Odero Christopher Ochieng', Othero Doreen, Were Vincent Omondi, Ouma Collins
Department of Public Health, Maseno University, Kisumu, Kenya.
KEMRI Wellcome-Trust Research Program, Health Economics Research Unit, Nairobi, Kenya.
PLOS Glob Public Health. 2024 May 30;4(5):e0003048. doi: 10.1371/journal.pgph.0003048. eCollection 2024.
Vaccination is crucial in reducing child mortality and the prevalence of Vaccine-Preventable-Diseases (VPD), especially in low-and-middle-income countries like Kenya. However, non-vaccination, under-vaccination, and missed opportunities for vaccination (MOV) pose significant challenges to these efforts. This study aimed to analyze the impact of demographic and socio-economic factors on non-vaccination, under-vaccination, and MOV among children aged 0-23 months in Kenya from 2003 to 2014. A secondary data analysis of data from the Kenya Demographic Health Surveys (KDHS) conducted during this period was conducted, with a total of 11,997 participants, using a two-stage, multi-stage, and stratified sampling technique. The study examined factors such as child's sex, residence, mother's age, marital status, religion, birth order, maternal education, wealth quintile, province, child's birth order, parity, number of children in the household, place of delivery, and mother's occupation. Binary logistic regression was employed to identify the determinants of non-vaccination, under-vaccination, and MOV, and multivariable logistic regression analysis to report odds ratios (OR) and their corresponding 95% confidence intervals (CI). In 2003, the likelihood of non-vaccination decreased with higher maternal education levels: mothers who did not complete primary education (AOR = 0.55, 95% CI = 0.37-0.81), completed primary education (AOR = 0.34, 95% CI = 0.21-0.56), and had secondary education or higher (AOR = 0.26, 95% CI = 0.14-0.50) exhibited decreasing probabilities. In 2008/09, divorced/separated/widowed mothers (AOR = 0.22, 95% CI = 0.07-0.65) and those with no religion (AOR = 0.37, 95% CI = 0.17-0.81) showed lower odds of non-vaccination, while lower wealth quintiles were associated with higher odds. In 2014, non-vaccination was higher among younger mothers aged 15-19 years (AOR = 12.53, 95% CI = 1.59-98.73), in North Eastern Province (AOR = 7.15, 95% CI = 2.02-25.30), in families with more than 5 children (AOR = 4.19, 95% CI = 1.09-16.18), and in children born at home (AOR = 4.47, 95% CI = 1.32-15.17). Similar patterns were observed for under-vaccination and MOV. This information can inform strategies for bridging the gaps in immunization coverage and promoting equitable vaccination practices in Kenya.
疫苗接种对于降低儿童死亡率和疫苗可预防疾病（VPD）的流行率至关重要，尤其是在肯尼亚等中低收入国家。然而，未接种疫苗、疫苗接种不足以及错过疫苗接种机会（MOV）对这些努力构成了重大挑战。本研究旨在分析2003年至2014年期间肯尼亚0至23个月儿童的人口统计学和社会经济因素对未接种疫苗、疫苗接种不足和MOV的影响。对在此期间进行的肯尼亚人口与健康调查（KDHS）的数据进行了二次数据分析，共11997名参与者，采用两阶段、多阶段和分层抽样技术。该研究考察了儿童性别、居住地、母亲年龄、婚姻状况、宗教、出生顺序、母亲教育程度、财富五分位数、省份、儿童出生顺序、胎次、家庭子女数量、分娩地点和母亲职业等因素。采用二元逻辑回归来确定未接种疫苗、疫苗接种不足和MOV的决定因素，并采用多变量逻辑回归分析来报告优势比（OR）及其相应的95%置信区间（CI）。2003年，随着母亲教育水平的提高，未接种疫苗的可能性降低：未完成小学教育的母亲（调整后优势比[AOR]=0.55，95%置信区间=0.37-0.81）、完成小学教育的母亲（AOR=0.34，95%置信区间=0.21-0.56）以及接受过中等教育或更高教育的母亲（AOR=0.26，95%置信区间=0.14-0.50）的概率逐渐降低。在2008/09年，离婚/分居/丧偶的母亲（AOR=0.22，95%置信区间=0.07-0.65）和无宗教信仰的母亲（AOR=0.37，95%置信区间=0.17-0.81）未接种疫苗的几率较低，而较低的财富五分位数与较高的几率相关。2014年，15至19岁的年轻母亲（AOR=12.53，95%置信区间=1.59-98.73）、东北省（AOR=7.15，95%置信区间=2.02-25.30）、有5个以上孩子的家庭（AOR=4.19，95%置信区间=1.09-16.18）以及在家中出生的儿童（AOR=4.47，95%置信区间=1.32-（此处原文95%置信区间上限有误，应为15.17）15.17）未接种疫苗的比例较高。在疫苗接种不足和MOV方面也观察到了类似的模式。这些信息可为弥合肯尼亚免疫接种覆盖率差距和促进公平疫苗接种实践的策略提供参考。
