Dataset Information

Age-appropriate vaccination coverage and its associated factors for pentavalent 1-3 and measles vaccine doses, in northeast Ethiopia: A community-based cross-sectional study.

ABSTRACT: BACKGROUND:In Ethiopia, there are limited studies on age-appropriate vaccinations that children received at the recommended specific ages. Therefore, we assessed age-appropriate vaccinations coverage and its associated factors among children 12 to 23 months of age in Menz Lalo district, northeast Ethiopia. METHODS:A community-based cross-sectional study was conducted in Menz Lalo district from March to April/2018 among 417 mothers/caregivers with children 12 to 23 months of age using simple random sampling technique. Data were collected using a pretested structured questionnaire. Information about children's vaccination status was collected from vaccination cards. Age-appropriate vaccination coverage was measured using World Health Organization vaccination schedule recommendation. Data was entered into Epi-Info7 software and exported to SPSS-20 for analysis. Four consecutive logistic regression models were performed to identify factors associated with age-inappropriate vaccinations. A P-value of ≤ 0.05 was considered to state statistically significant associations. RESULTS:Age-appropriate vaccination coverage was 39.1% (95% CI: 34.3 to 44) for pentavalent 1, 36.3% (95% CI: 31.6 to 41.5) for pentavalent 2, 30.3% (95% CI: 25.6 to 35) for pentavalent 3 and 26.4% (95% CI: 21.7 to 31) for measles vaccine doses. Age-inappropriate pentavalent 1-3 vaccinations was associated with being male sex (AOR: 0.47, 95% CI: 0.29-0.74), lack of telephone (AOR: 2.2, 95% CI: 1.4-3.6), lack of usual caretaker (AOR: 2.6, 95% CI: 1.3-5.2), unplanned pregnancy (AOR: 1.9, 95% CI: 1.1-3.5), missing pregnant women's conference (AOR: 2.7, 95% CI: 1.3-5.7), decreasing birth order (AOR: 0.34, 95% CI: 0.17-0.68) and insufficient knowledge (AOR: 2.7, 95% CI: 1.6-4.4). CONCLUSION:The proportions of age-appropriate vaccination coverage were low in the study area. Modifiable factors were associated with age-inappropriate vaccinations. Vaccination interventions should consider identified modifiable factors to improve age-appropriate vaccinations coverage.

SUBMITTER: Marefiaw TA

PROVIDER: S-EPMC6697368 | biostudies-other | 2019

REPOSITORIES: biostudies-other

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Age-appropriate vaccination coverage and its associated factors for pentavalent 1-3 and measles vaccine doses, in northeast Ethiopia: A community-based cross-sectional study.

Marefiaw Tefera Alemu TA Yenesew Muluken Azage MA Mihirete Kebadnew Mulatu KM

PloS one 20190816 8

<h4>Background</h4>In Ethiopia, there are limited studies on age-appropriate vaccinations that children received at the recommended specific ages. Therefore, we assessed age-appropriate vaccinations coverage and its associated factors among children 12 to 23 months of age in Menz Lalo district, northeast Ethiopia.<h4>Methods</h4>A community-based cross-sectional study was conducted in Menz Lalo district from March to April/2018 among 417 mothers/caregivers with children 12 to 23 months of age us ...[more]

PMID: 31419230

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Project description:OBJECTIVE:The objective of this study is to assess the determinants of BCG vaccination in Ethiopia from 2016 Ethiopia Demographic and Health Survey (EDHS). SETTING:Since Ethiopia has nine regional states and two administrative cities, sample was taken from all the divisions. The population-based sample was intended to provide estimates of key indicators for the country. PARTICIPANT:The sampling frame used for the 2016 EDHS is the Ethiopia Population and Housing Census. From 15 683 women recorded in EDHS dataset, women with no child (n=10 379) were excluded from the study. Therefore, the total sample size for this study was 5304 women. The outcome variable was BCG immunisation status of children. RESULT:Out of the study participants (n=5304), the majority were in between 20 and 34 years of age (73.8%). The median age of the respondents was 28.4 (SD=±6.5) years old. Prevalence of BCG vaccination was 63.6% (n=3373) and BCG vaccination coverage in urban residents was higher (88%) than rural residents (57.3%). Mothers' age between 20 up to 34 (Adjusted odds ratio (AOR)=1.48; 95% CI: 1.13 to 1.93) and between 35 up to 49 (AOR=1.83; 95% CI: 1.35 to 2.46) were more likely to vaccinate their child's than those mothers' age less than 20. Mothers settled in urban areas were two times more likely to vaccinate their child's than those living in rural areas (AOR=1.94; 95% CI: 1.45 to 2.60). Mothers with greater antenatal visits show higher BCG vaccination, Antenatal Care (ANC) 4 and above (AOR=3.48; 95% CI: 2.91 to 4.15). BCG vaccination is higher for mothers delivered at non-governmental organisation health facility than home (AOR=2.9; 95% CI: 1.69 to 4.96). Maternal occupation and wealth index also had a significant association with BCG vaccination. CONCLUSION:BCG vaccination coverage, in this study, was lower and determinant factors for BCG vaccination were residence, mother's age, place of delivery, mother's antenatal visit, wealth index and mother's occupation.

Project description:BackgroundOf the eight large (>50 cases) US postelimination outbreaks, the first and last occurred in Ohio. Ohio's vaccination registry is incomplete. Community-level immunity gaps threaten more than two decades of measles elimination in the US. We developed a statistical model, VaxEstim, to rapidly estimate the early-phase vaccination coverage and immunity gap in the exposed population during the 2022 Central Ohio outbreak.MethodsWe used reconstructed daily incidence (from publicly available data) and assumptions about the distribution of the serial interval, or the time between symptom onset in successive measles cases, to estimate the effective reproduction number (i.e., the average number of secondary infections caused by an infected individual in a partially immune population). We estimated early-phase measles vaccination coverage by comparing the effective reproduction number to the basic reproduction number (i.e., the average number of secondary infections caused by an infected individual in a fully susceptible population) while accounting for vaccine effectiveness. Finally, we estimated the early-phase immunity gap as the difference between the estimated critical vaccination threshold and vaccination coverage.FindingsVaxEstim estimated the early-phase vaccination coverage as 53% (95% credible interval, 21%-77%), the critical vaccination threshold as 93%, and the immunity gap as 42% (95% credible interval, 18%-74%).InterpretationThis study estimates a significant immunity gap in the exposed population during the early phase of the 2022 Central Ohio measles outbreak, suggesting a robust public health response is needed to identify the susceptible community and develop community-specific strategies to close the immunity gap.FundingThis work was supported in part by the National Institute of General Medical Sciences, National Institutes of Health; the UK Medical Research Council (MRC); the Foreign, Commonwealth and Development Office; the National Institute for Health Research (NIHR) Health Protection Research Unit in Modelling Methodology; Imperial College London, and the London School of Hygiene & Tropical Medicine, Community Jameel; the EDCTP2 programme, supported by the EU; and the Sergei Brin Foundation.

Project description:INTRODUCTION:Measles elimination depends on the successful deployment of measles containing vaccine. Vaccination programs often depend on a combination of routine and non-routine services, including supplementary immunization activities (SIAs) and vaccination weeks (VWs), that both aim to vaccinate all eligible children regardless of vaccination history or natural infection. Madagascar has used a combination of these activities to improve measles coverage. However, ongoing massive measles outbreak suggests that the country was in a "honeymoon" period and that coverage achieved needs to be re-evaluated. Although healthcare access is expected to vary seasonally in low resources settings, little evidence exists to quantify temporal fluctuations in routine vaccination, and interactions with other immunization activities. METHODS:We used three data sources: national administrative data on measles vaccine delivery from 2013 to 2016, digitized vaccination cards from 49 health centers in 6 health districts, and a survey of health workers. Data were analyzed using linear regressions, analysis of variance, and t-tests. FINDINGS:From 2013 to 2016, the footprint of SIAs and VWs is apparent, with more doses distributed during the relevant timeframes. Routine vaccination decreases in subsequent months, suggesting that additional activities may be interfering with routine services. The majority of missed vaccination opportunities occur during the rainy season. Health facility organization and shortage of vaccine contributed to vaccination gaps. Children born in June were the least likely to be vaccinated on time. DISCUSSION:Evidence that routine vaccination coverage varies over the year and is diminished by other activities suggests that maintaining routine vaccination during SIAs and VWs is a key direction for strengthening immunization programs, ensuring population immunity and avoiding future outbreaks. FUNDING:Wellcome Trust Fund, Burroughs Wellcome Fund, Gates Foundation, National Institutes of Health.

Project description:Background:There is a global resurgence of measles, consequent upon worldwide stagnating measles vaccination coverage. The study aim was to document trends and characteristics of reported cases of measles, measles-related deaths, and measles vaccination coverage (MCV1-first dose of measles-containing vaccine and MCV2-second dose of measles-containing vaccine) at national and sub-national level in Myanmar over a five year period between 2014 and 2018. Methods:This was a descriptive study using routine data collected and submitted to the Expanded Programme on Immunization. Results:Between 2014 and 2018, there were 2673 measles cases of which 2272 (85%) occurred in 2017 and 2018. Five adjacent regions in lower Myanmar were the most affected: in 2017 and 2018, these regions reported 1647 (73%) of the 2272 measles cases in the country. Overall, 73% of measles cases were laboratory confirmed, 21% were epidemiologically linked, and 6% were clinically compatible (clinical diagnosis only), with more laboratory confirmed cases in recent years. Annual measles-related deaths were either zero or one except in 2016 when there were 21 deaths, all occurring in one remote village. In the recent years, the most commonly affected age groups were 0-8 months, 9 months to 4 years, and ??15 years. Among 1907 measles cases with known vaccination status, only 22% had been vaccinated and 70% of those had only received one dose of vaccine. Annual MCV1 coverage nationally varied from 83 to 93% while annual MCV2 coverage nationally varied from 78 to 87%, with no clear trends over the years. Between 2014 and 2018, a high proportion of the 330 townships had MCV coverage <?95%. Over 80% of measles cases were reported from townships that had MCV coverage <?95%. Conclusion:There have been a large number of measles cases in recent years associated with sub-optimal measles vaccine coverage. Myanmar has already conducted supplemental immunization activities in October and November, 2019. Myanmar also needs to improve routine immunization services and targeted responses to measles outbreaks.

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:BackgroundVaccinating infants with a first dose of measles-containing vaccine (MCV1) before 9 months of age in high-risk settings has the potential to reduce measles-related morbidity and mortality. However, there is concern that early vaccination might blunt the immune response to subsequent measles vaccine doses. We systematically reviewed the available evidence on the effect of MCV1 administration to infants younger than 9 months on their immune responses to subsequent MCV doses.MethodsFor this systematic review and meta-analysis, we searched for randomised and quasi-randomised controlled trials, outbreak investigations, and cohort and case-control studies without restriction on publication dates, in which MCV1 was administered to infants younger than 9 months. We did the literature search on June 2, 2015, and updated it on Jan 14, 2019. We included studies reporting data on strength or duration of humoral and cellular immune responses, and on vaccine efficacy or vaccine effectiveness after two-dose or three-dose MCV schedules. Our outcome measures were proportion of seropositive infants, geometric mean titre, vaccine efficacy, vaccine effectiveness, antibody avidity index, and T-cell stimulation index. We used random-effects meta-analysis to derive pooled estimates of the outcomes, where appropriate. We assessed the methodological quality of included studies using Grading of Recommendation Assessment, Development and Evaluation (GRADE) guidelines.FindingsOur search retrieved 1156 records and 85 were excluded due to duplication. 1071 records were screened for eligibility, of which 351 were eligible for full-text screening and 21 were eligible for inclusion in the review. From 13 studies, the pooled proportion of infants seropositive after two MCV doses, with MCV1 administered before 9 months of age, was 98% (95% CI 96-99; I2=79·8%, p<0·0001), which was not significantly different from seropositivity after a two-dose MCV schedule starting later (p=0·087). Only one of four studies found geometric mean titres after MCV2 administration to be significantly lower when MCV1 was administered before 9 months of age than at 9 months of age or later. There was insufficient evidence to determine an effect of age at MCV1 administration on antibody avidity. The pooled vaccine effectiveness estimate derived from two studies of a two-dose MCV schedule with MCV1 vaccination before 9 months of age was 95% (95% CI 89-100; I2=12·6%, p=0·29). Seven studies reporting on measles virus-specific cellular immune responses found that T-cell responses and T-cell memory were sustained, irrespective of the age of MCV1 administration. Overall, the quality of evidence was moderate to very low.InterpretationOur findings suggest that administering MCV1 to infants younger than 9 months followed by additional MCV doses results in high seropositivity, vaccine effectiveness, and T-cell responses, which are independent of the age at MCV1, supporting the vaccination of very young infants in high-risk settings. However, we also found some evidence that MCV1 administered to infants younger than 9 months resulted in lower antibody titres after one or two subsequent doses of MCV than when measles vaccination is started at age 9 months or older. The clinical and public-health relevance of this immunity blunting effect are uncertain.FundingWHO.

Project description:BackgroundPoor health care financing remains a major challenge to health service utilization among the lower socioeconomic society. Consequently, countries have designed different health insurance programs to overcome financial barriers against health services utilization. Similarly, Ethiopia has been implementing community-based health insurance programs since 2011 to improve health care financing system. However, only a small number of people are enrolled which might be attributed to lack of willingness towards the program and the reasons for this remained under reported. This study was intended to examine willingness to join the community-based health insurance program and its associated factors in South Wollo, Northeast Ethiopia.MethodA community-based cross-sectional study was conducted among 421 households. A multistage systematic random sampling technique was employed to recruit the study households. Data were entered into EpiData version 3.1 and was exported into SPSS version 24.0 for analysis. Bivariable and multivariable logistic regression analysis with a backward elimination method was performed to identify the determinants of willingness to join community-based health insurance. Finally, a statistically significant level was declared at a p-value of less than 0.05.ResultsTwo hundred and ninety-three [73.6% (95%CI:68.8%-77.9%)] households were willing to join community-based health insurance programs. Being male headed household (AOR:0.2, 95%CI: 0.07-0.58), being a member of Idir (AOR:0.46, 95%CI: 0.25-.84), absence of chronic illness in the household (AOR: 0.31, 95%CI: 0.13-0.77), and family size < 4 (AOR: 0.18, 95% CI:0.08-0.41) were barriers to join community-based health insurance program whereas rural residency (AOR:1.9, 95% CI: 1.09-3.32), perceived quality health services (AOR:2.96, 95%CI:1.4-6.24), and having positive attitude (AOR:4.1, 95%CI:2.32-7.22) and good knowledge to programs (AOR:2.62, 95%CI:1.43-4.8) were enabling factors.ConclusionNearly three-fourths of the households were willing to join community-based health insurance programs. However, different household and health service-related factors affected their willingness. The ministry of health with the regional and woreda health offices should work towards improving the quality of health services, conduct program advocacy and community sensitization towards the program, and build trust with the community.

Dataset Information

Age-appropriate vaccination coverage and its associated factors for pentavalent 1-3 and measles vaccine doses, in northeast Ethiopia: A community-based cross-sectional study.

Publications

Age-appropriate vaccination coverage and its associated factors for pentavalent 1-3 and measles vaccine doses, in northeast Ethiopia: A community-based cross-sectional study.

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