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孟加拉国 06-59 个月儿童疫苗接种的趋势和决定因素:1993 年至 2014 年的国家代表性调查。

Trends and determinants of vaccination among children aged 06-59 months in Bangladesh: country representative survey from 1993 to 2014.

机构信息

Department of Statistics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.

School of Mathematics, Statistics & Physics, Newcastle University, Newcastle upon Tyne, UK.

出版信息

BMC Public Health. 2021 Aug 21;21(1):1578. doi: 10.1186/s12889-021-11576-0.

Abstract

BACKGROUND

Vaccination has important consequences for childhood development, mortality, and inequalities in health and well-being. This research explores the trend of vaccinations coverage from 1993 to 2014 and determines the significant factors for vaccinations coverage in Bangladesh, considering geospatial, socioeconomic, and demographic characteristics.

METHODS

This study uses a secondary dataset extracted from the Bangladesh Demographic and Health Survey (BDHS) from 1992 to 93 to 2014. The association between selected independent variables and vaccination coverage of children was examined through the Chi-square test. In addition, unadjusted and adjusted logistic regression approaches were applied to determine the effects of covariates on vaccination status by using the BDHS-2014 dataset.

RESULTS

The results reveal that the trend of the vaccination coverage rate has gradually been increased over the study period. The coverage rate of BCG is observed maximum while the lowest for Measles vaccination among all types of vaccinations. The findings revealed that the significantly lower coverage of all vaccination had been observed in the Sylhet region. Children of higher educated mothers (OR 10.21; CI: 4.10-25.37) and father (OR 8.71; CI: 4.03-18.80), born at health facilities (OR 4.53; CI: 2.4-8.55) and whose mother has media exposure (OR 3.20; CI: 2.22-4.60) have more chance of receiving BCG vaccine. For DPT vaccination coverage, there is a significant difference from children whose mothers have primary (OR 1.7; CI: 1.35-2.15), secondary (OR 3.5; CI: 2.75-4.45), and higher (OR 9.6; CI: 5.28-17.42) educational qualification compared to children of illiterate mothers. Findings demonstrated that children born in wealthier households have a higher likelihood of being immunized against DPT, Polio, and Measles vaccination than children born in the poorest households.

CONCLUSIONS

The findings reveal that to enhance and make sustainable the overall country's vaccination coverage, we should pay more attention to the mother's education, socioeconomic condition, children's age, birth order number, having media exposure, place of residence, and religion. The authors think that this finding would be helpful to accelerate the achievement target of Sustainable Development Goals (SDGs) for children's health in Bangladesh.

摘要

背景

疫苗接种对儿童发展、死亡率以及健康和福祉方面的不平等有着重要影响。本研究旨在探讨 1993 年至 2014 年期间疫苗接种覆盖率的趋势,并考虑到地理空间、社会经济和人口特征,确定孟加拉国疫苗接种覆盖率的重要影响因素。

方法

本研究使用了 1992 年至 1993 年至 2014 年期间从孟加拉国人口与健康调查(BDHS)中提取的二次数据集。通过卡方检验,研究了选定的自变量与儿童疫苗接种覆盖率之间的关联。此外,还使用 BDHS-2014 数据集,通过未调整和调整后的逻辑回归方法,确定了协变量对疫苗接种状况的影响。

结果

结果表明,在研究期间,疫苗接种覆盖率的趋势逐渐上升。在所有类型的疫苗接种中,BCG 的接种率最高,而麻疹的接种率最低。研究结果表明,在锡尔赫特地区,所有疫苗接种的覆盖率明显较低。母亲受过高等教育(OR 10.21;95%CI:4.10-25.37)和父亲(OR 8.71;95%CI:4.03-18.80)、在医疗设施出生(OR 4.53;95%CI:2.4-8.55)以及母亲接触媒体(OR 3.20;95%CI:2.22-4.60)的儿童更有可能接种卡介苗。在 DPT 疫苗接种覆盖率方面,与母亲为文盲的儿童相比,母亲接受过小学(OR 1.7;95%CI:1.35-2.15)、中学(OR 3.5;95%CI:2.75-4.45)和高等教育(OR 9.6;95%CI:5.28-17.42)的儿童更有可能接种 DPT 疫苗。研究结果表明,与出生在最贫困家庭的儿童相比,出生在较富裕家庭的儿童更有可能接种 DPT、脊髓灰质炎和麻疹疫苗。

结论

研究结果表明,为了提高和保持全国整体疫苗接种覆盖率,我们应该更加关注母亲的教育、社会经济状况、儿童的年龄、出生顺序、接触媒体、居住地和宗教信仰。作者认为,这一发现将有助于加速孟加拉国儿童健康可持续发展目标(SDGs)的实现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a1c/8379894/6968e5ce7ba4/12889_2021_11576_Fig1_HTML.jpg

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