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塞内加尔儿童免疫接种的决定因素:将之前的接种情况纳入社会人口背景因素之中。

Determinants of childhood immunizations in Senegal: Adding previous shots to sociodemographic background.

作者信息

Peretti-Watel Patrick, Cortaredona Sébastien, Ly Elhadji Yaya, Seror Valérie, Ndiaye Samba, Gaye Ibrahima, Fall Mouhamadou

机构信息

Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.

IHU-Méditerranée Infection, VITROME, Marseille, France.

出版信息

Hum Vaccin Immunother. 2020;16(2):363-370. doi: 10.1080/21645515.2019.1649553. Epub 2019 Sep 30.

Abstract

. Today, in Sub-Saharan Africa, vaccine-preventable diseases still contribute heavily to high child mortality. Maintaining high coverage rates for childhood vaccines and reducing related social inequalities are public health priorities in Senegal. Our aim was to investigate the determinants of childhood vaccination, including sociodemographic factors and previous vaccine-related decision-making.. Data come from the 2016 Senegalese Demographic and Health Survey, a nationally representative household survey targeting women aged 15-49, with a questionnaire focusing on health and reproductive issues, including their children's health. We restricted the analysis to children aged 12-23 months (n = 1,143). We used bivariate and multivariate analyses for investigating the determinants of several childhood vaccinations (Bacillus Calmette-Guérin, pentavalent, polio, measles and yellow fever vaccines), including sociodemographic factors and previous shots.. We identified two main sociodemographic predictors of childhood vaccination in Senegal: the mother's education level, which was strongly and positively correlated to every vaccination considered, except from the BCG vaccination, and the region of residence, with higher vaccination coverage rates in the Centre and West of Senegal. Moreover, previous shots were also strongly predictive of subsequent shots.. The positive impact of mother's education on child vaccination illustrates the wide-ranging benefits of educating girls, while the regional variability of immunization rates requires more research to be better understood. Previous shots are probably a proxy variable for unobservable factors strongly correlated to vaccinations, but beyond this 'proxy effect', they may also have their own specific effect on following shots. We believe this topic deserves further research.

摘要

如今,在撒哈拉以南非洲地区,疫苗可预防疾病仍是儿童高死亡率的主要原因。维持儿童疫苗的高接种率并减少相关的社会不平等现象是塞内加尔的公共卫生重点。我们的目的是调查儿童疫苗接种的决定因素,包括社会人口学因素和先前与疫苗相关的决策。

数据来自2016年塞内加尔人口与健康调查,这是一项针对15至49岁女性的全国代表性家庭调查,问卷聚焦于健康和生殖问题,包括其子女的健康状况。我们将分析限制在12至23个月大的儿童(n = 1143)。我们使用双变量和多变量分析来调查几种儿童疫苗(卡介苗、五价疫苗、脊髓灰质炎疫苗、麻疹疫苗和黄热病疫苗)接种的决定因素,包括社会人口学因素和先前的接种情况。

我们确定了塞内加尔儿童疫苗接种的两个主要社会人口学预测因素

母亲的教育水平,除卡介苗接种外,与所考虑的每种疫苗接种都呈强烈正相关;以及居住地区,塞内加尔中部和西部的疫苗接种率较高。此外,先前的接种情况也是后续接种的有力预测指标。

母亲教育对儿童疫苗接种的积极影响说明了女童教育的广泛益处,而免疫接种率的地区差异需要更多研究以更好地理解。先前的接种情况可能是与疫苗接种密切相关的不可观察因素的代理变量,但除了这种“代理效应”外,它们对后续接种可能也有其自身的特定影响。我们认为这个话题值得进一步研究。

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