Immunization dropout rate and data quality among children 12-23 months of age in Ghana
Immunization dropout rate and data quality among children 12-23 months of age in Ghana
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DOI：
10.1186/s13690-017-0186-8
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发表时间：
2017-04-17
影响因子：
3.3
通讯作者：
Adokiya, Martin Nyaaba
中科院分区：
文献类型：
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作者：
Baguune, Benjamin;Ndago, Joyce Aputere;Adokiya, Martin Nyaaba
背景资料：疾病免疫接种是最重要的公共卫生干预措施之一，是预防儿童发病、死亡和残疾的成本效益高的手段。然而，一部分儿童，特别是非洲儿童，没有得到推荐疫苗的充分免疫。因此，许多儿童仍然容易感染扩大免疫方案所针对的疾病。本研究的目的是确定12-23个月的儿童在Techiman市，Ghana.Methods的免疫辍学率和数据质量：一个横断面的聚类调查进行了600名儿童。研究资料采半结构式问卷调查，以面对面访谈方式收集。在主要数据收集之前，在该市的三个不同社区对这些工具进行了预先测试。对母亲/照顾者进行了访谈，从儿童免疫卡中提取信息，并进行观察，以确认每个儿童身上是否存在卡介苗（BCG）疤痕。结果：全市15种疫苗的免疫接种率均在90.0%以上，儿童全程免疫率为89.5%。免疫接种辍学率为5.6%（使用卡介苗和麻疹作为替代疫苗）。这低于世界卫生组织10.0%的临界点。然而，常规行政数据的特点是存在一些差异（例如，每种疫苗的免疫覆盖率均> 100.0%）和高辍学率（卡介苗-麻疹= 31.5%）。进行二元回归以确定辍学率的预测因素。以下是具有统计学意义的：已婚（OR = 0.31; 95% = CI 0.15-0.62; p = 0.001），基督教（OR = 0.27; 95%CI = 0.13-0.91; p < 0.001），女性儿童（OR = 0.50; 95%CI = 0.26-0.91; P = 0.024）和持有免疫卡（OR = 50.3，95%CI = 14.40-175.92; P < 0.001）与免疫脱落有关。儿童全程免疫率（89.5%）和免疫覆盖率（> 90%）较高，但辍学率低于世卫组织建议的临界点。然而，免疫接种数据的质量仍然不够。因此，迫切需要对服务提供者进行健康教育和定向。此外，免疫登记和数据质量也是需要关注的问题。
Background: Immunization against diseases is one of the most important public health interventions with cost effective means to preventing childhood morbidity, mortality and disability. However, a proportion of children particularly in Africa are not fully immunized with the recommended vaccines. Thus, many children are still susceptible to the Expanded Program on Immunization (EPI) targeted diseases. The objective of this study was to determine the immunization dropout rate and data quality among children aged 12-23 months in Techiman Municipality, Ghana.Methods: A cross-sectional cluster survey was conducted among 600 children. Data was collected using semi-structured questionnaire through face-to-face interviews. Before the main data collection, the tools were pre-tested in three different communities in the Municipality. The mothers/caregivers were interviewed, extracted information from the child immunization cards and observation employed to confirm the presence of Bacillus Calmette-Guerin (BCG) scar on each child. Routine immunization data was also extracted from immunization registers and annual reports in the Municipality.Results: Immunization coverage for each of the fifteen vaccines doses is above 90.0% while full childhood immunized status is 89.5%. Immunization dropout rate was 5.6% (using BCG and Measles as proxy vaccines). This is lower than the 10.0% cutoff point by World Health Organization. However, routine administrative data was characterized by some discrepancies (e.g. > 100.0% immunization coverage for each of the vaccines) and high dropout rate (BCG-Measles = 31.5%). Binary regression was performed to determine predictors of dropout rate. The following were statistically significant: married (OR = 0.31; 95% = CI 0.15-0.62; and p = 0.001), Christianity (OR = 0.27; 95% CI = 0.13-0.91; and p < 0.001), female child (OR = 0.50; 95% CI = 0.26-0.91; and p = 0.024) and possession of immunization card (OR = 50.3; 95% CI = 14.40-175.92; and p < 0.001) were found to be associated with immunization dropout.Conclusion: Childhood full immunized status (89.5%) and immunization coverages (> 90%) are high while dropout rate is lower than the recommended cutoff point by WHO. However, immunization data quality remains inadequate. Thus, health education and orientation of service providers is urgently needed. In addition, immunization registers and data quality are issues that require attention.