Factors influencing basic vaccination coverage in Myanmar: secondary analysis of 2015 Myanmar demographic and health survey data
Factors influencing basic vaccination coverage in Myanmar: secondary analysis of 2015 Myanmar demographic and health survey data
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DOI：
10.1186/s12889-019-6548-0
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发表时间：
2019-02-28
影响因子：
4.5
通讯作者：
Kitamura, Tomomi
中科院分区：
文献类型：
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作者：
Nozaki, Ikuma;Hachiya, Masahiko;Kitamura, Tomomi
背景：当疫苗接种覆盖率足够时，免疫接种是预防疾病的最有效措施之一。虽然已知疫苗接种覆盖率受到社会和文化障碍的影响，但缅甸儿童免疫接种的决定因素仍然知之甚少。本研究使用2015年缅甸人口健康与调查数据分析了影响完全疫苗接种状况的因素（卡介苗和麻疹各一剂，白喉-百日咳和脊髓灰质炎各三剂）。方法：从具有全国代表性的调查结果中抽取12 ~ 23月龄儿童及其母亲的数据。采用调查加权logistic回归进行双变量和多变量分析，以检验疫苗接种状况与各种社会人口统计学和医学因素之间的关系。分析的自变量包括居住地、经济状况、母亲年龄、婚姻状况、教育程度、识字率、就业状况、产前护理、破伤风疫苗接种、分娩地点、产后评估、儿童性别、儿童数量、以前的儿童死亡、儿童健康决策者、保健就诊频率、父亲的教育程度和父亲的职业。结果：抽取有代表性的样本904例进行分析。总体完全疫苗接种率为55.4%。在反向逐步选择的多因素分析中，完全接种疫苗与中高经济地位（调整优势比[AOR]: 2.64, 95%可信区间[CI]: 1.85-3.78）、产妇年龄较大（AOR: 2.87, 95% CI: 1.62-5.10）、bb0 = 4产前保健检查（AOR: 1.87, 95% CI: 1.28-2.73）、产妇产前接种破伤风疫苗（AOR: 3.26, 95% CI: 1.82-5.85）独立相关。结论：缅甸第一次人口与健康调查显示，在12-23岁的儿童中，只有大约一半的人接受了完全的疫苗接种，这低于常规行政覆盖的估计接种率。我们的研究结果表明，不完全免疫状况与低经济状况、较年轻的母亲年龄、较少的产前保健就诊和未接种破伤风疫苗有关。这些发现可能有助于改进扩大免疫规划的目标和战略实施。
Background: Immunization is one of the most effective measures for preventing disease when vaccination coverage is sufficient. Although vaccination coverage is known to be influenced by social and cultural barriers, the determinants of childhood immunization in Myanmar remain poorly understood. This study analyzed factors that influenced complete vaccination status (one dose each for Bacillus Calmette-Guerin and measles and three doses each for diphtheria-pertussis and polio) using 2015 data from the Myanmar Demographic Health and Survey.Methods: Data from 12 to 23-month-old children and their mothers were extracted from the nationally representative survey results. Bivariate and multivariate analyses with survey-weighted logistic regression were performed to examine the relationships between vaccination status and various sociodemographic and medical factors. The independent variables for the analyses included area of residence, economic status, maternal age, marital status, education, literacy, employment status, antenatal care attendance, tetanus vaccination, place of delivery, postnatal evaluations, child's sex, number of children, previous child death, decision maker(s) regarding child's health, frequency of healthcare visits, paternal education, and paternal occupation.Results: A representative sample of 904 cases were extracted for the analysis. The overall complete vaccination rate was 55.4%. In the multivariate analysis with backward step-wise selection, complete vaccination was independently associated with middle or high economic status (adjusted odds ratio [AOR]: 2.64, 95% confidence interval [CI]: 1.85-3.78), older maternal age (AOR: 2.87, 95% CI: 1.62-5.10), >= 4 antenatal care visits (AOR: 1.87, 95% CI: 1.28-2.73), and maternal tetanus vaccination before delivery (AOR: 3.26, 95% CI: 1.82-5.85).Conclusion: The first Demographic and Health Survey in Myanmar revealed that only approximately one-half of 12-23-year-old children had received complete vaccination, which was lower than the estimated rate from routine administrative coverage. Our results indicate that incomplete immunization status was associated with low economic status, younger maternal age, fewer antenatal care visits, and no maternal tetanus vaccination. These findings may help improve the targeting and strategic implementation of the Expanded Programme on Immunization.