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埃塞俄比亚沃雷巴博地区12至23个月儿童母亲中儿童疫苗接种不完全的影响因素:非匹配病例对照研究。

Determinants of incomplete child vaccination among mothers of children aged 12-23 months in Worebabo district, Ethiopia: Unmatched case-control study.

作者信息

Abegaz Mesfin Yimer, Seid Awol, Awol Shikur Mohammed, Hassen Seid Legesse

机构信息

Department of Public Health St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Amhara Public Health Institute, Research and Technology Transfer Directorate, Dessie, Ethiopia.

出版信息

PLOS Glob Public Health. 2023 Aug 16;3(8):e0002088. doi: 10.1371/journal.pgph.0002088. eCollection 2023.

Abstract

In nations like Ethiopia, vaccination rates are low despite being one of the most effective public health treatments to protect infants from common infectious diseases that can be prevented by immunization. In Worebabo District, the reasons of the underutilization of vaccination programs are poorly understood. Therefore, this study aimed to identify determinants of incomplete childhood vaccination in the study setting. Community based unmatched case-control study was carried out among 441 mothers of children aged 12-23 months old (147 cases and 294 controls) in Worebabo District, Ethiopia from March 1-April 30, 2020. Using a multistage sampling process, mothers were chosen. Health professionals were trained to collect data using a pre-tested standardized questionnaire. Data entered into Epi Info version 7.2 and put through statistical analysis in SPSS version 23. Binary logistic regression was performed to determine the odds ratio with a 95%CL. A p-value of under 0.05 was estimated statistically significant. The study found that older moms (>35 years old) were more likely than younger mothers to fail to properly immunize their children (AOR = 2.4, 95% CI: 1.09, 5.28). In addition, mothers with incomplete vaccinations had lower knowledge of the benefits of vaccination (AOR = 2.02, 95% CI: 1.20, 3.39), Negative attitudes towards immunization (AOR = 4.9, 95% CI: 2.82, 8.49), less access to prenatal care (AOR = 3.68, 95% CI: 1.58, 8.54), home delivery (AOR = 5.47, 95% CI: 2.58)., 11.58), absent home visits (AOR = 3.56, 95% CI: 1.69, 7.48), and longer time to reach vaccination site (>1 h) (AOR = 10.07)., 95% CI: 1.75, 57.79) were found associated with mother incomplete vaccination of the child. Mothers being older age, less access to antenatal care services, place of home delivery, longer time to reach vaccination site, negative attitude and poor knowledge towards the benefit of vaccination were associated with mothers' incomplete vaccination of the child. Therefore, health professionals should inform and counsel mothers about the advantages of childhood immunization as well as the consequences of incomplete or not vaccination of children at the time of the facility visit and by community health workers during the routine home visit.

摘要

在埃塞俄比亚等国家,尽管疫苗接种是保护婴儿免受可通过免疫预防的常见传染病侵害的最有效的公共卫生措施之一,但疫苗接种率仍然很低。在沃雷巴博区,人们对疫苗接种计划未得到充分利用的原因了解甚少。因此,本研究旨在确定该研究环境中儿童疫苗接种不完全的决定因素。2020年3月1日至4月30日,在埃塞俄比亚沃雷巴博区对441名12至23个月大儿童的母亲(147例病例和294名对照)进行了基于社区的非匹配病例对照研究。采用多阶段抽样方法选择母亲。对卫生专业人员进行培训,使其使用预先测试的标准化问卷收集数据。数据录入Epi Info 7.2版本,并在SPSS 23版本中进行统计分析。进行二元逻辑回归以确定比值比及95%置信区间。p值小于0.05被认为具有统计学意义。研究发现,年龄较大的母亲(>35岁)比年轻母亲更有可能未正确为子女接种疫苗(比值比=2.4,95%置信区间:1.09,5.28)。此外,疫苗接种不完全的母亲对疫苗接种益处的了解较少(比值比=2.02,95%置信区间:1.20,3.39),对免疫接种持消极态度(比值比=4.9,95%置信区间:2.82,8.49),获得产前护理的机会较少(比值比=3.68,95%置信区间:1.58,8.54),在家分娩(比值比=5.47,95%置信区间:2.58,11.58),没有家访(比值比=3.56,95%置信区间:1.69,7.48),以及到达疫苗接种地点的时间较长(>1小时)(比值比=10.07,95%置信区间:1.75,57.79),这些因素都与母亲未完全为孩子接种疫苗有关。母亲年龄较大、获得产前护理服务的机会较少、在家分娩的地点、到达疫苗接种地点的时间较长、对疫苗接种益处持消极态度和了解不足,都与母亲未完全为孩子接种疫苗有关。因此,卫生专业人员应在产妇到医疗机构就诊时以及社区卫生工作者在常规家访时,向母亲宣传并咨询儿童免疫接种的好处以及儿童未完全接种或未接种疫苗的后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d49c/10431650/db00a750bcfe/pgph.0002088.g001.jpg

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