Bassoum Oumar, Ba Mouhamadou Faly, Sougou Ndeye Mareme, Sow Adama, Seck Ibrahima
Department of preventive medicine and public health, faculty of medicine, pharmacy and odontology, Cheikh Anta Diop University, Dakar, Senegal.
Institute of Health and Development, Cheikh Anta Diop University, Dakar, Senegal.
PLOS Glob Public Health. 2024 Aug 27;4(8):e0002734. doi: 10.1371/journal.pgph.0002734. eCollection 2024.
In developing countries, hepatitis B is spread primarily by the perinatal or horizontal route. Thus, the Senegalese government recommends administering the birth dose of the hepatitis B vaccine (HepB0) within 24 hours of birth. The objective was to identify the determinants of timely administration of HepB0 in Senegal in 2019. A secondary analysis of the demographic and health survey was carried out. The study population consisted of children aged 12 to 23 months. A cluster survey, stratified in urban and rural areas, drawn at two stages, was carried out. Individual interviews were conducted. Logistic regression was applied to estimate the adjusted odds ratio (aOR) and their 95% confidence interval. In total, 1130 children were included. Among them, 48.1% were born to mothers aged 25 to 34, 46.8% were male and 82.6% were born in health facilities. The average time between birth and HepB0 administration was 13.1±46.6 days. The median is 0 days [IQR: 0-12] with a minimum of 0 days and a maximum of 414 days. Among 747 children vaccinated, only 65.2% were vaccinated within 24 hours of birth. The determinants were maternal age of at least 35 years (aOR = 2.03 [1.29-3.20]), primary education of the mother (aOR = 1.94 [1.13-3. 35]), at least four antenatal care visits (aOR = 1.74 [1.12-2.69]), belonging to the central (ORa = 0.22 [0.11-0.44]) and northern regions (aOR = 0.18 [0.08-0.40]), and delivery in a health facility (aOR = 3.42 [1.90-6.15]). Education and keeping girls in school, local postnatal care in hard-to-reach regions, promotion of antenatal acre and delivery in a health facility should improve the timeliness of HepB0 vaccination.
在发展中国家,乙型肝炎主要通过围产期或水平传播途径传播。因此,塞内加尔政府建议在婴儿出生后24小时内接种首剂乙型肝炎疫苗(HepB0)。目的是确定2019年塞内加尔及时接种HepB0的决定因素。对人口与健康调查进行了二次分析。研究人群为12至23个月大的儿童。开展了一项分城市和农村地区、分两个阶段进行的整群抽样调查,并进行了个人访谈。应用逻辑回归来估计调整后的优势比(aOR)及其95%置信区间。总共纳入了1130名儿童。其中,48.1%的儿童母亲年龄在25至34岁之间,46.8%为男性,82.6%在医疗机构出生。出生至接种HepB0的平均时间为13.1±46.6天。中位数为0天[四分位间距:0 - 12],最短为0天,最长为414天。在747名接种疫苗的儿童中,只有65.2%在出生后24小时内接种。决定因素包括母亲年龄至少35岁(aOR = 2.03 [1.29 - 3.20])、母亲接受过小学教育(aOR = 1.94 [1.13 - 3.35])、至少进行过四次产前检查(aOR = 1.74 [1.12 - 2.69])、属于中部地区(ORa = 0.22 [0.11 - 0.44])和北部地区(aOR = 0.18 [0.08 - 0.40]),以及在医疗机构分娩(aOR = 3.42 [1.90 - 6.15])。教育并让女孩上学、在难以到达的地区提供当地产后护理、推广产前护理以及在医疗机构分娩应能提高HepB0疫苗接种的及时性。