Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Public Health. 2024 Nov;236:365-372. doi: 10.1016/j.puhe.2024.09.011. Epub 2024 Sep 19.
Vaccination is a crucial public health intervention protecting individuals and communities from vaccine-preventable diseases. However, unvaccinated children in low- and middle-income countries pose a significant challenge. Ethiopia, a Global Alliance for Vaccines and Immunisation (GAVI)-supported country, ranks fifth in zero-dose immunisation burden, indicating concerning vaccine coverage gaps. Despite the severity of this issue, there is a dearth of research investigating the disparities, prevalence and contributing factors associated with zero-dose children in Ethiopia. This study aimed to assess the prevalence, spatial distribution and determinants of zero-dose children in Ethiopia.
A community-based cross-sectional study was conducted using data from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). Data were collected from 21 March 2019 to 28 June 2019.
The study included a total of 1334 children aged 12-35 months (weighted sample). For spatial and multilevel analyses, ArcGIS 10.8 and Stata 17 software were used, respectively. The measure of association was determined by computing the adjusted odds ratio (AOR) at a 95 % confidence interval (95 % CI), and a p-value <0.05 was considered statistically significant.
The prevalence of zero-dose children in Ethiopia was 46.5 % (95 % CI: 43.8, 49.2). Southeast Amhara, Afar, Somali, Oromia and SNNPR (Southern Nations, Nationalities and Peoples' Region) regions had high zero-dose proportions. Maternal age 15-19 years (AOR = 1.63; 95 % CI: 1.05, 2.64), lack of antenatal care (AOR = 1.77; 95 % CI: 1.34, 2.35), rural residence (AOR = 1.94; 95 % CI: 1.17, 3.19) and region were significantly associated to zero-dose status in Ethiopia.
The prevalence of zero-dose children in Ethiopia was high and the distribution exhibited significant variation across the country's clusters. Individual and community factors were key contributors. It is essential that areas with a high prevalence of zero-dose children have access to recommended childhood vaccines. This proactive approach can help protect children from morbidity and mortality caused by vaccine-preventable diseases.
接种疫苗是保护个人和社区免受可预防疾病侵害的重要公共卫生干预措施。然而，低收入和中等收入国家未接种疫苗的儿童是一个重大挑战。埃塞俄比亚是全球疫苗和免疫联盟（GAVI）支持的国家，在零剂量免疫负担方面排名第五，这表明疫苗覆盖差距令人担忧。尽管这一问题很严重，但很少有研究调查埃塞俄比亚零剂量儿童的差异、流行情况和相关因素。本研究旨在评估埃塞俄比亚零剂量儿童的流行率、空间分布和决定因素。
这是一项基于社区的横断面研究，使用了 2019 年埃塞俄比亚微型人口和健康调查（EMDHS）的数据。数据收集于 2019 年 3 月 21 日至 6 月 28 日。
本研究共纳入了 1334 名 12-35 月龄儿童（加权样本）。对于空间和多层次分析，分别使用了 ArcGIS 10.8 和 Stata 17 软件。关联度的衡量指标是计算调整后的优势比（AOR）和 95%置信区间（95%CI），p 值<0.05 被认为具有统计学意义。
埃塞俄比亚零剂量儿童的流行率为 46.5%（95%CI：43.8，49.2）。东南阿姆哈拉、阿法尔、索马里、奥罗莫和南苏丹（南方州、民族和人民地区）地区的零剂量比例较高。母亲年龄 15-19 岁（AOR=1.63；95%CI：1.05，2.64）、缺乏产前保健（AOR=1.77；95%CI：1.34，2.35）、农村居住（AOR=1.94；95%CI：1.17，3.19）和地区与埃塞俄比亚的零剂量状况显著相关。
埃塞俄比亚零剂量儿童的流行率较高，其分布在全国各地区呈现出显著差异。个人和社区因素是主要因素。高零剂量儿童地区获得推荐的儿童疫苗至关重要。这种积极主动的方法有助于保护儿童免受疫苗可预防疾病的发病率和死亡率的影响。
