Bendera Anderson, Nakamura Keiko, Tran Xuan Minh Tri, Kapologwe Ntuli A, Bendera Elice, Mahamba Dina, Meshi Eugene Benjamin
Department of Global Health Entrepreneurship, Division of Public Health, Institute of Science Tokyo, Tokyo, Japan; Department of Radiology and Medical Imaging, Monduli District Hospital, Arusha, Tanzania.
Department of Global Health Entrepreneurship, Division of Public Health, Institute of Science Tokyo, Tokyo, Japan.
Vaccine. 2025 Apr 11;52:126904. doi: 10.1016/j.vaccine.2025.126904. Epub 2025 Feb 24.
This study examined the trends, disparities, and factors associated with childhood vaccination coverage in Tanzania between 2010 and 2022.
We used data from three recent Tanzania Demographic and Health Surveys. We included a total of 5637 children aged 12-23 months and their mothers. Socioeconomic disparities in childhood vaccination coverage were evaluated using concentration curves and indices, and decomposition analysis was performed to identify the contributing factors. Poisson regression analysis was conducted to determine the factors associated with childhood vaccination uptake in Tanzania.
Full vaccination coverage remained stable at approximately 75.6 % from 2010 to 2015 but declined to 70.5 % by 2022. Throughout all three survey rounds, children from households with a lower socioeconomic position consistently had lower full vaccination coverage than those from families with a higher socioeconomic position. The concentration index for full vaccination coverage was 0.1531 in 2010 (p < 0.001), 0.1466 in 2015 (p < 0.001), and 0.1314 in 2022 (p < 0.001), indicating persistent but slightly decreasing inequality favoring upper-class children (F-stat = 3.27, p = 0.038). The key contributors to these inequalities were maternal illiteracy, poverty, and lack of exposure to mass media. Factors that increased childhood vaccination uptake included higher socioeconomic position, facility-based childbirth, antenatal care utilization, proximity to healthcare facilities, and having fewer children under the age of five in the household.
Despite Tanzania's considerable overall childhood vaccination coverage, the findings indicated significant socioeconomic disparities. Urgent action is needed to close these gaps and ensure that every child in Tanzania receives life-saving protection regardless of their background or circumstances.
本研究调查了2010年至2022年坦桑尼亚儿童疫苗接种覆盖率的趋势、差异及相关因素。
我们使用了坦桑尼亚最近三次人口与健康调查的数据。共纳入了5637名12至23个月大的儿童及其母亲。利用集中曲线和指数评估儿童疫苗接种覆盖率的社会经济差异，并进行分解分析以确定影响因素。进行泊松回归分析以确定坦桑尼亚儿童疫苗接种的相关因素。
2010年至2015年，全程疫苗接种覆盖率保持在约75.6%的稳定水平，但到2022年降至70.5%。在所有三轮调查中，社会经济地位较低家庭的儿童全程疫苗接种覆盖率始终低于社会经济地位较高家庭的儿童。2010年全程疫苗接种覆盖率的集中指数为0.1531（p<0.001），2015年为0.1466（p<0.001），2022年为0.1314（p<0.001），表明有利于上层阶级儿童的不平等现象持续存在但略有下降（F统计量=3.27，p=0.038）。这些不平等现象的主要促成因素是母亲文盲、贫困和缺乏接触大众媒体的机会。提高儿童疫苗接种率的因素包括较高的社会经济地位、在医疗机构分娩、利用产前护理、靠近医疗机构以及家中五岁以下儿童较少。
尽管坦桑尼亚儿童疫苗接种总体覆盖率较高，但研究结果表明存在显著的社会经济差异。需要采取紧急行动来缩小这些差距，确保坦桑尼亚的每个儿童无论其背景或情况如何都能获得挽救生命的保护。
