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Ichimura Y, Yanagisawa N, Thandar MM, Pathammavong C, Phounphenghuk K, Nouanthong P, Tengbriacheu C, Khamphaphongphane B, Franzel-Sassanpour LE, Yang TU, Raaijmakers H, Ota T, Komada K, Hachiya M, Miyano S. The determinants of immunization coverage among children aged between 12 and 35 months: a nationwide cross-sectional study in Lao People's Democratic Republic. BMC Public Health 2022; 22:2259. [PMID: 36463130 PMCID: PMC9719255 DOI: 10.1186/s12889-022-14522-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/02/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Immunization is one of the most important public health interventions for reducing morbidity and mortality in children. However, factors contributing to low immunization coverage are not fully understood in the Lao People's Democratic Republic (Lao PDR). Therefore, this study aimed to identify factors associated with full immunization coverage among children between 12 and 35 months, providing up-to-date information for immunization programs in Lao PDR. METHODS We analyzed the subpopulation of a nationwide cross-sectional survey using a multistage cluster sampling procedure to evaluate the measles and rubella seroepidemiology. In addition, we categorized children aged between 12 and 35 months into two groups: "fully immunized" children with a birth dose of Bacillus Calmette and Guérin vaccine, hepatitis B vaccine (Hep B), one and three doses for the measles-containing vaccine (MCV) and pentavalent vaccine and pneumococcal conjugate vaccine (PCV) and "partially immunized" children who missed any dose of vaccine. Immunization coverage was calculated as the ratio of "fully immunized" to the total. We compared the groups' demographic characteristics and health service utilization as independent variables. Multivariate logistic regression was used to assess the relationship between immunization coverage, various demographic factors, and health service utilization. RESULTS Overall, 256 of the 416 targeted pairs were included in the analysis. In total, 67.6% of the children were fully immunized. Childbirth at hospitals or health facilities (adjusted odds ratio: 9.75, 95% confidence interval: 5.72-16.62, p < 0.001) was the predictor of full immunization coverage. The 83 children in the partially immunized groups were attributed to Hep B at birth (46, 55.4%), three doses of PCV (34, 41.0%), and the first dose of the MCV (27, 32.5%). CONCLUSION Our study elucidated that the immunization status among children aged between 12 and 35 months in Lao PDR is satisfactory in improving access to healthcare by strengthening communication with residents regarding health service utilization, and expanding mobile outreach services may play a pivotal role in this endeavor. Further research is warranted to evaluate efforts to increase immunization coverage and target populations with limited access to healthcare.
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Affiliation(s)
- Yasunori Ichimura
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655, Japan.
| | - Naoki Yanagisawa
- grid.45203.300000 0004 0489 0290Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655 Japan
| | - Moe Moe Thandar
- grid.45203.300000 0004 0489 0290Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655 Japan
| | - Chansay Pathammavong
- grid.415768.90000 0004 8340 2282National Immunization Program, Ministry of Health, Simuang Road, Vientiane, Lao People’s Democratic Republic
| | - Kongxay Phounphenghuk
- grid.415768.90000 0004 8340 2282National Immunization Program, Ministry of Health, Simuang Road, Vientiane, Lao People’s Democratic Republic
| | - Phonethipsavanh Nouanthong
- grid.415768.90000 0004 8340 2282Institute Pasteur du Laos, National Immunization Technical Advisory Group, Ministry of Health, Samsenthai Road, Ban Kao-Gnot, Sisattanak district, Vientiane, Lao People’s Democratic Republic
| | - Chankham Tengbriacheu
- grid.415768.90000 0004 8340 2282Mother and Child Health Center, Ministry of Health, Simuang Road, Vientiane, Lao People’s Democratic Republic
| | - Bouaphane Khamphaphongphane
- National Center Laboratory and Epidemiology, KM3 Thadeua road, Sisattanak District, Vientiane, Lao People’s Democratic Republic
| | - Lauren Elizabeth Franzel-Sassanpour
- Vaccine-Preventable Diseases and Immunization section, World Health Organization Representative Office in the Lao People’s Democratic Republic, 125 Saphanthong Road, Unit 5, Ban Saphangthongtai, Sisattanak District, Vientiane, Lao People’s Democratic Republic
| | - Tae Un Yang
- Vaccine-Preventable Diseases and Immunization section, World Health Organization Representative Office in the Lao People’s Democratic Republic, 125 Saphanthong Road, Unit 5, Ban Saphangthongtai, Sisattanak District, Vientiane, Lao People’s Democratic Republic
| | - Hendrikus Raaijmakers
- Health and Nutrition section, United Nations Children’s Fund Lao People’s Democratic Republic, KM3 Thadeua road, Sisattanak District, Vientiane, Lao People’s Democratic Republic
| | - Tomomi Ota
- grid.45203.300000 0004 0489 0290Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655 Japan
| | - Kenichi Komada
- grid.45203.300000 0004 0489 0290Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655 Japan
| | - Masahiko Hachiya
- grid.45203.300000 0004 0489 0290Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655 Japan
| | - Shinsuke Miyano
- grid.45203.300000 0004 0489 0290Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655 Japan
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Wariri O, Okomo U, Kwarshak YK, Utazi CE, Murray K, Grundy C, Kampmann B. Timeliness of routine childhood vaccination in 103 low-and middle-income countries, 1978-2021: A scoping review to map measurement and methodological gaps. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000325. [PMID: 36962319 PMCID: PMC10021799 DOI: 10.1371/journal.pgph.0000325] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/14/2022] [Indexed: 11/19/2022]
Abstract
Empiric studies exploring the timeliness of routine vaccination in low-and middle-income countries (LMICs) have gained momentum in the last decade. Nevertheless, there is emerging evidence suggesting that these studies have key measurement and methodological gaps that limit their comparability and utility. Hence, there is a need to identify, and document these gaps which could inform the design, conduct, and reporting of future research on the timeliness of vaccination. We synthesised the literature to determine the methodological and measurement gaps in the assessment of vaccination timeliness in LMICs. We searched five electronic databases for peer-reviewed articles in English and French that evaluated vaccination timeliness in LMICs, and were published between 01 January 1978, and 01 July 2021. Two reviewers independently screened titles and abstracts and reviewed full texts of relevant articles, following the guidance framework for scoping reviews by the Joanna Briggs Institute. From the 4263 titles identified, we included 224 articles from 103 countries. China (40), India (27), and Kenya (23) had the highest number of publications respectively. Of the three domains of timeliness, the most studied domain was 'delayed vaccination' [99.5% (223/224)], followed by 'early vaccination' [21.9% (49/224)], and 'untimely interval vaccination' [9% (20/224)]. Definitions for early (seven different definitions), untimely interval (four different definitions), and delayed vaccination (19 different definitions) varied across the studies. Most studies [72.3% (166/224)] operationalised vaccination timeliness as a categorical variable, compared to only 9.8% (22/224) of studies that operationalised timeliness as continuous variables. A large proportion of studies [47.8% (107/224)] excluded the data of children with no written vaccination records irrespective of caregivers' recall of their vaccination status. Our findings show that studies on vaccination timeliness in LMICs has measurement and methodological gaps. We recommend the development and implement of guidelines for measuring and reporting vaccination timeliness to bridge these gaps.
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Affiliation(s)
- Oghenebrume Wariri
- Vaccines and Immunity Theme, MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Vaccine Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Uduak Okomo
- Vaccines and Immunity Theme, MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | | | - Chigozie Edson Utazi
- WorldPop, School of geography and Environmental Science, University of Southampton, Southampton, United Kingdom
- Southampton Statistical Sciences Research Institute, University of Southampton, Southampton, United Kingdom
| | - Kris Murray
- MRC Unit The Gambia at The London School of Hygiene and Tropical Medicine, Fajara, The Gambia
- MRC Centre for Global Infectious Disease Analysis, Imperial College School of Public Health, Imperial College London, London, United Kingdom
| | - Chris Grundy
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Beate Kampmann
- Vaccines and Immunity Theme, MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
- Vaccine Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Gore H, Bansod V, Nannaware M, Kulkarni S, Agawane S, Chawla P, Kalra K. A hospital-based cross-sectional study for assessment of immunization status of children in western Maharashtra, India. MGM JOURNAL OF MEDICAL SCIENCES 2021. [DOI: 10.4103/mgmj.mgmj_71_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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