Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Front Public Health. 2024 May 1;12:1359572. doi: 10.3389/fpubh.2024.1359572. eCollection 2024.
One of the biggest breakthroughs of contemporary medicine is measles vaccination. It is essential for the total elimination of measles. Understanding the magnitude and determinants of effective second-dose measles vaccination coverage is a critical task. Accordingly, we set out to check the best available evidence of the pooled second-dose measles vaccination coverage among under-five children in East Africa.
We searched electronic databases such as PubMed, Google Scholar, Cochrane, and others. Two reviewers separately carried out the search of the Joanna Briggs Institute, selection of studies, critical appraisal, and data extraction. A third party was involved in resolving the disagreement among the reviewers. Seven studies included in this study, four from Ethiopia, two from Kenya, and one from Tanzania were cross-sectional and published in English language, with publication dates before 29 November 2023. Articles lacking full-text, the intended outcome, and that are not qualitative studies were excluded from the analysis. The Microsoft Excel checklist was used to extract the data and then exported to STATA 11. In addition, , Funnel plots, and Egger's test were employed to measure heterogeneity and detect publication bias, respectively. A random effect model was used.
The meta-analysis includes a total sample size of 4,962 children from seven articles. The pooled prevalence of second-dose measles vaccination among under-five children in East Africa was found to be 32.22% [95% CI; (18.82, 45.63)], and the significant factors were as follows: birth order (1.72; OR = 95% CI: 1.32, 2.23), information about measles-containing second-dose vaccine (MCV 2) (7.39; OR = 95% CI: 5.21, 10.50), mother's marital status (1.47; OR = 95% CI: 1.05, 2.07), complete immunization for other vaccines (2.17; OR = 95% CI: 1.49, 3.17), and distance of vaccination site (3.31; OR = 95% CI: 2.42, 4.53).
The current study found that pooled prevalence of second-dose measles vaccination coverage among under-five children was still very low. It was also observed that birth order, distance of the vaccination site, complete immunization for other vaccines, mother's marital status, and information about MCV were factors associated with second-dose measles vaccination. These factors imply that there is a need for countries and their partners to act urgently to secure political commitment, expand primary health service and health education, and increase vaccination coverage.
当代医学的最大突破之一是麻疹疫苗接种。它对于麻疹的全面消除至关重要。了解有效第二剂麻疹疫苗接种覆盖率的规模和决定因素是一项关键任务。因此,我们着手检查东非五岁以下儿童中第二剂麻疹疫苗接种覆盖率的最佳现有证据。
我们搜索了电子数据库,如 PubMed、Google Scholar、Cochrane 等。两位审查员分别进行了乔纳森·布里格斯研究所的搜索、研究选择、批判性评估和数据提取。第三方参与解决审查员之间的分歧。这项研究包括 7 项研究,其中 4 项来自埃塞俄比亚,2 项来自肯尼亚,1 项来自坦桑尼亚,均为横断面研究,发表于英语,发表日期在 2023 年 11 月 29 日之前。文章缺乏全文、预期结果且不是定性研究的文章被排除在分析之外。使用 Microsoft Excel 清单提取数据,然后将其导出到 STATA 11。此外,还使用漏斗图和 Egger 检验分别测量异质性和检测发表偏倚,使用随机效应模型。
荟萃分析包括来自七篇文章的总共 4962 名儿童的样本量。发现东非五岁以下儿童第二剂麻疹疫苗接种的总体流行率为 32.22%[95%CI;(18.82, 45.63)],显著相关因素包括:出生顺序(1.72;OR=95%CI:1.32, 2.23)、含麻疹成分的第二剂疫苗(MCV 2)信息(7.39;OR=95%CI:5.21, 10.50)、母亲的婚姻状况(1.47;OR=95%CI:1.05, 2.07)、其他疫苗的完全免疫接种(2.17;OR=95%CI:1.49, 3.17)和疫苗接种地点的距离(3.31;OR=95%CI:2.42, 4.53)。
目前的研究发现,五岁以下儿童第二剂麻疹疫苗接种覆盖率的总体流行率仍然很低。还观察到,出生顺序、疫苗接种地点的距离、其他疫苗的完全免疫接种、母亲的婚姻状况和 MCV 信息是与第二剂麻疹疫苗接种相关的因素。这些因素表明,各国及其合作伙伴需要紧急采取行动,确保政治承诺、扩大初级保健服务和健康教育,并提高疫苗接种覆盖率。