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Bekele G, Darega J, Mulu E, Tsegaw M. Determinants of immunization defaulters among children aged 12-23 months in Ambo town, Oromia, Ethiopia: A case-control study. Hum Vaccin Immunother 2024; 20:2338952. [PMID: 38606820 PMCID: PMC11018067 DOI: 10.1080/21645515.2024.2338952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/01/2024] [Indexed: 04/13/2024] Open
Abstract
Immunization is a public health intervention to reduce morbidity and mortality among children. However, vaccination becomes more effective if the child can receive the full course of recommended vaccination doses according to the schedule. Many children fail to complete the full course of vaccination. To identify the determinants of immunization defaulters among children aged 12-23 months in Ambo town, Oromia, Ethiopia. A community-based, unmatched, case-control study was done from October 1 to 25, 2021. A simple random sampling was used to select 317 (106 cases and 211 controls). Data were collected by using a pretested and structured questionnaire. Data were coded and entered to Epi-data version 3.1 and then transported to SPSS version 21.0 for statistical analysis. Descriptive analysis like frequency, mean, and percentage was calculated. Binary and multivariable logistic regression analysis was done. Finally, variables with a p value < .05 were considered statistically significant. Urban residences (AOR = 0.288, 95% CI, 0.146, 570), government employee (AOR = 0.179, 95% CI, 0.057, 0.565), number of family members more than four (AOR = 2.696, 95% CI, 1.143, 6.358), higher income (AOR = 0.250, 95% CI, 0.099, 0.628), attending ANC (AOR = 0..237, 95% CI, 0.107, 0.525), and good awareness (AOR = 0.070, 95% CI, 0.005, 308) were significant predictors of immunization defaulters. This study has found that urban residences, government employee by occupation, number of family members more than four, higher monthly income, and attending ANC were identified as determinants of childhood immunization defaulters. Social Behavior Change intervention programs should focus on providing health information about the importance of the vaccine and vaccine schedule. Due attention should be given for rural residents and farmers who had limited access to information and are more prone to defaulting. Policy-makers should consider those identified factors while designing intervention programs to enhance vaccination coverage.
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Affiliation(s)
| | - Jiregna Darega
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Erimiyas Mulu
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Menen Tsegaw
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
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Piamonte BLC, Easton A, Wood GK, Davies NWS, Granerod J, Michael BD, Solomon T, Thakur KT. Addressing vaccine-preventable encephalitis in vulnerable populations. Curr Opin Neurol 2023; 36:185-197. [PMID: 37078664 DOI: 10.1097/wco.0000000000001158] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
PURPOSE OF REVIEW Vaccinations have been pivotal in lowering the global disease burden of vaccine-preventable encephalitides, including Japanese encephalitis, tick-borne encephalitis, measles encephalitis, and rabies encephalitis, among others. RECENT FINDINGS Populations vulnerable to vaccine-preventable infections that may lead to encephalitis include those living in endemic and rural areas, military members, migrants, refugees, international travelers, younger and older persons, pregnant women, the immunocompromised, outdoor, healthcare and laboratory workers, and the homeless. There is scope for improving the availability and distribution of vaccinations, vaccine equity, surveillance of vaccine-preventable encephalitides, and public education and information. SUMMARY Addressing these gaps in vaccination strategies will allow for improved vaccination coverage and lead to better health outcomes for those most at risk for vaccine-preventable encephalitis.
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Affiliation(s)
- Bernadeth Lyn C Piamonte
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Ava Easton
- The Encephalitis Society, Malton
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
| | - Greta K Wood
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, Liverpool
| | - Nicholas W S Davies
- The Encephalitis Society, Malton
- Department of Neurology, Chelsea and Westminster Hospital, NHS Trust
| | - Julia Granerod
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
- Dr JGW Consulting Ltd., London
| | - Benedict D Michael
- The Encephalitis Society, Malton
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, Liverpool
- Department of Neurology, The Walton Centre NHS Foundation Trust
| | - Tom Solomon
- The Encephalitis Society, Malton
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, Liverpool
- Department of Neurology, The Walton Centre NHS Foundation Trust
- Department of Neurological Science, University of Liverpool, Liverpool, United Kingdom
| | - Kiran T Thakur
- The Encephalitis Society, Malton
- Department of Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, USA
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Kundu S, Kundu S, Seidu AA, Okyere J, Ghosh S, Hossain A, Alshahrani NZ, Banna MHA, Rahman MA, Ahinkorah BO. Factors influencing and changes in childhood vaccination coverage over time in Bangladesh: a multilevel mixed-effects analysis. BMC Public Health 2023; 23:862. [PMID: 37170088 PMCID: PMC10173930 DOI: 10.1186/s12889-023-15711-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 04/19/2023] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION This study aimed to investigate the associated factors and changes in childhood vaccination coverage over time in Bangladesh. METHODS Bangladesh's Demographic and Health Surveys from 2011, 2014, and 2017-18 provided data for this study on vaccination coverage among children aged 12 to 35 months. For three survey periods, multilevel binary logistic regression models were employed. RESULTS The overall prevalence (weighted) of full vaccination among children aged 12-35 months were 86.17% in 2011, 85.13% in 2014, and 89.23% in 2017-18. Children from families with high wealth index, mothers with higher education, and over the age of 24 and who sought at least four ANC visits, as well as children from urban areas were more likely to receive full vaccination. Rangpur division had the highest change rate of vaccination coverage from 2011 to 2014 (2.26%), whereas Sylhet division had the highest change rate from 2014 to 2017-18 (34.34%). CONCLUSION To improve immunization coverage for Bangladeshi children, policymakers must integrate vaccine programs, paying special attention to mothers without at least a high school education and families with low wealth index. Increased antenatal care visits may also aid in increasing the immunization coverage of their children.
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Affiliation(s)
- Satyajit Kundu
- Global Health Institute, North South University, Dhaka, 1229, Bangladesh.
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh.
| | - Subarna Kundu
- Statistics Discipline, Khulna University, Khulna, 9208, Bangladesh
| | - Abdul-Aziz Seidu
- Faculty of Built and Natural Environment, Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Susmita Ghosh
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali, Bangladesh
- Department of Nutrition Science, Purdue University, West Lafayette, IN, 47907, USA
| | - Ahmed Hossain
- College of Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Najim Z Alshahrani
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah, 21589, Saudi Arabia
| | - Md Hasan Al Banna
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh
- Nutrition Initiative (NI), Kushtia, Bangladesh
| | - Md Ashfikur Rahman
- Development Studies Discipline, Khulna University, Khulna, 9208, Bangladesh
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Guye AH, Nigussie T, Tesema M, Shambi DB, Diriba BS, Tefera EM, Girma Y. Exploring barriers of childhood full vaccination among children living in Siraro District, West Arsi Zone, Oromia region, Ethiopia: A qualitative study. Front Pediatr 2023; 11:1083358. [PMID: 36937956 PMCID: PMC10020180 DOI: 10.3389/fped.2023.1083358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/06/2023] [Indexed: 03/06/2023] Open
Abstract
Background Childhood immunization is one of the most effective global public health interventions to reduce childhood morbidity and mortality. However, some children remain not fully vaccinated in developing countries due to defaulting from full vaccination, which can put them at risk of acquiring vaccine-preventable disease outbreaks. The barriers to full vaccination were well explored in Ethiopia using a qualitative approach. The study aimed to explore barriers to full childhood vaccination in Siraro District, West Arsi Zone, Oromia, Ethiopia. Methods A qualitative study was conducted in Siraro District through 15 key informant health workers interviews and 6 in-depth interviews with children's mothers from April 20 to May 15, 2022. Data were collected by semi-structured questionnaires and captured using audio tape recorders and field note-taking. A heterogeneous purposive sampling technique was used to select representative study participants. Data transcription and translation were done according to the respondents' verbatim from the local language to English. Data coding and key categories were identified and analyzed using thematic analysis. Finally, data were presented in narrative forms using respondents' own words as an illustration. Result Twenty-one study participants were interviewed and included in this study. Of the explored barriers to full childhood vaccination, the evidence from the respondents was integrated from subcategories and presented as a whole within each thematic area. Five thematic areas emerged from interviews of the participants through thematic analysis of the data. The identified barriers were forgetting the next vaccination schedule, migration of parents, work overload, lack of knowledge and awareness, rumors, and misinformation. Additionally, vaccination service delivery-related barriers such as vaccine vials not being opened for a few children, fear of vaccine side effects, closed health posts during visits by mothers for vaccination, and absence of health extension workers at health posts were the key barriers to full childhood vaccination. Conclusion Forgetting vaccination schedule, migration of parents, work overload, rumors, and misinformation, fear of vaccine side effects, vaccine vial not opened for few children, closed health posts during visiting by mothers, absence of health extension workers from health posts were the key barriers to the full vaccination status of children. Thus, the district health office should work on barriers to full vaccination by strengthening vaccination service delivery and improving vaccination awareness through a health extension program.
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Affiliation(s)
- Ararso Hordofa Guye
- Department of Public Health, College of Health Sciences, Salale University, Fiche, Ethiopia
| | - Tadesse Nigussie
- Department of Public Health, College of Health Sciences, Salale University, Fiche, Ethiopia
| | - Mengistu Tesema
- Department of Pediatrics and Child Health, College of Health Sciences, Salale University, Fiche, Ethiopia
| | - Dame Banti Shambi
- Department of Public Health, College of Health Sciences, Salale University, Fiche, Ethiopia
| | - Berhanu Senbeta Diriba
- Department of Public Health, College of Health Sciences, Salale University, Fiche, Ethiopia
| | - Esayas Mekonen Tefera
- Department of Public Health, College of Health Sciences, Salale University, Fiche, Ethiopia
| | - Yeabsira Girma
- Department of Maternal and Child Health, Center for Family Service Organization, Addis Ababa, Ethiopia
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Nchinjoh SC, Saidu Y, Agbor VN, Mbanga CM, Jude Muteh N, Njoh AA, Ndoula ST, Nsah B, Edwige NN, Roberman S, Zamir CS. Factors Associated with Zero-Dose Childhood Vaccination Status in a Remote Fishing Community in Cameroon: A Cross-Sectional Analytical Study. Vaccines (Basel) 2022; 10:vaccines10122052. [PMID: 36560465 PMCID: PMC9784537 DOI: 10.3390/vaccines10122052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Cameroon's suboptimal access to childhood vaccinations poses a significant challenge to achieving the Immunization Agenda 2030 goal-ranking among the top 15 countries with a high proportion of zero-dose (unvaccinated) children worldwide. There are clusters of zero-dose children in pockets of communities that traditionally miss essential healthcare services, including vaccination. The Manoka Health District (MHD) is home to such settlements with consistently low vaccination coverages (DPT-HepB-Hib-1: 19.8% in 2021) and frequent outbreaks of vaccine-preventable diseases (VPD). Therefore, the absence of literature on zero-dose children in this context was a clarion call to characterize zero-dose children in fragile settings to inform policy and intervention design. Methodology: This cross-sectional analytical study involved 278 children, 0-24 months of age, selected from a 2020 door-to-door survey conducted in the two most populous health areas in an archipelago rural district, MHD (Cap-Cameroon and Toube). We used R Statistical Software (v4.1.2; R Core Team 2021) to run a multivariable logistic regression to determine zero-dose associated factors. Results: The survey revealed a zero-dose proportion of 91.7% (255) in MHD. Children who were delivered in health facilities were less likely to be zero-dose than those born at home (AOR: 0.07, 95% CI: 0.02-0.30, p = 0.0003). Compared to children born of Christian mothers, children born to minority non-Christian mothers had higher odds of being zero-dose (AOR: 6.55, 95% CI: 1.04-41.25, p = 0.0453). Children born to fathers who are immigrants were more likely to be zero-dose children than Cameroonians (AOR: 2.60, 95% CI = 0.65-10.35, p = 0.0016). Younger children were likely to be unvaccinated compared to older peers (AOR: 0.90, 95% CI: 0.82-1.00, p = 0.0401). Conclusions: In the spirit of "leaving no child behind," the study highlights the need to develop context-specific approaches that consider minority religious groups, immigrants, and younger children, including newborns, often missed during vaccination campaigns and outreaches.
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Affiliation(s)
- Sangwe Clovis Nchinjoh
- Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon
- Faculty of Medicine, The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem 91120, Israel
- Correspondence: ; Tel.: +237-678-687-939
| | - Yauba Saidu
- Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon
- Institute for Global Health, University of Siena, 53100 Siena, Italy
| | - Valirie Ndip Agbor
- Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon
- Nuffield Department of Population Health, University of Oxford, Oxford OX1 2JD, UK
| | | | | | - Andreas Ateke Njoh
- Expanded Program on Immunization, Cameroon Ministry of Public Health, Yaoundé P.O. Box 2084, Cameroon
- School of Global Health and Bioethics, Euclid University, Bangui BP 157, Central African Republic
| | - Shalom Tchofke Ndoula
- Expanded Program on Immunization, Cameroon Ministry of Public Health, Yaoundé P.O. Box 2084, Cameroon
| | - Bernard Nsah
- Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon
| | | | - Sveta Roberman
- Faculty of Medicine, The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem 91120, Israel
- The Gordon Academic College of Education, Haifa 3570503, Israel
| | - Chen Stein Zamir
- Faculty of Medicine, The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem 91120, Israel
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Chikako TU, Seidu AA, Hagan JE, Aboagye RG, Ahinkorah BO. Bayesian Analysis of Predictors of Incomplete Vaccination against Polio among Children Aged 12-23 Months in Ethiopia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211820. [PMID: 34831576 PMCID: PMC8624229 DOI: 10.3390/ijerph182211820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022]
Abstract
Background: The re-introduction of polio among children aged 12–23 months is likely to occur in Ethiopia due to the low vaccination rates against poliovirus. The study sought to examine the predictors of incomplete vaccination against polio among children aged 12–23 months in Ethiopia. Methods: The data used were obtained from the 2016 Ethiopia Demographic and Health Survey. Binary and Bayesian logistic regressions were used for the data analysis, with parameters estimated using classical maximum likelihood and the Bayesian estimation method. Results: The results revealed that 43.7% of the children were not fully vaccinated against polio in Ethiopia. Maternal age, educational level, household wealth index, exposure to mass media, place of residence, presence of nearby healthy facility, counseling on vaccination, and place of delivery were significant determinants of incomplete polio vaccination among children aged between 12 and 23 months in Ethiopia. Conclusion: Considerable numbers of children are not fully vaccinated against polio in Ethiopia. Individual and contextual factors significantly contributed to incomplete polio vaccination among children in the country. Therefore, the government and other stakeholders should pay particular attention to maternal education to increase mothers’ educational level in all regions and give training and counseling in all urban and rural parts of the country on child vaccination to overcome the problem of children’s incomplete polio vaccination and/or vaccination dropout.
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Affiliation(s)
- Teshita Uke Chikako
- Wondo Genet College of Forestry and Natural Resource, Hawassa University, Hawassa P.O. Box 05, Ethiopia;
| | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia;
- Department of Estate Management, Takoradi Technical University, Takoradi P.O. Box 256, Ghana
- Centre For Gender and Advocacy, Takoradi Technical University, Takoradi P.O. Box 256, Ghana
| | - John Elvis Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast TF0494, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Postfach 100131, 33501 Bielefeld, Germany
- Correspondence:
| | - Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho PMB 31, Ghana;
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW 2007, Australia;
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