the few countries where wild polio is still endemic. The purpose of this study was to find out the coverage rate and factors associated with the failure of OPV in urban and rural areas of Peshawar.
  
  
  METHODS
  This cross-sectional study was conducted in Peshawar. Data was collected through random sampling in Peshawar University, Peshawar Saddar, Hashtnagri, Naway Kalay and Pawaka from 9th to 19th June 2010. A questionnaire was used to interview parents of 548 children, aged four years and below, about demographics, OPV vaccination status, reasons for missed vaccination and views on immunization and EPI staff. Forty workers from immunization staff were also interviewed through a separate questionnaire to find out factors associated with low OPV coverage. Chi-square test was used for statistical testing and p < 0.05 was considered significant.
  
  
  RESULTS
  Only 64.2% children were completely vaccinated, 13.3 % not vaccinated at all, and 22.4% were incompletely vaccinated. The reasons for not vaccinating were lack of awareness (23.8%), family problem/mother busy (20.8%), centre too far (21.3%), wrong ideas (10.2%), fear of reaction (7.6%), child ill (5.6%) and miscellaneous causes (10.6%). The problems faced by the EPI staff were lack of awareness among people (32.5%), load shedding (20.0%), poor transport facilities (10.0%), unavailability of vaccines (10.0%) and insecurity (10.0%).
  
  
  CONCLUSIONS
  Low vaccination coverage in Peshawar is mainly due to low awareness among people, poor economic conditions and poor salaries, insecurity and transport problems faced by the immunization staff.
authors.affiliation: Department of Community Medicine, Khyber Medical College, Peshawar, Pakistan. eaglebook86@gmail.com
authors.forename: Mohammad
authors.initials: M
authors.lastname: Naeem
authors.forename: Muhammad
authors.initials: M
authors.lastname: Adil
authors.forename: Syed Hussain
authors.initials: SH
authors.lastname: Abbas
authors.forename: Muhammad Zia-ul-Islam
authors.initials: MZ
authors.lastname: Khan
authors.forename: Syeda Maria
authors.initials: SM
authors.lastname: Naz
authors.forename: Ayasha
authors.initials: A
authors.lastname: Khan
authors.forename: Muhammad Usman
authors.initials: MU
authors.lastname: Khan
mesh_terms: D016009:Chi-Square Distribution; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D010349:Patient Compliance; D011051:Poliomyelitis / Q000453:epidemiology / Q000517:prevention & control*; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage*; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D011055:Poliovirus Vaccine, Oral