Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Bangladesh.
Coraxo Consulting, Copenhagen, Denmark.
Vaccine. 2018 May 31;36(23):3323-3330. doi: 10.1016/j.vaccine.2018.04.059. Epub 2018 Apr 24.
Immunization is one of the most successful and effective health intervention to reduce vaccine preventable diseases for children. Recently, Bangladesh has made huge progress in immunization coverage. In this study, we compared the recent immunization coverage between boys and girls in a rural area of Bangladesh.
The study is based on data from Chakaria Health and Demographic Surveillance System (HDSS) of icddr,b, which covers a population of 90,000 individuals living in 16,000 households in 49 villages.
We calculated the coverage of fully immunized children (FIC) for 4584 children aged 12-23 months of age between January 9, 2012 and January 19, 2016. We analyzed immunization coverage using crude FIC coverage ratio (FCR) and adjusted FCR (aFCR) from binary regression models. The dynamic of gender inequality was examined across sociodemographic and economic conditions.
The adjusted female/male (F/M) FIC coverage ratios in various sociodemographic and economic categories.
Among children who lived below the lower poverty line, the F/M aFCR was 0.89 (0.84-0.94) compared to 0.98 (0.95-1.00) for children from the households above lower poverty line (p = 0.003, test for interaction). For children of mothers with no high school education, the F/M aFCR was 0.94 (0.91-0.97), whereas it was 1.00 (0.96-1.04) for children of mothers who attended high school (p = 0.04, test for interaction). The F/M aFCR was 1.01 (0.96-1.06) for first born children but 0.95 (0.93-0.98) for second or higher birth order children (p = 0.04, test for interaction).
Fewer girls than boys were completely vaccinated by their first birthday due to girls' lower coverage for measles vaccine. The tendency was most marked for children living below the poverty line, for children whose mothers did not attend high school, and for children of birth order two or higher. In the study setting and similar areas, sex differentials in coverage should be taken into account in ongoing immunization programmes.
免疫接种是降低儿童疫苗可预防疾病最成功和最有效的健康干预措施之一。最近，孟加拉国在免疫接种覆盖率方面取得了巨大进展。在这项研究中，我们比较了孟加拉国农村地区男童和女童最近的免疫接种覆盖率。
本研究基于 icddr,b 的恰卡里亚健康和人口监测系统（HDSS）的数据，该系统覆盖了 90000 人，分布在 49 个村庄的 16000 户家庭中。
我们计算了 2012 年 1 月 9 日至 2016 年 1 月 19 日期间 12-23 个月龄的 4584 名儿童的完全免疫儿童（FIC）覆盖率。我们使用二元回归模型中的未调整 FIC 覆盖率比（FCR）和调整 FCR（aFCR）来分析免疫接种覆盖率。在社会人口和经济条件方面，我们研究了性别不平等的动态变化。
在各种社会人口和经济类别中，调整后的女性/男性（F/M）FIC 覆盖率比。
在生活在贫困线以下的儿童中，F/M aFCR 为 0.89（0.84-0.94），而生活在贫困线以上家庭的儿童为 0.98（0.95-1.00）（p=0.003，交互检验）。母亲未接受过高中教育的儿童的 F/M aFCR 为 0.94（0.91-0.97），而母亲接受过高中教育的儿童的 F/M aFCR 为 1.00（0.96-1.04）（p=0.04，交互检验）。第一个孩子的 F/M aFCR 为 1.01（0.96-1.06），而第二个或更高出生顺序的孩子的 F/M aFCR 为 0.95（0.93-0.98）（p=0.04，交互检验）。
由于麻疹疫苗接种率较低，女孩完全接种疫苗的比例低于男孩。这种趋势在生活在贫困线以下的儿童、母亲未接受过高中教育的儿童以及第二胎或更高胎次的儿童中最为明显。在研究环境和类似地区，在进行免疫接种方案时，应考虑覆盖范围方面的性别差异。
