Inequities in childhood immunisation coverage associated with socioeconomic, geographic, maternal, child, and place of birth characteristics in Kenya.
Inequities in childhood immunisation coverage associated with socioeconomic, geographic, maternal, child, and place of birth characteristics in Kenya.
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DOI：
10.1186/s12879-021-06271-9
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发表时间：
2021-06-11
影响因子：
3.7
通讯作者：
Abbas K
中科院分区：
文献类型：
--
作者：
Allan S;Adetifa IMO;Abbas K
2030 年全球免疫议程强调覆盖率和公平性作为战略优先目标，以在国家层面和所有地区实现高度公平的免疫覆盖率。我们估计了肯尼亚 12-23 个月儿童中与社会经济、地理、孕产妇、儿童和出生地特征相关的全面免疫覆盖率的不平等。我们分析了 2014 年肯尼亚 3943 名 12-23 月龄儿童的完整免疫覆盖率（1 剂卡介苗、3 剂 DTP-HepB-Hib（白喉、破伤风、百日咳、乙型肝炎和 B 型流感嗜血杆菌）、3 剂脊髓灰质炎疫苗、1 剂麻疹疫苗和 3 剂肺炎球菌疫苗）人口统计和健康调查。我们按社会经济（家庭财富、宗教、种族）、地理（居住地、省份）、孕产妇（孕产妇出生年龄、孕产妇教育、孕产妇婚姻状况、孕产妇户主身份）、儿童（儿童性别、出生顺序）和出生地特征对平均覆盖率进行分类，并使用双变量和多元逻辑回归估计了全面免疫覆盖率的不平等。免疫覆盖率从第三剂脊髓灰质炎的 82% [81–84] 到第一剂 DTP-HepB-Hib 的 97.4% [96.7–98.2]，而 2014 年的完全免疫覆盖率为 68% [66–71]。通过多元逻辑回归控制其他背景特征后，母亲受过小学或以上教育的孩子的几率至少高出 54% 与未受过教育的母亲的孩子相比，他们获得了充分的免疫。与在家中出生的儿童相比，在临床环境中出生的儿童获得完全免疫的几率高 41%。与东北地区的儿童相比，沿海、西部、中部和东部地区的儿童完全免疫的几率至少高出 74%，而城市地区的儿童完全免疫的几率比农村地区的儿童低 26%。与最贫困财富五分之一家庭的儿童相比，中等和富裕财富五分之一家庭的儿童获得全面免疫覆盖的可能性高出 43-57%。与第一个出生的孩子相比，第六个或以上出生的孩子完全免疫的几率低 37%。母亲没有受过教育、在家庭环境中出生、在卫生基础设施有限的地区出生、生活在贫困家庭中以及出生顺序较高的孩子的完全免疫率较低。覆盖这些亚人群中免疫不足儿童的有针对性的计划将减少肯尼亚儿童免疫覆盖率的不平等。在线版本包含可在 10.1186/s12879-021-06271-9 获取的补充材料。
The global Immunisation Agenda 2030 highlights coverage and equity as a strategic priority goal to reach high equitable immunisation coverage at national levels and in all districts. We estimated inequities in full immunisation coverage associated with socioeconomic, geographic, maternal, child, and place of birth characteristics among children aged 12–23 months in Kenya. We analysed full immunisation coverage (1-dose BCG, 3-dose DTP-HepB-Hib (diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type B), 3-dose polio, 1-dose measles, and 3-dose pneumococcal vaccines) of 3943 children aged 12–23 months from the 2014 Kenya Demographic and Health Survey. We disaggregated mean coverage by socioeconomic (household wealth, religion, ethnicity), geographic (place of residence, province), maternal (maternal age at birth, maternal education, maternal marital status, maternal household head status), child (sex of child, birth order), and place of birth characteristics, and estimated inequities in full immunisation coverage using bivariate and multivariate logistic regression. Immunisation coverage ranged from 82% [81–84] for the third dose of polio to 97.4% [96.7–98.2] for the first dose of DTP-HepB-Hib, while full immunisation coverage was 68% [66–71] in 2014. After controlling for other background characteristics through multivariate logistic regression, children of mothers with primary school education or higher have at least 54% higher odds of being fully immunised compared to children of mothers with no education. Children born in clinical settings had 41% higher odds of being fully immunised compared to children born in home settings. Children in the Coast, Western, Central, and Eastern regions had at least 74% higher odds of being fully immunised compared to children in the North Eastern region, while children in urban areas had 26% lower odds of full immunisation compared to children in rural areas. Children in the middle and richer wealth quintile households were 43–57% more likely to have full immunisation coverage compared to children in the poorest wealth quintile households. Children who were sixth born or higher had 37% lower odds of full immunisation compared to first-born children. Children of mothers with no education, born in home settings, in regions with limited health infrastructure, living in poorer households, and of higher birth order are associated with lower rates of full immunisation. Targeted programmes to reach under-immunised children in these subpopulations will lower the inequities in childhood immunisation coverage in Kenya. The online version contains supplementary material available at 10.1186/s12879-021-06271-9.
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影响因子：
3.3
作者：
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通讯作者：
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影响因子：
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作者：
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