Fatiregun Akinola Ayoola, Etukiren Emem Emmanuel
Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Int Health. 2014 Sep;6(3):213-24. doi: 10.1093/inthealth/ihu027. Epub 2014 May 20.
High dropout rates in the uptake of oral polio vaccine (OPV) and DTP vaccine persist despite efforts to improve immunisation coverage. This study identified determinants of uptake of third doses of OPV3 and DTP3 among infants who received first doses of either or both vaccines at immunisation centres in the Ibadan North Local Government Area of Nigeria.
Using a cohort study design, 400 mother-child pairs were assessed. A semi-structured, interviewer-administered questionnaire was used to collect data from each participant who were followed up for 90 days. Dates of subsequent doses of the vaccines were recorded. Multivariate analysis was performed using the log-rank test and Cox's regression analysis to identify predictive factors.
Only 43.5% (174/400) and 24.8% (89/359) of children completed the OPV3 and DTP3 vaccines, respectively. Factors predictive of uptake of OPV3 were first birth (HR=1.66, 95% CI 1.11-2.48) and attending a tertiary health facility (HR=2.27, 95% CI 1.41-3.65), while attending a secondary health facility was significant for DTP3 uptake (HR=2.43, 95% CI 1.30-4.61).
Uptake of third doses of vaccines was influenced by the type of health facility attended and the child birth order. Efforts to reduce vaccination dropouts should include creation of awareness of the importance of completing immunisation schedules for children of higher birth orders as well as improved service delivery at health facilities.
尽管为提高免疫覆盖率做出了努力,但口服脊髓灰质炎疫苗(OPV)和白喉、破伤风、百日咳三联疫苗(DTP)的高接种率仍持续存在。本研究确定了在尼日利亚伊巴丹北部地方政府辖区的免疫中心接种了首剂OPV或DTP疫苗或两者的婴儿中第三剂OPV3和DTP3接种率的决定因素。
采用队列研究设计,评估了400对母婴。使用半结构化、由访谈员实施的问卷从每位参与者收集数据,并对其进行90天的随访。记录后续疫苗接种日期。使用对数秩检验和Cox回归分析进行多变量分析,以确定预测因素。
分别只有43.5%(174/400)和24.8%(89/359)的儿童完成了OPV3和DTP3疫苗接种。预测OPV3接种的因素是头胎出生(HR=1.66,95%CI 1.11-2.48)和前往三级医疗机构就诊(HR=2.27,95%CI 1.41-3.65),而前往二级医疗机构就诊对DTP3接种具有显著意义(HR=2.43,95%CI 1.30-4.61)。
第三剂疫苗的接种受就诊医疗机构类型和孩子出生顺序的影响。减少疫苗接种率下降的努力应包括提高对头胎出生儿童完成免疫接种计划重要性的认识,以及改善医疗机构的服务提供。