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Factors associated with incomplete childhood immunization in Arbegona district, southern Ethiopia: a case--control study.

ABSTRACT: BACKGROUND:The prevention of child mortality through immunization is one of the most cost-effective and widely applied public health interventions. In Ethiopia, the Expanded Program on Immunization (EPI) schedule is rarely completed as planned and the full immunization rate is only 24%. The objective of this study was to identify determinant factors of incomplete childhood immunization in Arbegona district, Sidama zone, southern Ethiopia. METHODS:A community based unmatched case-control study was undertaken among randomly selected children aged 12 to 23 months and with a total sample size of 548 (183 cases and 365 controls). A multi-stage sampling technique was used to get representative cases and controls. Data was collected using a structured questionnaire and analyzed using SPSS version 16 statistical software. Bivariate and multiple logistic regression analyses were done to identify independent factors for incomplete immunization status of children. Qualitative data were also generated and analyzed using thematic framework. RESULTS:The incomplete immunization status of children was significantly associated with young mothers (AOR = 9.54; 95% CI = 5.03, 18.09), being born second to fourth (AOR = 3.64; 95% CI = 1.63, 8.14) and being born fifth or later in the family (AOR = 5.27; 95% CI = 2.20, 12.64) as compared to being born first, a mother's lack of knowledge about immunization benefits (AOR = 5.51; 95% CI = 1.52, 19.94) and a mother's negative perception of vaccine side effects (AOR = 1.92; 95% CI = 1.01, 3.70). The qualitative finding revealed that the migration of mothers and unavailability of vaccines on appointed immunization dates were the major reasons for partial immunization of children. CONCLUSION:To reduce the number of children with incomplete immunization status, the Arbegona district needs to consider specific planning for mothers with these risk profiles. A focus on strengthening health communication activities to raise immunization awareness and address concerns of vaccine side effects at community level is also needed. This could be achieved through integrating the immunization service to other elements of primary health care.

SUBMITTER: Negussie A

PROVIDER: S-EPMC4711011 | biostudies-literature | 2016 Jan

REPOSITORIES: biostudies-literature

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Factors associated with incomplete childhood immunization in Arbegona district, southern Ethiopia: a case--control study.

Negussie Abel A Kassahun Wondewosen W Assegid Sahilu S Hagan Ada K AK

BMC public health 20160112

<h4>Background</h4>The prevention of child mortality through immunization is one of the most cost-effective and widely applied public health interventions. In Ethiopia, the Expanded Program on Immunization (EPI) schedule is rarely completed as planned and the full immunization rate is only 24%. The objective of this study was to identify determinant factors of incomplete childhood immunization in Arbegona district, Sidama zone, southern Ethiopia.<h4>Methods</h4>A community based unmatched case-c ...[more]

PMID: 26757893

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Project description:BackgroundBirth preparedness and complication readiness is a holistic approach that empowers mothers and families with the knowledge, attitude, and resources to alleviate potential challenges during childbirth. Despite its benefits, husbands' participation in maternal care differs significantly between countries and regions. There is a lack of previous studies that look at husbands' responses to birth preparedness and complication readiness in the research area. Thus, the primary goal of this study is to find out how husbands who have wives with infants under 12 months old feel about birth preparation, readiness for problems, and its associated factors.MethodsA community-based cross-sectional study design was conducted from May 30 to July 29, 2022. Simple random sampling was employed to select 499 husbands. An interviewer-administered, structured, and pretested questionnaire was used to collect the data. Data entry and analysis were performed using Epi Data version 4.6 and SPSS version 25, respectively. We used multivariable logistic regression to find statistically significant factors. P-values less than 0.05, 95% confidence intervals, and adjusted odds ratios are used to declare statistical significance. The findings were shown in figures, tables, and text.ResultsThe study found that 55.9% (95% CI: 51.4 to 61.4%) of husbands responded to birth preparedness and complication readiness. This response was significantly associated with being employed (AOR = 3.7, 95% CI: 2.27-5.95), engaging in self-business (AOR = 5.3, 95% CI: 2.34-12.01), having wives who delivered in health facilities (AOR = 7.1, 95% CI: 3.92-12.86), accompanying wives for antenatal care (AOR = 2.2, 95% CI: 1.39-3.56), possessing good knowledge of danger signs during labor (AOR = 2.0, 95% CI: 1.08-3.74) and the postnatal period (AOR = 7.1, 95% CI: 3.14-16.01). Interestingly, residents living near a health facility (AOR = 0.6, 95% CI: 0.39-0.97) were less likely to respond.ConclusionThe present study found that nearly 6 out of 10 husbands actively responded in terms of birth preparedness and complication readiness. While husbands in this study showed some involvement in birth preparedness and complications, it is good when compared to studies carried out nationally. To improve this, educating husbands by focusing on the danger signs and their role in childbirth is recommended.

Project description:BackgroundGlobally in 2015 about 214 million malaria cases and 438,000 deaths were reported with 75% were from Sub-Saharan Africa. Malaria transmission in Ethiopia is unstable, and outbreaks are considered public health emergencies. Understanding the trigger for outbreaks in low-transmission areas can help facilitate malaria elimination. On July 8th malaria outbreak was reported from Laelay Adyabo district. The objective was to investigate the magnitude and associated factors with malaria outbreak.MethodsWe defined a case as confirmed malaria using microscopy or a rapid diagnostic test for Plasmodium parasites in a resident of Laelay-Adyabo District from July 9-28, 2017. We identified cases by reviewing health facility records and conducted a case-control study using randomly-selected cases from a line list, and two neighborhood controls per case. A pretested semi-structured questionnaire adapted from WHO malaria guidelines was used to collect data from case-patients and controls. We calculated crude (COR) and adjusted (AOR) odds ratios to identify factors associated with malaria.ResultA total of 145 confirmed malaria cases (57.9% males) were identified with village attack rate (AR) of 12.1/1000. The AR was higher among males than females (14.1 verses 10.1/1000), children aged 5-14 years (12.9/1000), and in Zelazle Kebelle (13.6/1000 population). Wearing protective clothing (AOR = 0.27, 95% CI 0.11-0.66), having good knowledge of malaria transmission (AOR = 0.25, 95% CI 0.08-0.75), having waste collection material at home (AOR = 0.25 95% CI 0.11-0.61), availability of mosquito breeding sites around home (AOR = 9.08, 95% CI 3.6-22.93), and staying outdoor overnight (AOR = 3.7, 95% CI 1.44-9.56) were independently associated with malaria.ConclusionThe overall attack rate for malaria during this outbreak was high affecting > 1% of the population. Wearing protective clothing at night, knowing about malaria transmission, having mosquito breeding sites around the home, staying outdoors overnight, and having waste collection material in their house were predictors of the infection. Laelay Adyabo district health office should provide health education on malaria transmission and prevention measures and how to clear mosquito breeding sites.

Project description:IntroductionImmunization is a cost-effective intervention that prevented more than 5 million deaths worldwide from 2010 to 2015. Despite increased vaccination coverage over the past four decades in many African countries, including Ethiopia, universal coverage has not yet been reached. Only 39% of children aged 12-23 months received full vaccinations in Ethiopia, according to the 2016 Ethiopian Demographic Health Survey. This study aimed to evaluate immunization coverage and identify individual and community factors that explain incomplete vaccination coverage among children aged 6-36 months in the Wonago district of southern Ethiopia.MethodsWe conducted a community-based, cross-sectional study in three randomly selected kebeles in the Wonago district from June to July 2017. Our nested sample of 1,116 children aged 6-36 months included 923 child-mother pairs (level 1) within kebeles (level 2). We conducted multilevel regression analysis using STATA software.ResultsAmong participants, 85.0% of children aged 12-36 months received at least one vaccine, and 52.4% had complete immunization coverage. After controlling for several individual and community variables, we identified six significant predictor variables for complete immunization: Older mothers' age (AOR = 1.05, 95% CI: 1.00-1.09), higher utilization of antenatal care (AOR = 1.36, 95% CI: 1.14-1.62), one or more tetanus-toxoid vaccination during pregnancy (AOR = 2.64, 95% CI: 1.43-4.86), mothers knowing the age at which to complete child's vaccinations (AOR = 2.00, 95% CI: 1.25-3.20), being a female (AOR = 0.64, 95% CI: 0.43-0.95), and child receiving vitamin A supplementation within the last 6 months (AOR = 2.79, 95% CI: 1.59-4.90). We observed a clustering effect at the individual and community levels with an intra-cluster correlation coefficient of 48.1%.ConclusionsWe found low immunization coverage among children in the Wonago district of southern Ethiopia, with significant differences across communities. Promoting maternal health care and community service could enhance immunization coverage.

Project description:BackgroundChildhood immunization is one of the most cost effective health interventions but its rate has been declining recently in Ghana. Information on immunization coverage and determinants is needed to improve immunization programmes. The objective of this study was to determine the prevalence and factors associated with incomplete immunization of children (12-23 months) in Kwabre East District, Ghana.MethodsA cross-sectional, community-based survey involving 322 children and their mothers was carried out. Data were collected on socio-demographic characteristics of mothers, childhood immunization history and mothers' knowledge and practices of immunization using a structured questionnaire. Children were classified as incompletely immunized if they failed to receive at least one of 8 vaccine doses: - one dose of Bacillus Calmette-Guérin (BCG), 3 doses each of pentavalent, 3 doses of polio and one dose of measles per WHO/UNICEF definition. Chi-square and logistic regression analyses were used to identify the factors associated with incomplete immunisation.ResultsThe prevalence of incomplete immunization was low (15.5%) suggesting high immunisation coverage but the coverage of the second measles dose, taken at 18 months of age, was the lowest (23.9%). Most of the mothers knew the importance of immunisation (95.7%) and at least one vaccine-preventable disease or symptom (84.9%). Two factors associated with incomplete immunisation in bivariate analyses (community of residence, and mother's knowledge of number of oral polio vaccines given to children) were no longer significant in a logistic regression model. Compared to children in Aboaso, children in Gyamfi Wonoo (AOR = 1.81, 95% CI = 0.80-4.08), Mamponteng (Bonwunu) (AOR = 0.59, 95% CI = 0.24-1.48) and Mamponteng (Town) (AOR = 0.63, 95% CI = 0.26-1.55) had similar odds of incomplete immunisation. Similarly, mother's lack of knowledge of the number of doses of polio vaccine given to children had no effect on the odds of incomplete immunisation (AOR = 0.53, 95% CI = 0.22-1.26).ConclusionsImmunization coverage is high in the Kwabre East district but very few children received the second measles dose. None of the maternal and child factors assessed is associated with immunisation coverage. Further research is needed to identify the determinants of immunisation coverage and the reasons for the low uptake of second measles dose in the study area.

Project description:BackgroundPreterm birth is defined as the birth of a baby before 37 completed weeks of gestation. Worldwide, prematurity is the second foremost cause of death in children under the age of 5 years. Preterm birth also gives rise to short and long term complications. Therefore, the primary aim of this study was to identify the factors associated with preterm birth in Wachemo University Nigist Eleni Mohammed Memorial referral hospital, Hadiya Zone, Southern Ethiopia.MethodsAn institution-based unmatched case-control study was conducted from July 01, 2018 to June 30, 2019 among mothers who gave birth in Wachemo University Nigest Eleni Mohammed Memorial referral hospital. A retrospective one-year data was retrieved from medical records of mothers with their index neonates. Simple random sampling technique was employed to recruit study participants. SPSS version 20 software was used for data entry and computing statistical analysis. Both bivariable and multivariable logistic regression analyses were used to determine the association of each independent variable with the dependent variable. Odds ratio with their 95% confidence intervals was computed to identify the presence and strength of association, and statistical significance was affirmed if p < 0.05.ResultThe current study evaluated 213 medical records of mothers with index neonates (71 cases and 142 controls). Urban residency [AOR = 0.48; 95% Cl; 0.239, 0.962], antenatal care follow up [AOR = 0.08; 95 Cl; 0.008, 0.694], premature rupture of membranes [AOR = 3.78; 95% Cl; 1.467, 9.749], pregnancy induced hypertension [AOR = 3.77; 95% Cl; 1.408, 10.147] and multiple pregnancies [AOR = 5.53; 95% Cl; 2.467, 12.412] were the factors associated with preterm birth. More than one-third (36.6%) preterm neonates died in the present study.ConclusionsThe present study found that urban residency, antenatal care follow up, premature rupture of membranes, pregnancy induced hypertension and multiple pregnancies were factors associated with preterm birth. The mortality among preterm neonates is high. Enhancing antenatal care follow up and early detection and treatment of disorders among pregnant women during antenatal care and undertaking every effort to improve outcomes of preterm birth and reduce neonatal mortality associated with prematurity is decisive.

Project description:In nations like Ethiopia, vaccination rates are low despite being one of the most effective public health treatments to protect infants from common infectious diseases that can be prevented by immunization. In Worebabo District, the reasons of the underutilization of vaccination programs are poorly understood. Therefore, this study aimed to identify determinants of incomplete childhood vaccination in the study setting. Community based unmatched case-control study was carried out among 441 mothers of children aged 12–23 months old (147 cases and 294 controls) in Worebabo District, Ethiopia from March 1—April 30, 2020. Using a multistage sampling process, mothers were chosen. Health professionals were trained to collect data using a pre-tested standardized questionnaire. Data entered into Epi Info version 7.2 and put through statistical analysis in SPSS version 23. Binary logistic regression was performed to determine the odds ratio with a 95%CL. A p-value of under 0.05 was estimated statistically significant. The study found that older moms (>35 years old) were more likely than younger mothers to fail to properly immunize their children (AOR = 2.4, 95% CI: 1.09, 5.28). In addition, mothers with incomplete vaccinations had lower knowledge of the benefits of vaccination (AOR = 2.02, 95% CI: 1.20, 3.39), Negative attitudes towards immunization (AOR = 4.9, 95% CI: 2.82, 8.49), less access to prenatal care (AOR = 3.68, 95% CI: 1.58, 8.54), home delivery (AOR = 5.47, 95% CI: 2.58)., 11.58), absent home visits (AOR = 3.56, 95% CI: 1.69, 7.48), and longer time to reach vaccination site (>1 h) (AOR = 10.07)., 95% CI: 1.75, 57.79) were found associated with mother incomplete vaccination of the child. Mothers being older age, less access to antenatal care services, place of home delivery, longer time to reach vaccination site, negative attitude and poor knowledge towards the benefit of vaccination were associated with mothers’ incomplete vaccination of the child. Therefore, health professionals should inform and counsel mothers about the advantages of childhood immunization as well as the consequences of incomplete or not vaccination of children at the time of the facility visit and by community health workers during the routine home visit.

Project description:BackgroundStunting remains one of the most common malnutrition problems among children in Ethiopia. Identifying the risk factors of stunting assists health planners to prioritize prevention strategies, and is a fundamental step for intervention. Therefore, this study aimed to assess factors associated with stunting among children aged 6-59 months in Bensa district, Sidama Region, South Ethiopia, 2018.MethodsA facility-based unmatched case-control study was conducted from January 10 to March 10, 2018, on a sample of 237(79 cases and 158 controls) children aged 6-59 months with their respective mothers/caretakers. Data were collected using a structured, face-to-face interviewer-administered questionnaire and standard physical measurements. The data were entered into EP INFO version 7 and WHO Anthro software and analyzed using SPSS version 20. The variables were entered into the multivariable model using the backward stepwise regression approach. Multivariable logistic regression analysis was used to identify factors associated with stunting. Adjusted odds ratio (AOR) with 95% confidence interval (95%CI) and p-value <0.05 was used to declare the significance.ResultsSex distribution was almost equal (Males = 52.3%, Females = 47.7%).The mean (standard deviation) age of cases and controls was 27.35 (±12.71) and 28.70 (±13.27) months respectively. The risk factors for stunting were diarrhea in the past two weeks (AOR = 2.71, 95% CI: 1.42-5.16), being male (AOR = 2.37, 95% CI: 1.224-4.59), inappropriate exclusive breastfeeding (AOR =2.07, 95%CI: 1.07-4.01), having less than or equal to three under-five children in the household (AOR = 2.18, 95%CI: 1.03-4.64), and mothers who had no formal education (AOR =3.28, 95%CI :1.56-6.924).ConclusionsDiarrhea in the past two weeks, sex of a child, inappropriate exclusive breastfeeding, number of under-five children in the household, and mothers who had no formal education were the risk factors of stunting. Thus organized efforts aimed at focus on prevention of diarrhea as part of an overall public health strategy for improving child health and nutrition. Educating mothers/caretakers on the importance of exclusive breastfeeding should be considered. Moreover, mothers need to be encouraged to space birth between children through the use of family planning services.

Dataset Information

Factors associated with incomplete childhood immunization in Arbegona district, southern Ethiopia: a case--control study.

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Factors associated with incomplete childhood immunization in Arbegona district, southern Ethiopia: a case--control study.

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