Bantie Getasew Mulat, Tadege Melaku, Nigussie Teshager Zerihun, Woya Ashenafi Abate, Tekile Abay Kassa, Melese Amare Alemu, Ayalew Simeneh, Beyene Belay Bezabih, Wubetu Gizachew Yismaw
Regional Data Management Center for Health, Amhara National Regional State Public Health Institute, Bahir Dar, Ethiopia.
Department of Statistics, College of Science, Debre Tabor University, Debre Tabor, Ethiopia.
PLoS One. 2025 Jan 9;20(1):e0312514. doi: 10.1371/journal.pone.0312514. eCollection 2025.
The full pentavalent (DPT-HepB-Hib) vaccination is the main strategy to prevent five communicable diseases in early childhood, especially in countries with huge communicable disease burdens like Ethiopia. Exploring spatial distributions and determinants of full pentavalent vaccination status in minor ecological areas in Ethiopia is crucial for creating targeted immunization campaigns and monitoring the advancement of accomplishing sustainable development goals. This study aimed to investigate the spatial disparities and determinants of full pentavalent vaccination among 12-23-month-old children in Ethiopia.
The data on pentavalent vaccine uptake was found in the Ethiopian Health and Demographic Survey (EDHS, 2019). A two-stage cluster sampling method was applied to collect the EDHS data. The enumeration area was the primary sample unit while the household served as the secondary sampling unit. The geographical variations of full pentavalent vaccine uptake were explored using Quantum Geographic Information System (QGIS) software. The significant predictors of full pentavalent vaccination were identified using a simple logistic regression model through R version 4.1 software.
The national full pentavalent vaccine uptake was 59.2%. The spatial distribution of full pentavalent vaccine uptake was not uniform in Ethiopia. Spatial cluster analysis revealed that most of low coverage regions for full pentavalent vaccine uptake were Afar, Somali, and Harari. The regions with the highest and lowest rates of vaccine uptake were Tigray and Harari region, respectively. Maternal age of 35-49 years (AOR = 3.42; 95% CI: 1.99, 5.87), and 25-34 years (AOR = 1.55; 95% CI: 1.17, 2.19), primary education attended (AOR = 1.51; 95%CI: 1.07, 2.11), richness wealth index (AOR = 1.96; 95% CI: 1.40, 2.75), birth order of 1-3 (AOR = 1.88; 95% CI: 1.19, 2.96), and delivery in the health facility (AOR = 3.41: 95% CI: 2.52, 4.61) were the determinants of full pentavalent vaccine uptake in Ethiopia.
Ethiopia's full pentavalent vaccine uptake was far lower than the global target. Older maternal age, maternal education, wealth index, birth order, and giving birth in a health facility were the determinants of full pentavalent vaccine uptake. Special attention should be given to Afar, Somali, and Harari regions, to strengthen the vaccine uptake. Moreover, improved socioeconomic status and getting maternal health services during delivery are necessary to enhance vaccine uptake.
五价联合疫苗（白百破-乙肝- Hib）接种是预防幼儿期五种传染病的主要策略，尤其是在像埃塞俄比亚这样传染病负担沉重的国家。探索埃塞俄比亚小生态区域内五价联合疫苗接种状况的空间分布及其决定因素，对于开展有针对性的免疫运动以及监测实现可持续发展目标的进展情况至关重要。本研究旨在调查埃塞俄比亚12至23个月大儿童中五价联合疫苗接种的空间差异及其决定因素。
五价疫苗接种数据来自埃塞俄比亚卫生和人口调查（EDHS，2019年）。采用两阶段整群抽样方法收集EDHS数据。枚举区域是主要抽样单位，家庭是次要抽样单位。使用量子地理信息系统（QGIS）软件探索五价联合疫苗接种的地理差异。通过R 4.1版软件，使用简单逻辑回归模型确定五价联合疫苗接种的显著预测因素。
全国五价联合疫苗接种率为59.2%。埃塞俄比亚五价联合疫苗接种的空间分布并不均匀。空间聚类分析显示，五价联合疫苗接种覆盖率低的地区大多是阿法尔州、索马里州和哈拉里州。疫苗接种率最高和最低的地区分别是提格雷州和哈拉里州。母亲年龄在35至49岁（调整后比值比[AOR]=3.42；95%置信区间[CI]：1.99，5.87）以及25至34岁（AOR = 1.55；95% CI：1.17，2.19）、接受过小学教育（AOR = 1.51；95% CI：1.07，2.11）、富裕指数较高（AOR = 1.96；95% CI：1.40，2.75）、出生顺序为1至3（AOR = 1.88；95% CI：1.19，2.96）以及在医疗机构分娩（AOR = 3.41：95% CI：2.52，4.61）是埃塞俄比亚五价联合疫苗接种的决定因素。
埃塞俄比亚五价联合疫苗接种率远低于全球目标。母亲年龄较大、母亲受教育程度、富裕指数、出生顺序以及在医疗机构分娩是五价联合疫苗接种的决定因素。应特别关注阿法尔州、索马里州和哈拉里州，以提高疫苗接种率。此外，改善社会经济状况以及在分娩期间获得孕产妇保健服务对于提高疫苗接种率是必要的。
