比较乌干达坎帕拉市贫民窟和伊甘加区农村地区 0-23 个月儿童的完全免疫接种状况：一项横断面研究。

Comparing full immunisation status of children (0-23 months) between slums of Kampala City and the rural setting of Iganga District in Uganda: a cross-sectional study.

机构信息

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

Edward Francis Small Teaching Hospital, Banjul, The Gambia.

出版信息

BMC Health Serv Res. 2023 Aug 14;23(1):856. doi: 10.1186/s12913-023-09875-w.

DOI:10.1186/s12913-023-09875-w

PMID:37580708

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10424339/

Abstract

BACKGROUND

Immunisation remains the most cost-effective public health intervention in preventing morbidity and mortality due to Vaccine-Preventable Diseases (VPDs). The study aims to compare the differences in immunisation coverage amongst children aged 0 to 23 months living in slums of Kampala city and Iganga as rural districts in Uganda.

METHODS

This study utilises data from a cross-sectional survey done in 2019 in the slums of Kampala City and the rural district of Iganga within the Health and Demographic Surveillance Site (HDSS). It included 1016 children aged 0-23 months and their parents. A logistic regression model was used to analyse the relationship between multiple independent variables and the binary dependent variables (fully immunised) using Stata statistical software. The measures of association were odds ratios reported with a corresponding 95% confidence interval.

RESULTS

Out of the 1016 participants, 544 participants live in the rural area and 472 participants in the slums. Slums had 48.9% (n = 231) of fully immunised children whilst rural areas had 43.20% (n = 235). The multivariate analysis showed that children living in slums are more likely to be fully immunised as compared to their counterparts in rural areas (Odds ratio:1.456; p = 0.033; CI:1.030-2.058). Immunisation coverage for BCG (98.9%), Polio 0 (88.2%), Penta1 (92.7%), and Pneumo1 (89.8%) were high in both settlements. However, the dropout rate for subsequent vaccines was high 17%, 20% and 41% for Penta, pneumococcal and rota vaccines respectively. There was poor uptake of the new vaccines with slums having 73.4% and 47.9% coverage for pneumococcal and rota vaccines respectively and rural areas had 72.1% and 7.5% for pneumococcal and rota vaccines respectively.

CONCLUSION

The low full immunisation status in this study was attributed to the child's residence and the occupation of the parents. Lack of education and poor access to messages on immunisation (inadequate access to mass media) are other contributing factors. Educational messages on the importance of immunisation targeting these underserved populations will improve full immunisation coverage.

摘要

背景

免疫接种仍然是预防疫苗可预防疾病（VPD）导致发病率和死亡率的最具成本效益的公共卫生干预措施。本研究旨在比较居住在坎帕拉市贫民窟和乌干达伊甘加农村地区的 0 至 23 个月龄儿童的免疫接种覆盖率差异。

方法

本研究利用了 2019 年在坎帕拉市贫民窟和伊甘加农村地区进行的横断面调查的数据，该调查位于健康和人口监测站点（HDSS）内。它包括 1016 名 0-23 个月大的儿童及其父母。使用 Stata 统计软件，使用逻辑回归模型分析多个自变量与二项因变量（完全免疫）之间的关系。使用比值比（OR）及其相应的 95%置信区间（CI）报告关联度量。

结果

在 1016 名参与者中，544 名参与者居住在农村地区，472 名参与者居住在贫民窟。贫民窟中有 48.9%（n=231）的儿童完全接种了疫苗，而农村地区则有 43.20%（n=235）。多变量分析表明，与农村地区的同龄人相比，居住在贫民窟的儿童更有可能完全接种疫苗（比值比：1.456；p=0.033；95%CI：1.030-2.058）。卡介苗（BCG）接种率为 98.9%，脊髓灰质炎 0 （Polio 0）接种率为 88.2%，百白破疫苗（Penta1）接种率为 92.7%，肺炎球菌 1 型疫苗（Pneumo1）接种率为 89.8%，两者的接种率都很高。然而，后续疫苗的辍学率很高，百白破疫苗、肺炎球菌疫苗和轮状病毒疫苗的辍学率分别为 17%、20%和 41%。新疫苗的接种率较低，贫民窟的肺炎球菌疫苗和轮状病毒疫苗覆盖率分别为 73.4%和 47.9%，农村地区的肺炎球菌疫苗和轮状病毒疫苗覆盖率分别为 72.1%和 7.5%。