Factors associated with incomplete immunisation in children aged 12-23 months at subnational level, Nigeria: a cross-sectional study.
Factors associated with incomplete immunisation in children aged 12-23 months at subnational level, Nigeria: a cross-sectional study.
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DOI：
10.1136/bmjopen-2020-047445
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发表时间：
2021-06-25
期刊：
影响因子：
2.9
通讯作者：
Acharya Y
中科院分区：
文献类型：
--
作者：
Eze P;Agu UJ;Aniebo CL;Agu SA;Lawani LO;Acharya Y
国家免疫覆盖率掩盖了州和地方地区一级的次国家免疫覆盖差距。本研究的目的是确定与次国家一级儿童免疫接种不完全相关的社会人口因素。采用WHO抽样方法（2018参考手册）进行的横断面研究。在尼日利亚埃努古州的四个区（两个城市和两个农村）随机选择50个群组（病房）。2020年7月，1254名12-23个月大孩子的母亲。完全免疫儿童和未完全免疫儿童。埃努古州的完全免疫覆盖率为78.9%（95% CI 76.5%至81.1%）。然而，城市和农村地区的FIC比率存在明显差异。农村社区只有55.5%的儿童得到全面免疫接种，而城市社区为94.5%。与不完全免疫相关的重要因素有：单身母亲的子女（aOR=5.74，95% CI 1.45 - 22.76），在无熟练助产士在场的情况下分娩的儿童（aOR=1.93，95%CI 1.24至2.99），未接受产后护理的母亲的孩子（aOR=6.53，95%CI 4.17 - 10.22），母亲对常规免疫接种知识缺乏的儿童（aOR=1.76，95%CI 1.09 ~ 2.87），居住在农村地区（aOR=7.49，95%CI 4.84 - 11.59），低收入家庭（aOR=1.56，95% CI 1.17 - 2.81），居住距离最近的疫苗接种设施超过30分钟（aOR=2.15，95% CI 1.31 - 3.52）。虽然埃努古州完全免疫的儿童比例很低，但在农村地区则要低得多。研究结果表明，需要创新的解决方案，以改善地理可及性，并加强在当地地区一级报告疫苗接种覆盖率的重要性，以确定更有针对性的干预措施的地区。
National immunisation coverage rate masks subnational immunisation coverage gaps at the state and local district levels. The objective of the current study was to determine the sociodemographic factors associated with incomplete immunisation in children at a sub-national level. Cross-sectional study using the WHO sampling method (2018 Reference Manual). Fifty randomly selected clusters (wards) in four districts (two urban and two rural) in Enugu state, Nigeria. 1254 mothers of children aged 12–23 months in July 2020. Fully immunised children and not fully immunised children. Full immunisation coverage (FIC) rate in Enugu state was 78.9% (95% CI 76.5% to 81.1%). However, stark difference exists in FIC rate in urban versus rural districts. Only 55.5% of children in rural communities are fully immunised compared with 94.5% in urban communities. Significant factors associated with incomplete immunisation are: children of single mothers (aOR=5.74, 95% CI 1.45 to 22.76), children delivered without skilled birth attendant present (aOR=1.93, 95% CI 1.24 to 2.99), children of mothers who did not receive postnatal care (aOR=6.53, 95% CI 4.17 to 10.22), children of mothers with poor knowledge of routine immunisation (aOR=1.76, 95% CI 1.09 to 2.87), dwelling in rural district (aOR=7.49, 95% CI 4.84 to 11.59), low-income families (aOR=1.56, 95% CI 1.17 to 2.81) and living further than 30 min from the nearest vaccination facility (aOR=2.15, 95% CI 1.31 to 3.52). Although the proportion of fully immunised children in Enugu state is low, it is significantly lower in rural districts. Study findings suggest the need for innovative solutions to improve geographical accessibility and reinforce the importance of reporting vaccination coverage at local district level to identify districts for more targeted interventions.
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