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评估索马里12至23个月大儿童零剂量免疫接种的患病率及地区差异。

Assessing Prevalence and Regional Disparities in Zero-Dose Immunization Among Children Aged 12-23 Months in Somalia.

作者信息

Halane Salad, Ahmed Abdiwali, Ahmed Mohamed Mustaf, Hersi Mohamed Dahir, Sani Jamilu

机构信息

Department of Public Health, Ministry of Health, Galmudug, Somalia.

Department of Health System Strengthening, Ministry of Health, Galmudug, Somalia.

出版信息

J Epidemiol Glob Health. 2025 Apr 14;15(1):59. doi: 10.1007/s44197-025-00395-w.

Abstract

BACKGROUND

Childhood immunization is a critical public health intervention that significantly reduces child morbidity and mortality. However, despite global progress, disparities in immunization coverage persist, particularly in low-income and conflict-affected settings such as Somalia. Zero-dose immunization, defined as the complete absence of routine vaccinations, remains a major challenge, leaving children vulnerable to vaccine-preventable diseases. Understanding the prevalence and sociodemographic determinants of zero-dose immunization is essential for developing targeted interventions.

METHODS

This study analyzed data from the 2020 Somalia Demographic and Health Survey (SDHS) to estimate the prevalence of zero-dose immunization among children aged 12-23 months and assess its distribution across key sociodemographic and geographic factors. The study defined zero-dose children as those who had not received the first dose of the diphtheria-tetanus-pertussis vaccine (DPT1). Descriptive statistical analyses were conducted to examine variations in zero-dose prevalence by maternal characteristics, household wealth, healthcare access, and geographic region.

RESULTS

The prevalence of zero-dose immunization among Somali children was 44.0%, with significant disparities across socioeconomic and regional characteristics. Zero-dose prevalence was highest among children of younger mothers (54.0% for those aged 15-19 years) and those whose mothers had no formal education (49.0%). Household wealth was also a key determinant, with zero-dose prevalence reaching 53.0% in the poorest households compared to 29.0% in the wealthiest. Geographic disparities were evident in the administrative regions of Somalia, with the highest zero-dose prevalence recorded in Lower Juba (62.0%), Bay (62.0%), and Banadir (55.0%), while the lowest was observed in Togdheer (24.0%) and Sool (28.0%). Children residing in rural areas had lower immunization coverage, likely due to limited healthcare access.

CONCLUSION

The high prevalence of zero-dose immunization in Somalia underscores the urgent need for targeted interventions to improve vaccine uptake. Addressing disparities related to maternal education, household wealth, and geographic accessibility is crucial. Strengthening routine immunization services, expanding community outreach, and improving healthcare infrastructure in high-prevalence regions are necessary to reduce the proportion of zero-dose children and improve child health outcomes.

摘要

背景

儿童免疫接种是一项关键的公共卫生干预措施,可显著降低儿童发病率和死亡率。然而,尽管全球在这方面取得了进展,但免疫接种覆盖率的差距依然存在,特别是在索马里等低收入和受冲突影响的地区。零剂量免疫接种被定义为完全未进行常规疫苗接种,这仍然是一项重大挑战,使儿童易患疫苗可预防疾病。了解零剂量免疫接种的患病率及其社会人口学决定因素对于制定有针对性的干预措施至关重要。

方法

本研究分析了2020年索马里人口与健康调查(SDHS)的数据,以估计12至23个月大儿童的零剂量免疫接种患病率,并评估其在关键社会人口学和地理因素中的分布情况。该研究将零剂量儿童定义为未接种第一剂白喉-破伤风-百日咳疫苗(DPT1)的儿童。进行描述性统计分析,以研究零剂量患病率在母亲特征、家庭财富、医疗服务可及性和地理区域方面的差异。

结果

索马里儿童的零剂量免疫接种患病率为44.0%,在社会经济和区域特征方面存在显著差异。零剂量患病率在年轻母亲的子女中最高(15至19岁母亲的子女为54.0%),以及母亲未接受正规教育的儿童中最高(49.0%)。家庭财富也是一个关键决定因素,最贫困家庭的零剂量患病率达到53.0%,而最富裕家庭为29.0%。索马里各行政区存在明显的地理差异,下朱巴(62.0%)、巴伊(62.0%)和巴纳迪尔(55.0%)的零剂量患病率最高,而托格迪尔(24.0%)和苏勒(28.0%)的患病率最低。居住在农村地区的儿童免疫接种覆盖率较低,可能是由于医疗服务可及性有限。

结论

索马里零剂量免疫接种的高患病率凸显了采取针对性干预措施以提高疫苗接种率的迫切需求。解决与母亲教育、家庭财富和地理可及性相关的差距至关重要。加强常规免疫服务、扩大社区宣传以及改善高患病率地区的医疗基础设施对于减少零剂量儿童比例和改善儿童健康状况是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56b7/11996740/9b2361625da9/44197_2025_395_Fig1_HTML.jpg

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