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加纳12至35个月儿童按国家免疫规划程序完成疫苗接种的覆盖率及影响因素

Prevalence and determinants of full vaccination coverage according to the national schedule among children aged 12-35 months in Ghana.

作者信息

Tekeba Berhan, Tamir Tadesse Tarik, Zegeye Alebachew Ferede

机构信息

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.

出版信息

Sci Rep. 2025 Jan 2;15(1):13. doi: 10.1038/s41598-024-84481-2.

Abstract

Universal immunization of children against common vaccine-preventable diseases is crucial in reducing infant and child morbidity and mortality. Assessing the vaccination coverage is a key step to improve utilization and coverage of vaccines for under-five children. Accordingly, vaccination coverage according to the national schedule assesses the vaccination coverage of children aged 12-35 months. However, there is a scarcity of information on the full vaccination coverage according to the national schedule and its determinants in Ghana. Therefore, this study aimed to assess the prevalence and predictors of vaccination coverage according to the national schedule among children aged 12-35 months in Ghana. A cross-sectional study design using the most recent demographic and health survey data from the Ghana Demographic and Health Survey was used. We included a total weighted sample of 1,823 children aged 12-35 months in the five years preceding the survey. We used a multilevel logistic regression model to identify associated factors for vaccination coverage according to the national schedule in Ghana. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of < 0.05 are declared statistically significant. In this study, the full coverage of vaccination according to the national schedule among children aged 12-35 months in Ghana was 56.45% (95% CI 51.77-56.17). Women having an ANC visit were 40% more likely (AOR = 1.40, 95% CI 1.07-1.83), women involved in healthcare decision-making were 35% more likely (AOR = 1.35, 95% CI 1.05-1.75), Women who deliver in a health facility were 1.91 times more likely (AOR = 1.91, 95% CI 1.36-2.66), and communities with high media exposure were 47% more likely (AOR = 1.47, 95% CI 1.06-2.05) to achieve full vaccination coverage as compared to their counterparts. On the other hand, being in the Western (AOR = 0.4, 95% CI 0.18-0.88) and Northern (AOR = 0.33, 95% CI 0.15-0.74) regions decreased the odds of attaining full vaccination coverage according to the national schedule in Ghana. The full vaccination coverage according to the national schedule in Ghana was lower as compared to 90% coverage recommendation by World Health organization, and there is also in-equality among regions. Maternal optimal ANC contact, health facility delivery, women involved in health care decision-making, community media exposure, and region were significantly associated with full vaccination coverage according to the national schedule in Ghana. To improve child immunization coverage, relevant authorities and stakeholders should work together to improve ANC visits, media exposure, facility delivery, and women's empowerment, and attention should be given to deviant regions.

摘要

让儿童普遍接种针对常见疫苗可预防疾病的疫苗对于降低婴幼儿发病率和死亡率至关重要。评估疫苗接种覆盖率是提高五岁以下儿童疫苗利用率和覆盖率的关键一步。因此,按照国家免疫规划程序评估疫苗接种覆盖率可评估12至35个月龄儿童的疫苗接种情况。然而,在加纳,关于按照国家免疫规划程序的全程疫苗接种覆盖率及其决定因素的信息匮乏。因此,本研究旨在评估加纳12至35个月龄儿童按照国家免疫规划程序的疫苗接种覆盖率及其预测因素。采用横断面研究设计,使用了来自加纳人口与健康调查的最新人口与健康调查数据。我们纳入了调查前五年中1823名年龄在12至35个月之间的儿童的加权样本。我们使用多水平逻辑回归模型来确定加纳按照国家免疫规划程序的疫苗接种覆盖率的相关因素。计算95%置信区间下的调整比值比,以评估解释变量和结果变量之间关联的强度和显著性。p值<0.05的因素被判定具有统计学显著性。在本研究中,加纳12至35个月龄儿童按照国家免疫规划程序的全程疫苗接种覆盖率为56.45%(95%置信区间51.77 - 56.17)。进行过产前检查的女性实现全程疫苗接种的可能性高40%(调整比值比=1.40,95%置信区间1.07 - 1.83),参与医疗保健决策的女性可能性高35%(调整比值比=1.35,95%置信区间1.05 - 1.75),在医疗机构分娩的女性可能性高1.91倍(调整比值比=1.91,95%置信区间1.36 - 2.66),与其他社区相比,媒体曝光度高的社区实现全程疫苗接种的可能性高47%(调整比值比=1.47,95%置信区间1.06 - 2.05)。另一方面,位于西部地区(调整比值比=0.4,95%置信区间0.18 - 0.88)和北部地区(调整比值比=0.33,95%置信区间0.15 - 0.74)会降低加纳按照国家免疫规划程序实现全程疫苗接种的几率。与世界卫生组织90%的覆盖率建议相比加纳按照国家免疫规划程序的全程疫苗接种覆盖率较低,并且各地区之间也存在不平等现象。产妇进行最佳产前检查、在医疗机构分娩、参与医疗保健决策的女性、社区媒体曝光度以及地区与加纳按照国家免疫规划程序的全程疫苗接种覆盖率显著相关。为提高儿童免疫接种覆盖率,相关当局和利益攸关方应共同努力改善产前检查、媒体曝光度、在医疗机构分娩以及增强妇女权能的情况,并应对存在偏差的地区予以关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0d3/11696136/4a63331d50b4/41598_2024_84481_Fig1_HTML.jpg

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