孟加拉国农村地区婴儿及时接种疫苗覆盖率的产妇决定因素。

Maternal determinants of timely vaccination coverage among infants in rural Bangladesh.

机构信息

Duke Global Health Institute, Durham, NC, United States; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.

Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.

出版信息

Vaccine. 2014 Sep 22;32(42):5514-9. doi: 10.1016/j.vaccine.2014.06.092. Epub 2014 Aug 12.

DOI:10.1016/j.vaccine.2014.06.092

PMID:25132336

Abstract

BACKGROUND

Timely vaccination, i.e., the receipt of all scheduled vaccinations in an age-appropriate fashion, is critical for the prevention of deadly diseases in infants and achievement of the UN Millennium Development Goal to reduce infant mortality. Infants, especially in rural or underprivileged settings often receive delayed vaccinations leaving them susceptible to vaccine-preventable illnesses early in the first year of life. In this study, we examined rates of timely vaccination among 24,435 infants born in Gaibandha and Rangpur rural districts of Bangladesh from 2001 to 2007.

METHODS

Vaccinations due by 14 weeks of age and administered through routine government immunization services were assessed using interviews with enrolled mothers between 11 and 18 weeks postpartum. We created a Timely Vaccination (TV) score to classify infants as vaccinated fully and on schedule (TV=1) or not (TV=0), and used multivariable logistic regression to identify maternal characteristics associated with infant's timely vaccination status.

RESULTS

Our results suggest that only 19% of infants in this cohort received scheduled vaccinations on time by 11-18 weeks postpartum. Mothers' engagement in paid employment [OR=1.13, 95% CI: 1.03-1.23], receipt of tetanus toxoid vaccination [OR=1.24, 95% CI: 1.11-1.38], history of antenatal care [OR=1.22, 95% CI: 1.12-1.32], or higher socioeconomic status [OR=1.07, 95% CI: 1.03-1.11] were positively associated with timely vaccination of their infants. Mother's perception of small infant size at birth was negatively associated with timely vaccination [OR=0.89, 95% CI: 0.82-0.97].

CONCLUSION

Timely vaccination coverage of infants in rural Gaibandha and Rangpur districts is extremely low. This analysis identifies important shortcomings associated with the 1-year vaccination benchmark of routine immunization performance and suggests the need for specific interventions based on potential maternal determinants as well as known system and programmatic barriers of timely vaccination among infants in rural Bangladesh.

摘要

背景

及时接种疫苗，即按照年龄适当的方式接受所有计划疫苗接种，对于预防婴儿致命疾病和实现联合国千年发展目标减少婴儿死亡率至关重要。婴儿，尤其是在农村或贫困地区，往往会延迟接种疫苗，使他们在生命的第一年早期容易感染可通过疫苗预防的疾病。在这项研究中，我们检查了 2001 年至 2007 年期间在孟加拉国盖班达和兰普尔农村地区出生的 24435 名婴儿的及时接种疫苗率。

方法

通过在产后 11 至 18 周期间对登记母亲进行访谈，评估了 14 周龄时应接种的疫苗，并通过常规政府免疫服务进行了接种。我们创建了一个及时接种疫苗（TV）评分，将婴儿分为完全按时接种疫苗（TV=1）和未按时接种疫苗（TV=0），并使用多变量逻辑回归来确定与婴儿及时接种疫苗状况相关的产妇特征。

结果

我们的研究结果表明，在该队列中，只有 19%的婴儿在产后 11 至 18 周时按时接受了计划疫苗接种。母亲从事有偿工作[OR=1.13，95%CI：1.03-1.23]、接受破伤风类毒素疫苗接种[OR=1.24，95%CI：1.11-1.38]、有产前保健史[OR=1.22，95%CI：1.12-1.32]或较高的社会经济地位[OR=1.07，95%CI：1.03-1.11]与婴儿的及时接种疫苗呈正相关。母亲对婴儿出生时体型较小的看法与及时接种疫苗呈负相关[OR=0.89，95%CI：0.82-0.97]。