Kenya Field Epidemiology and Laboratory Training Program, Ministry of Health, Nairobi, Kenya.
Department of Health, Trans Nzoia County, Kitale, Kenya.
PLoS One. 2022 Feb 23;17(2):e0263780. doi: 10.1371/journal.pone.0263780. eCollection 2022.
Measles is a vaccine-preventable disease whose elimination depends on the measles-containing vaccine (MCV) coverage of ≥95% in the population. In 2020, Kenya reported 597 cases, an increase of 158 cases from those reported in 2019. This study aimed to estimate the measles vaccine coverage and factors associated with its uptake in Cherangany Sub County.
We conducted a cross-sectional study using cluster sampling in the Cherangany Sub County of Trans Nzoia County in May 2021. We enrolled eligible children aged between 24-59 months and interviewed their caregivers using a structured questionnaire. We conducted descriptive, bivariate, and multivariate analyses. We used Prevalence Odds Ratio (POR) at bivariate and adjusted POR (aPOR) at multivariate with their corresponding 95% confidence interval as the measure of association. We regarded the variables with a p-value of less <0.05 at the multivariate level as independently associated with immunization status.
We recruited 536 eligible children. The median age of the participants was 39 months (Interquartile Range 31-50). The coverage was 96.6% (518/536) for MCV dose one (MCV 1), and 56.2% (301/536) MCV dose two (MCV 2). At the bivariate level, family monthly income (POR 2.32, 95% CI 1.14-4.72), child vaccination status for other scheduled vaccines (POR 0.21, 95% CI 0.07-0.66), caregiver's level of education (POR = 1.82, 95% CI 1.29-2.57), knowledge of the vaccine-preventable diseases (POR = 0.55, 95% CI 0.38-0.80), and knowledge of the number of MCV scheduled doses (POR = 0.13, 95% CI 0.09-0.02) were significantly associated with MCV uptake. The Caregiver's knowledge on the number of MCV scheduled doses (POR = 5.73, 95% CI 3.48-9.45) and children whose birth order was ≤5th born (POR = 0.5, 95% CI 0.22-0.95) were significantly associated with MCV uptake at the multivariate analysis.
The MCV 2 coverage was lower than the WHO recommended ≥ 95%. Lack of knowledge of the number of MCV scheduled doses and the child's birth order in the family are factors associated with not being fully vaccinated against measles.
There is a need to strengthen the defaulter tracing system to follow up the children who default after receiving MCV 1, focusing interventions on the identified factors.
麻疹是一种可通过疫苗预防的疾病,其消除取决于人群中含麻疹疫苗(MCV)的覆盖率≥95%。2020 年,肯尼亚报告了 597 例病例,比 2019 年报告的病例增加了 158 例。本研究旨在评估切兰加尼县的麻疹疫苗覆盖率及其与疫苗接种率相关的因素。
我们于 2021 年 5 月在肯尼亚Trans Nzoia 县切兰加尼县进行了一项横断面研究,采用了聚类抽样方法。我们招募了 24-59 个月龄的合格儿童,并使用结构化问卷对其照顾者进行了访谈。我们进行了描述性、双变量和多变量分析。我们使用双变量时的患病率比值比(POR)和多变量时的调整后 POR(aPOR)及其相应的 95%置信区间作为关联的衡量标准。我们认为多变量水平下 p 值<0.05 的变量与免疫状况独立相关。
我们招募了 536 名合格儿童。参与者的中位年龄为 39 个月(四分位距 31-50)。MCV1 覆盖率为 96.6%(518/536),MCV2 覆盖率为 56.2%(301/536)。在双变量水平上,家庭月收入(POR 2.32,95%CI 1.14-4.72)、儿童其他计划疫苗接种状况(POR 0.21,95%CI 0.07-0.66)、照顾者的教育水平(POR=1.82,95%CI 1.29-2.57)、疫苗可预防疾病的知识(POR=0.55,95%CI 0.38-0.80)和 MCV 计划剂量数的知识(POR=0.13,95%CI 0.09-0.02)与 MCV 接种率显著相关。照顾者对 MCV 计划剂量数的知识(POR=5.73,95%CI 3.48-9.45)和孩子的出生顺序在第 5 位及以后(POR=0.5,95%CI 0.22-0.95)与多变量分析中的 MCV 接种率显著相关。
MCV2 覆盖率低于世卫组织建议的≥95%。缺乏对 MCV 计划剂量数的了解以及家庭中孩子的出生顺序是未完全接种麻疹疫苗的相关因素。
有必要加强对 MCV1 接种后未及时接种的儿童进行追踪,重点关注已确定的因素。