Barriers to timely administration of birth dose vaccines in The Gambia, West Africa.
Barriers to timely administration of birth dose vaccines in The Gambia, West Africa.
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DOI：
10.1016/j.vaccine.2016.05.017
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发表时间：
2016-06-17
期刊：
影响因子：
5.5
通讯作者：
Roca A
中科院分区：
文献类型：
--
作者：
Miyahara R;Jasseh M;Gomez P;Shimakawa Y;Greenwood B;Keita K;Ceesay S;D'Alessandro U;Roca A
尽管撒哈拉以南非洲婴儿的疫苗覆盖率很高，但估计是在6-12个月大的婴儿中。关于及时接种出生剂量疫苗的资料很少。本研究的目的是评估冈比亚出生剂量疫苗（乙型肝炎、卡介苗和口服脊髓灰质炎）的接种时间和延迟接种的原因。我们使用了2004年至2014年间来自法拉芬尼健康和人口监测系统（FHDSS）的疫苗接种数据。在出生（0-1天）、第7天、第28天、6个月和1岁时计算覆盖率。使用Logistic回归模型确定与2011年至2014年出生的儿童第7天接种疫苗相关的人口统计学和社会经济变量。10851名儿童中，大多数在6个月前接种了第一剂乙型肝炎病毒（HBV）疫苗（93.1%）。然而，只有1.1%的人在出生时接种疫苗，5.4%的人在第7天接种，58.4%的人在第28天接种。第7天接种疫苗与居住在城市地区（西部农村：调整后的OR (AOR) = 6.13, 95%CI: 3.20-11.75，东部农村：调整后的OR = 6.72, 95%CI: 3.66-12.33）和母亲受教育程度（高中教育：AOR = 2.43, 95%CI: 1.17-5.06）有关；与接种点距离（≧2 km: AOR = 0.41, 95%CI: 0.24-0.70）和富拉族（AOR = 0.60, 95%CI: 0.40-0.91）呈负相关。冈比亚的疫苗覆盖率很高，但婴儿通常在新生儿期后接种疫苗。迫切需要采取干预措施，确保实施国家疫苗接种政策。
Although vaccine coverage in infants in sub-Saharan Africa is high, this is estimated at the age of 6–12 months. There is little information on the timely administration of birth dose vaccines. The objective of this study was to assess the timing of birth dose vaccines (hepatitis B, BCG and oral polio) and reasons for delayed administration in The Gambia. We used vaccination data from the Farafenni Health and Demographic Surveillance System (FHDSS) between 2004 and 2014. Coverage was calculated at birth (0–1 day), day 7, day 28, 6 months and 1 year of age. Logistic regression models were used to identify demographic and socio-economic variables associated with vaccination by day 7 in children born between 2011 and 2014. Most of the 10,851 children had received the first dose of hepatitis B virus (HBV) vaccine by the age of 6 months (93.1%). Nevertheless, only 1.1% of them were vaccinated at birth, 5.4% by day 7, and 58.4% by day 28. Vaccination by day 7 was associated with living in urban areas (West rural: adjusted OR (AOR) = 6.13, 95%CI: 3.20–11.75, east rural: AOR = 6.72, 95%CI: 3.66–12.33) and maternal education (senior-educations: AOR = 2.43, 95%CI: 1.17–5.06); and inversely associated with distance to vaccination delivery points (≧2 km: AOR = 0.41, 95%CI: 0.24–0.70), and Fula ethnicity (AOR = 0.60, 95%CI: 0.40–0.91). Vaccine coverage in The Gambia is high but infants are usually vaccinated after the neonatal period. Interventions to ensure the implementation of national vaccination policies are urgently needed.