Baruwa Ololade Julius, Akokuwebe Monica Ewomazino, Adeleye Oluwafemi John, Gbadebo Babatunde Makinde
Centre for Social Sciences Research, University of Cape Town, Cape Town, Rondebosch, South Africa.
SAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
BMC Public Health. 2025 Mar 5;25(1):882. doi: 10.1186/s12889-025-22143-2.
Childhood immunization is a vital component of public health, preventing the spread of infectious diseases and reducing child mortality. This study examines variations in basic immunization coverage across districts and explores socio-demographic disparities in immunization coverage among children aged 12-23 months in Malawi.
The study employed a cross-sectional design, utilizing data from the 2016 MDHS, a nationally representative survey. The analysis included 3,248 children aged 12-23 months. Socio-demographic variables, including the child's sex, maternal age, marital status (currently married), education, place of residence, region, wealth status, and employment status, were analysed using multivariate logistic regression models and a choropleth map to assess variations in basic immunization coverage across all 28 districts in Malawi.
The results showed that only 77.1% of children aged 12-23 months received basic immunization. The findings also highlighted significant variations in immunization coverage across different socio-demographic groups and among the 28 districts of Malawi. The highest coverage rates, ranging from 84.9 to 90.7%, were observed in Mwanza and Chiradzulu districts, while the lowest rates, between 65.3% and 68.0%, were found in Ntchisi, Blantyre, and Machinga districts. Multivariable analysis further indicated that children whose mothers were from a high household wealth index (OR = 1.45, 95% CI = 1.15-1.82), residing in rural areas (OR = 1.55, 95% CI = 1.20-2.01), currently married (OR = 1.33, 95% CI = 1.10-1.61), and with secondary or higher education (OR = 1.57, 95% CI = 1.11-2.21) were more likely to receive basic immunization.
The study highlights low coverage of basic immunization in some districts as well as socio-demographic disparities in under-two immunization coverage in Malawi, necessitating tailored interventions such as educational campaigns and region-specific strategies.
儿童免疫是公共卫生的重要组成部分，可预防传染病传播并降低儿童死亡率。本研究调查了各地区基础免疫覆盖率的差异，并探讨了马拉维12至23个月龄儿童免疫覆盖率的社会人口统计学差异。
本研究采用横断面设计，利用2016年马拉维人口与健康调查（MDHS）的数据，该调查具有全国代表性。分析纳入了3248名12至23个月龄的儿童。使用多变量逻辑回归模型和分级统计图分析社会人口统计学变量，包括儿童性别、母亲年龄、婚姻状况（当前已婚）、教育程度、居住地点、地区、财富状况和就业状况，以评估马拉维所有28个地区基础免疫覆盖率的差异。
结果显示，只有77.1%的12至23个月龄儿童接受了基础免疫。研究结果还突出了不同社会人口群体以及马拉维28个地区之间免疫覆盖率的显著差异。姆万扎和奇拉祖卢地区的覆盖率最高，在84.9%至90.7%之间，而恩奇西、布兰太尔和马钦加地区的覆盖率最低，在65.3%至68.0%之间。多变量分析进一步表明，母亲来自高家庭财富指数的儿童（比值比[OR]=1.45，95%置信区间[CI]=1.15 - 1.82）、居住在农村地区的儿童（OR=1.55，95%CI=1.20 - 2.01）、当前已婚的儿童（OR=1.33，95%CI=1.10 - 1.61）以及接受过中等或更高教育的儿童（OR=1.57，95%CI=1.11 - 2.21）更有可能接受基础免疫。
该研究凸显了马拉维一些地区基础免疫覆盖率较低以及2岁以下儿童免疫覆盖率的社会人口统计学差异，因此需要开展针对性干预措施，如教育宣传活动和针对特定地区的策略。
