Uzochukwu B S, Okeke C C, Envuladu E, Mbachu C, Okwuosa C, Onwujekwe O E
Department of Community Medicine, College of Medicine, University of Nigeria, Enugu-Campus; Health Policy Research Group, College of Medicine, University of Nigeria, Enugu-Campus; Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu-Campus, Nigeria.
Department of Community Medicine, University of Nigeria, Teaching Hospital, Enugu, Nigeria.
Niger J Clin Pract. 2017 Aug;20(8):971-977. doi: 10.4103/njcp.njcp_375_16.
The Nigerian National Programme on Immunization aims at increasing the immunization coverage of children under 1 year of age. However, there is still a gap between the national immunization targets and the immunization coverage rates, and data are rarely disaggregated according to socioeconomic status. As a result, there is a dearth of information about the coverage of subgroups, especially at the local level. This study determined the socioeconomic differentials in immunization coverage for children under 5 years and under 1 year in Enugu urban, Southeast Nigeria.
This was a community-based, descriptive cross-sectional study in Enugu urban of Southeast Nigeria. A modified 30 × 7 cluster sampling design was adopted as the sampling method to select and interview 462 mothers of 685 children under the age of 5 years on their sociodemographic and economic characteristics and immunization status of their children. Principal components analysis in STATA software was used to characterize socioeconomic inequity.
Immunization coverage was as follows: Diphtheria, pertussis, tetanus third dose(DPT3), 3, 65.3%; oral polio vaccine 3, 78.0%; hepatitis B3, 65.2%; and measles, 55.8%. The full immunization rates for children 1-5 years and st year of life was selected as the reference group, the immunization rates in all other age groups decreased significantly. Using the same logistic regression model for children under 1 year of age, every added month of the child's life increased the full immunization coverage, and this was statistically significant (OR 2.752, 95% CI 2.304-3.418).
Full immunization coverage for children aged < 1 year was lower than the national target of 95%. There are differences in immunization coverage rates between different wealth quartiles in the area with the least poor benefiting more than the poorest, thus creating equity problems. Health managers need such community-based information about the vaccination status of their target population to plan and implement interventions that aim to improve immunization coverage in these areas.
尼日利亚国家免疫规划旨在提高1岁以下儿童的免疫接种覆盖率。然而，国家免疫目标与免疫接种覆盖率之间仍存在差距，且数据很少按社会经济状况进行分类。因此，关于亚组覆盖率的信息匮乏，尤其是在地方层面。本研究确定了尼日利亚东南部埃努古市5岁以下和1岁以下儿童免疫接种覆盖率的社会经济差异。
这是一项在尼日利亚东南部埃努古市开展的基于社区的描述性横断面研究。采用改良的30×7整群抽样设计作为抽样方法，选取并访谈了462名5岁以下儿童的母亲，了解她们的社会人口学和经济特征以及孩子的免疫接种状况。使用STATA软件中的主成分分析来描述社会经济不平等情况。
免疫接种覆盖率如下：白喉、百日咳、破伤风第三剂（DPT3），65.3%；口服脊髓灰质炎疫苗第三剂，78.0%；乙肝疫苗第三剂，65.2%；麻疹疫苗，55.8%。以1 - 5岁儿童和生命第1年的儿童的全程免疫接种率作为参照组，所有其他年龄组的免疫接种率均显著下降。对于1岁以下儿童使用相同的逻辑回归模型，孩子年龄每增加1个月，全程免疫接种覆盖率就会提高，且具有统计学意义（比值比2.752，95%置信区间2.304 - 3.418）。
1岁以下儿童的全程免疫接种覆盖率低于95%的国家目标。该地区不同财富四分位数之间的免疫接种覆盖率存在差异，最不贫困的群体比最贫困的群体受益更多，从而产生了公平性问题。卫生管理人员需要此类关于目标人群疫苗接种状况的基于社区的信息，以规划和实施旨在提高这些地区免疫接种覆盖率的干预措施。
