School of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
School of Public and Environmental Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
PLoS One. 2019 Jul 24;14(7):e0220144. doi: 10.1371/journal.pone.0220144. eCollection 2019.
Immunization 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.
We 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.
Among 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%.
We 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.
免疫接种是一种具有成本效益的干预措施，它在 2010 年至 2015 年期间在全球范围内预防了 500 多万人死亡。尽管在过去的四十年中，包括埃塞俄比亚在内的许多非洲国家的疫苗接种覆盖率有所提高，但尚未实现普遍覆盖。根据 2016 年埃塞俄比亚人口与健康调查，埃塞俄比亚有 12-23 个月大的儿童中只有 39%完全接种了疫苗。本研究旨在评估免疫接种覆盖率，并确定个体和社区因素，解释南部 Wonago 区 6-36 个月儿童不完全接种疫苗的情况。
我们于 2017 年 6 月至 7 月在 Wonago 区的三个随机选定的 kebeles 进行了一项基于社区的横断面研究。我们嵌套的 1116 名 6-36 个月大的儿童样本包括 kebeles（二级）内的 923 名儿童-母亲对（一级）。我们使用 STATA 软件进行多水平回归分析。
在参与者中，12-36 个月大的儿童中有 85.0%至少接种了一种疫苗，52.4%的儿童完全接种了疫苗。在控制了几个个体和社区变量后，我们确定了六个完全免疫接种的显著预测变量：年龄较大的母亲（AOR=1.05，95%CI：1.00-1.09），更高的产前护理利用率（AOR=1.36，95%CI：1.14-1.62），妊娠期间接种过一种或多种破伤风类毒素疫苗（AOR=2.64，95%CI：1.43-4.86），母亲知道儿童接种疫苗的年龄（AOR=2.00，95%CI：1.25-3.20），女性（AOR=0.64，95%CI：0.43-0.95），以及儿童在过去 6 个月内接受过维生素 A 补充剂（AOR=2.79，95%CI：1.59-4.90）。我们在个体和社区层面观察到聚类效应，其群内相关系数为 48.1%。
我们发现埃塞俄比亚南部 Wonago 区儿童的免疫接种覆盖率较低，社区之间存在显著差异。促进母婴保健和社区服务可以提高免疫接种覆盖率。
