Dinga Jerome Nyhalah, Ngunjoh Fred Ngwa, Tendongfor Nicholas, Mbah Glory Enjong, Qin Haowen, Ahmed Irshad, Muki Synthia Eni, Gamua Stanley Dobgima, Manyam Rameshbabu, Titanji Vincent P K
Michael Gahnyam Gbeugvat Foundation, Buea P.O. Box 63, Cameroon.
Biotechnology Unit, University of Buea, Buea P.O. Box 63, Cameroon.
Healthcare (Basel). 2025 Jan 24;13(3):239. doi: 10.3390/healthcare13030239.
Under-immunization remains a major global public health concern. The World Health Organization (WHO) reports that approximately 20 million children globally are not fully vaccinated, with more than half of these children residing in Africa. African countries including Cameroon face unique challenges in achieving high vaccination coverage. This study aimed to determine the prevalence and determinants of under-immunization among children aged 0-59 months in Buea, Cameroon to contribute to effective national immunization policy. This cross-sectional study used the World Health Organization Behavioural and Social Determinants of vaccination tool to collect data from 438 caregivers of children aged 0-59 months in the city of Buea. Data were collected on socio-demographics, immunization factors, and health system variables for the study cohort. It was found that 25.11% of children in urban Buea were under-immunized. Children in Buea Town were three times more likely to be under-immunized than those in Molyko (AOR = 3.0, 95% CI: 1.3-7.3, = 0.013). Children of separated caregivers were 0.2 times less likely to be under-immunized than those of widowed caregivers (AOR = 0.2, 95% CI: 0.1-0.9, = 0.036). Children whose caregivers did not receive unsolicited advice were 2.1 times more likely to be under-immunized (AOR = 2.1, 95% CI: 1.2-3.4, = 0.006). Children living less than 1 mile from health facilities were 2.9 times more likely to be under-immunized than those living more than 10 miles away (AOR = 2.9, 95% CI: 1.1-7.5, = 0.030). Children of caregivers employed in the private sector were 4.3 times more likely to be under-immunized compared to those of unemployed caregivers (AOR = 4.3, 95% CI: 1.1-16.2, = 0.031). Children in non-owned/non-rented houses were 0.3 times less likely to be under-immunized compared to those in rented houses (AOR = 0.3, 95% CI: 0.1-0.9, = 0.030). Children whose caregivers did not discuss vaccination concerns with healthcare workers were 0.6 times less likely to have under-immunized children (COR = 0.6, 95% CI: 0.3-0.9, = 0.020). It was concluded that under-immunization is a significant public health problem in the city of Buea. Interventions that target the quality of services, community engagement, and the unique challenges faced by different caregiver groups, are needed.
免疫接种不足仍然是一个重大的全球公共卫生问题。世界卫生组织（WHO）报告称，全球约有2000万儿童未完全接种疫苗，其中一半以上的儿童居住在非洲。包括喀麦隆在内的非洲国家在实现高疫苗接种覆盖率方面面临独特挑战。本研究旨在确定喀麦隆布埃亚市0至59个月儿童免疫接种不足的患病率及其决定因素，以促进有效的国家免疫政策。这项横断面研究使用了世界卫生组织疫苗接种行为和社会决定因素工具，从布埃亚市438名0至59个月儿童的照料者那里收集数据。收集了研究队列的社会人口统计学、免疫接种因素和卫生系统变量的数据。研究发现，布埃亚市城区25.11%的儿童免疫接种不足。布埃亚镇的儿童免疫接种不足的可能性是莫利科镇儿童的三倍（调整后比值比[AOR]=3.0，95%置信区间[CI]：1.3 - 7.3，P = 0.013）。父母分居的儿童免疫接种不足的可能性是丧偶照料者子女的0.2倍（AOR = 0.2，95% CI：0.1 - 0.9，P = 0.036）。照料者未获得主动提供的建议的儿童免疫接种不足的可能性高2.1倍（AOR = 2.1，95% CI：1.2 - 3.4，P = 0.006）。居住在距离卫生设施不到1英里的儿童免疫接种不足的可能性是居住在距离卫生设施超过10英里的儿童的2.9倍（AOR = 2.9，95% CI：1.1 - 7.5，P = 0.030）。在私营部门工作的照料者的子女免疫接种不足的可能性是失业照料者子女的4.3倍（AOR = 4.3，95% CI：1.1 - 16.2，P = 0.031）。居住在非自有/非租赁房屋中的儿童免疫接种不足的可能性是居住在租赁房屋中的儿童的0.3倍（AOR = 0.3，95% CI：0.1 - 0.9，P = 0.030）。照料者未与医护人员讨论疫苗接种问题的儿童免疫接种不足的可能性低0.6倍（校正比值比[COR]=0.6，95% CI：0.3 - 0.9，P = 0.020）。研究得出结论，免疫接种不足是布埃亚市一个重大的公共卫生问题。需要针对服务质量、社区参与以及不同照料者群体面临的独特挑战采取干预措施。
