埃塞俄比亚北沃洛地区 2 岁以下儿童因战争而疫苗接种率下降的关联
Association of War With Vaccination Dropout Among Children Younger Than 2 Years in the North Wollo Zone, Ethiopia.
机构信息
School of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia.
Department of Statistics, Faculty of Natural and Computational Science, Woldia University, Woldia, Ethiopia.
出版信息
JAMA Netw Open. 2023 Feb 1;6(2):e2255098. doi: 10.1001/jamanetworkopen.2022.55098.
IMPORTANCE
A civil war that lasted for about 6 months in the North Wollo zone of Ethiopia destroyed numerous health care facilities. However, no studies have been conducted to determine the association of the war with vaccination dropout in the area.
OBJECTIVE
To assess the association of war with vaccination dropout among children younger than 2 years in the North Wollo zone.
DESIGN, SETTING, AND PARTICIPANTS: This population-based cross-sectional study was conducted in the North Wollo zone from April 1 to June 30, 2022. Participants included children younger than 2 years and their mothers. A multistage sampling technique was used to select the participants.
MAIN OUTCOMES AND MEASURES
A vaccination dropout rate (yes or no) was assessed by interviewing mothers.
RESULTS
The study included 449 children younger than 2 years and their mothers, 291 (64.8%) of whom were 20 to 34 years of age. Almost all of the mothers (426 [94.9%]) were married. More than half of the mothers (271 [60.4%]) had a primary level education. Seventy-one children (15.8%) in the area received all basic vaccinations. One hundred ninety-eight children (44.1%) who started vaccination prior to the war dropped out of the immunization program. Additionally, 64 children (14.3%) born during the war did not receive any vaccination. Losing a family member (adjusted odds ratio [AOR], 3.11 [95% CI, 1.63-5.93]; P = .001), not being informed about catch-up vaccination (AOR, 2.18 [95% CI, 1.39-3.43]; P < .001), being a rural resident (AOR, 2.22 [95% CI, 1.37-3.58]; P < .001), home birth (AOR, 1.75 [95% CI, 1.11-2.77]; P = .002), and length of war (AOR for 5 months, 0.51 [95% CI, 0.28-0.93; P = .04]) were associated with the outcome variable.
CONCLUSIONS AND RELEVANCE
The findings of this cross-sectional study suggest that nearly 60% of children in the North Wollo zone remained undervaccinated or unvaccinated. Stakeholders should make coordinated efforts to overcome the humanitarian crisis in the area and optimize the accessibility of health services.
重要性
埃塞俄比亚北沃洛地区持续约 6 个月的内战摧毁了众多医疗保健设施。然而，尚未有研究确定战争与该地区疫苗接种率下降之间的关联。
目的
评估北沃洛地区 2 岁以下儿童因战争导致的疫苗接种率下降情况。
设计、地点和参与者：这是一项基于人群的横断面研究，于 2022 年 4 月 1 日至 6 月 30 日在北沃洛地区进行。参与者包括 2 岁以下的儿童及其母亲。采用多阶段抽样技术选择参与者。
主要结果和措施
通过采访母亲来评估疫苗接种率（是或否）。
结果
该研究纳入了 449 名 2 岁以下的儿童及其母亲，其中 291 名（64.8%）年龄在 20 至 34 岁之间。几乎所有的母亲（426 名[94.9%]）都已婚。超过一半的母亲（271 名[60.4%]）接受过小学教育。该地区有 71 名儿童（15.8%）接受了所有基础疫苗接种。在战争前开始接种疫苗的 198 名儿童（44.1%）退出了免疫计划。此外，有 64 名（14.3%）在战争期间出生的儿童未接受任何疫苗接种。失去家庭成员（调整后的优势比[OR]，3.11[95%置信区间，1.63-5.93]；P=0.001）、未被告知补种疫苗（OR，2.18[95%置信区间，1.39-3.43]；P<0.001）、居住在农村地区（OR，2.22[95%置信区间，1.37-3.58]；P<0.001）、在家分娩（OR，1.75[95%置信区间，1.11-2.77]；P=0.002）和战争持续时间（5 个月的 OR，0.51[95%置信区间，0.28-0.93；P=0.04]）与结局变量相关。
结论和相关性
这项横断面研究的结果表明，北沃洛地区近 60%的儿童仍未接种或未接种疫苗。利益相关者应共同努力，克服该地区的人道主义危机，并优化卫生服务的可及性。
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