索马里摩加迪沙5岁以下儿童实现全面免疫覆盖的障碍。
Barriers for full immunization coverage among under 5 years children in Mogadishu, Somalia.
作者信息
Mohamud Hayir T Mohamed, Magan Mohamed A, Mohamed Lul M, Mohamud Mohamed A, Muse Abdishakur A
机构信息
Faculty of Medicine and Surgery, Jazeera University, Mogadishu, Somalia.
出版信息
J Family Med Prim Care. 2020 Jun 30;9(6):2664-2669. doi: 10.4103/jfmpc.jfmpc_119_20. eCollection 2020 Jun.
BACKGROUND
Immunization is amongst the most cost-effective public health interventions for reducing childhood morbidity and mortality. However, globally 9 million deaths of children occur as a result of vaccine-preventable diseases in which 4.4 million are from the sub-Saharan region. Therefore, this study aimed to assess barriers for complete vaccination coverage among under five years children in Mogadishu, Somalia.
METHODS
A community-based cross-sectional study was conducted between April to July 2019 in Mogadishu-Somalia. Two-stage cluster sampling with systematic random sampling was used to select a sample of 820 households. Data was collected through a structured, interviewer administrator questionnaire. In case more eligible children found at a single selected household, one child was randomly selected and the information related to immunization was interviewed from his/her caregiver.
RESULTS
The overall, fully vaccinated under 5 years children were found to be 45.2%. Immunization was found to be increased by being a younger caregiver (β=-0.024, -Value=0.019) being father with secondary and above education (AOR = 1.755, 95% CI = 1.161-2.655, -Value = 0.008), being a young child (β = -0.018, -value = 0.011), being children from birth order of fifth and above (AOR = 1.539, 95% CI = 1.011-2.343, -value = 0.044), being a married caregiver (AOR = 4.101, 95% CI=1.062-15.835, -Value = 0.041), increased monthly family income (β =0.003, -value = 0.000), availability of vaccine at the time of visit (AOR = 6.147, 95% CI = 1.943-19.441, -value = 0.002), cost affordability of vaccine (AOR = 1.951, 95% CI = 1.238-3.076, -value = 0.004), being born at health facility (AOR = 1.517, 95% CI = 1.104-2.086, -value = 0.010), having good knowledge on immunization (AOR = 1.125, 95% CI = 1.070-1.181, -value = 0.001), having good practice on immunization (AOR = 2.756, 95% CI = 2.233-3.402, -value = 0.001) and having good perception on vaccine (AOR = 4.976, 95% CI = 2.183-11.340, -value = 0.001).
CONCLUSION
The result of this study has revealed that the proportion of fully immunized under-5 children in Mogadishu is very low. Several factors were found to the barriers achieving full immunization coverage. Steps to promote health education and vaccine availability should be lounged.
背景
免疫接种是降低儿童发病率和死亡率最具成本效益的公共卫生干预措施之一。然而，全球有900万儿童死于可通过疫苗预防的疾病，其中440万来自撒哈拉以南地区。因此，本研究旨在评估索马里摩加迪沙5岁以下儿童完全接种疫苗的障碍。
方法
2019年4月至7月在索马里摩加迪沙进行了一项基于社区的横断面研究。采用两阶段整群抽样和系统随机抽样方法，选取820户家庭作为样本。通过结构化的、由访谈员管理的问卷收集数据。如果在单个选定家庭中发现更多符合条件的儿童，则随机选择一名儿童，并从其照顾者那里访谈与免疫接种相关的信息。
结果
总体而言，5岁以下儿童完全接种疫苗的比例为45.2%。研究发现，照顾者年龄较小（β=-0.024，P值=0.019）、父亲具有高中及以上教育程度（调整后比值比[AOR]=1.755，95%置信区间[CI]=1.161-2.655，P值=0.008）、儿童年龄较小（β=-0.018，P值=0.011）、出生顺序为第五及以上（AOR=1.539，95%CI=1.011-2.343，P值=0.044）、照顾者已婚（AOR=4.101，95%CI=1.062-15.835，P值=0.041）、家庭月收入增加（β=0.003，P值=0.000）、就诊时疫苗可及（AOR=6.147，95%CI=1.943-19.441，P值=0.002）、疫苗成本可承受（AOR=1.951，95%CI=1.238-3.076，P值=0.004）、在医疗机构出生（AOR=1.517，95%CI=1.104-2.086，P值=0.010）、对免疫接种有良好认知（AOR=1.125，95%CI=1.070-1.181（此处原文可能有误，应为95%CI=1.070-1.181），P值=0.001）、对免疫接种有良好实践（AOR=2.756，95%CI=2.233-3.402，P值=0.001）以及对疫苗有良好认知（AOR=4.976，95%CI=2.183-11.340，P值=0.001）会增加免疫接种率。
结论
本研究结果显示，摩加迪沙5岁以下儿童完全免疫接种的比例非常低。发现有几个因素是实现完全免疫接种覆盖的障碍。应采取措施促进健康教育和疫苗可及性。
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