Coverage, inequity and predictors of hepatitis B birth vaccination in Myanmar from 2011-2016: results from a national survey.
Coverage, inequity and predictors of hepatitis B birth vaccination in Myanmar from 2011-2016: results from a national survey.
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DOI：
10.1186/s12913-022-07902-w
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发表时间：
2022-04-19
影响因子：
2.8
通讯作者：
Khalili M
中科院分区：
文献类型：
--
作者：
Anderson ACT;Richards A;Delucchi K;Khalili M
建议接种乙肝病毒出生剂量(HepB-BD)疫苗以减少母婴传播。我们使用2015年至2016年缅甸人口和健康调查评估了2011至2016年间生育的妇女(N = 3,583)的乙肝-BD状况。乙肝疫苗接种在孕产妇和卫生系统因素、浓度指数和Logistic回归模型中的频率分布被用来估计覆盖率、不公平和与疫苗接种相关的因素。大多数参与者年龄在30岁以下，生活在农村，并经产。几乎所有人都接受了产前护理(ANC)，但只有43%的人接受了推荐的ANC服务，60%的人在家分娩。乙肝-胆汁淤积症总覆盖率为26%。城市地区的疫苗接种覆盖率较高，而且不公平地集中在受过更高教育和更富有的妇女的子女中。在非政府机构接受ANC、在机构分娩、在出生时熟练的提供者和剖腹产也与乙肝-BD的覆盖率呈正相关。在调整了社会人口学和卫生系统因素后，接受乙肝-BD治疗与每周媒体暴露、接受推荐的ANC和剖腹产呈正相关，与家庭分娩呈负相关。社会经济和卫生系统因素都影响了次优和不公平的疫苗接种覆盖率。改善获得高质量ANC和分娩服务的机会可能会增加乙肝-BD的覆盖率，尽管可能需要有针对性的方法来实现家庭分娩，以实现国家目标。网上版载有补充材料，可在10.1186/s12913-022-07902-w查阅。
Hepatitis B virus birth dose (HepB-BD) vaccination is recommended to reduce mother to infant transmission. We evaluated the HepB-BD status of women who gave birth between 2011 and 2016 (N = 3,583) using the 2015–2016 Myanmar Demographic and Health Survey. Frequency distributions of HepB-BD vaccination across maternal and health system factors, concentration indices, and logistic regression models were used to estimate coverage, inequity, and factors associated with vaccination. The majority of participants were younger than 30 years of age, lived in rural areas, and were multiparous. Almost all received antenatal care (ANC), but only 43% received recommended ANC services, and 60% gave birth at home. The overall HepB-BD coverage rate was 26%. Vaccination coverage was higher in urban areas and was inequitably concentrated among children of more educated and wealthier women. HepB-BD coverage was also positively associated with receipt of ANC at non-governmental facilities, and delivery at a facility, skilled provider at birth and Cesarean delivery. After adjusting for sociodemographic and health system factors, receipt of the HepB-BD was positively associated with weekly media exposure, receipt of recommended ANC, and Cesarean delivery, and inversely associated with home delivery. Both socioeconomic and health systems factors influenced suboptimal and inequitable vaccination coverage. Improved access to quality ANC and delivery services may increase HepB-BD coverage although targeted approaches to reach home births are likely required to achieve national goals. The online version contains supplementary material available at 10.1186/s12913-022-07902-w.
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