{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T03:56:52Z","timestamp":1773374212202,"version":"3.50.1"},"reference-count":39,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T00:00:00Z","timestamp":1689120000000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,6,21]]},"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Vaccine-preventable infectious diseases (VPDs) are major causes of morbidity\/mortality among children under 5\u2009years of age worldwide and in Nigeria\/Ebonyi state. Routine childhood immunisation is an invaluable prevention strategy for many VPDs. Due to suboptimal coverage and untimely receipt\/delay in receipt of vaccinations, outbreaks of VPDs such as measles, yellow fever, diphtheria and others continue to reoccur around the world and in Nigeria\/Ebonyi state. This study aims to evaluate the effectiveness of hybrid parents and health workers adaptive intervention in increasing the optimal\/timely (cumulative age-appropriate) routine childhood immunisation coverage in the communities in Ebonyi state, Nigeria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analyses<\/jats:title>\n                    <jats:p>A two-arm, parallel, open label, covariate-constrained cluster-randomised controlled trial with 1:1 allocation of 16 geographical clusters (the nearest catchment areas for at least one public primary healthcare (PHC) facility with at least 500 households or a population size of 3000) will be used to evaluate the effects of hybrid\/combined parents and PHC workers adaptive engagement compared with control. The primary outcomes are the optimal\/timely (cumulative age-appropriate) receipt of the recommended vaccines in the routine childhood immunisation schedule by children aged 5\u20139 completed months and 10\u201311 completed months and the age-appropriate vaccines receipt score for the recommended vaccines. The outcomes will be measured through a population-based household survey of at least 15 children aged 5\u20139 and 10\u201311 months per cluster at baseline and at the end of the study using a structured interviewer-administered questionnaire in KoBoCollect installed in android devices. All analyses will be done using a cluster-level method on as-randomised basis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval for the trial was obtained from the Ebonyi State Health Research and Ethics Committee (EBSHREC\/01\/06\/2022\u201331\/05\/2023) and verbal consent will be obtained from participants. Study findings will be reported at local\/national and international levels as appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN59811905\">ISRCTN59811905<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-068953","type":"journal-article","created":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T10:36:51Z","timestamp":1689158211000},"page":"e068953","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Study protocol for a cluster-randomised controlled trial of hybrid parents and health workers adaptive intervention for optimal routine childhood immunisation coverage in the communities of Ebonyi state, Nigeria: the AGINTOPIC trial protocol"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"isrctn59811905","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6586-8992","authenticated-orcid":false,"given":"Ugwu I","family":"Omale","sequence":"first","affiliation":[{"name":"Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard L","family":"Ewah","sequence":"additional","affiliation":[{"name":"Anaesthesia, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria"},{"name":"Surgery, Anaesthesia Unit, Ebonyi State University, Abakaliki, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chidinma I","family":"Amuzie","sequence":"additional","affiliation":[{"name":"Community Medicine, Federal Medical Centre Umuahia, Umuahia, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cordis O","family":"Ikegwuonu","sequence":"additional","affiliation":[{"name":"Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glory E","family":"Nkwo","sequence":"additional","affiliation":[{"name":"Community Medicine, Federal Medical Centre Umuahia, Umuahia, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chimaobi C","family":"Iwegbulam","sequence":"additional","affiliation":[{"name":"Paediatrics, Federal Medical Centre Umuahia, Umuahia, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louisa C","family":"Ekwuazi","sequence":"additional","affiliation":[{"name":"Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,7,12]]},"reference":[{"key":"2025120519063761000_13.7.e068953.1","unstructured":"Business case for WHO immunization activities on the African continent, 2018\u20132030. 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