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埃塞俄比亚西北部城市行政区儿童的乙肝疫苗接种覆盖率及相关因素:一项基于社区的研究。

Hepatitis B vaccination coverage and associated factors among children living in northwest Ethiopia city administrations: A community-based study.

作者信息

Geta Mekuanint, Hailu Asrat, Woldeamanuel Yimtubezinash

机构信息

Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Department of Medical Microbiology, School of Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Public Health Pract (Oxf). 2025 Mar 27;9:100608. doi: 10.1016/j.puhip.2025.100608. eCollection 2025 Jun.

Abstract

OBJECTIVE

A study was being conducted to assess the current vaccination coverage, dropout rates, and associated risk factors in children under 15 years old in northwest Ethiopia.

STUDY DESIGN

A community-based cross-sectional survey.

METHODS

A community-based survey was conducted in northwest Ethiopia from January to March 2024. A two-stage cluster-sampling technique was used to select a representative sample. Sociodemographic information, vaccination history, and epidemiological risk factors were collected using a pre-tested, structured questionnaire. Data analysis was performed using SPSS version 23, employing descriptive statistics, chi-square test, and logistic regression model. Associations of vaccination determinants were investigated, with a p-value <0.05 considered statistically significant.

RESULTS

In the study, 808 children were surveyed, with 53.0 % being female and 53.0 % were born at hospitals. Most (52.5 %) were under 5 years old, with a mean age of 5.4 ± 3.5 years. Seven hundred thirty four (90.8 %) had received at least one dose of the hepatitis B vaccine, and 82.7 % had received three doses, with a 9.0 % dropout rate. Among children completely vaccinated against hepatitis B, 366 (54.8 %) were in the age group of 1-4 years. The vaccination coverage was 85.4 %, 82.9 %, and 76.5 % in Bahir Dar, Gondar, and Debre Markos, respectively. Several factors have been identified as predictors of complete hepatitis B vaccination in children, including mothers who attended primary school (AOR = 2.9; 95 % CI: 1.4-5.8) and those with secondary education or higher (AOR = 2.2; 95 % CI: 1.3-4.0), married mothers (AOR = 2.5; 95 % CI: 1.5-4.3), and mothers aged 21-30 years (AOR = 2.7; 95 % CI: 1.3-5.6) and those aged 31-40 years (AOR = 2.8; 95 % CI: 1.4-5.5) were more likely to have their children fully vaccinated. Additionally, children born in hospitals (AOR = 2.4; 95 % CI: 1.3-4.3) or health centers (AOR = 4.0; 95 % CI: 2.2-7.4), increased access to vaccination services (AOR = 2.5; 95 % CI: 1.5-4.3), children aged 1-4 years (AOR = 3.1; 95 % CI: 1.7-5.5) and 5-9 years (AOR = 3.8; 95 % CI: 2.1-7.1) had higher HB vaccination coverage.

CONCLUSION

The complete hepatitis B vaccination coverage in this study was lower than the WHO recommendation for developing countries. Therefore, enhancing the promotion of facility delivery and ensuring easy access to vaccines are crucial for improving children's vaccination coverage.

摘要

目的

开展一项研究以评估埃塞俄比亚西北部15岁以下儿童的当前疫苗接种覆盖率、辍学率及相关风险因素。

研究设计

基于社区的横断面调查。

方法

2024年1月至3月在埃塞俄比亚西北部进行了一项基于社区的调查。采用两阶段整群抽样技术选取具有代表性的样本。使用经过预测试的结构化问卷收集社会人口学信息、疫苗接种史和流行病学风险因素。使用SPSS 23版进行数据分析,采用描述性统计、卡方检验和逻辑回归模型。研究了疫苗接种决定因素之间的关联,p值<0.05被认为具有统计学意义。

结果

在该研究中,共调查了808名儿童,其中53.0%为女性,53.0%在医院出生。大多数(52.5%)年龄在5岁以下,平均年龄为5.4±3.5岁。734名(90.8%)儿童至少接种了一剂乙肝疫苗,82.7%接种了三剂,辍学率为9.0%。在完全接种乙肝疫苗的儿童中,366名(54.8%)在1至4岁年龄组。巴赫达尔、贡德尔和德布雷马科斯的疫苗接种覆盖率分别为85.4%、82.9%和76.5%。已确定几个因素是儿童完全接种乙肝疫苗的预测因素,包括上过小学的母亲(比值比=2.9;95%置信区间:1.4 - 5.8)和受过中等教育或更高教育的母亲(比值比=2.2;95%置信区间:1.3 - 4.0)、已婚母亲(比值比=2.5;95%置信区间:1.5 - 4.3)、年龄在21至30岁的母亲(比值比=2.7;95%置信区间:1.3 - 5.6)以及年龄在31至40岁的母亲(比值比=2.8;95%置信区间:1.4 - 5.5),她们的孩子更有可能完全接种疫苗。此外,在医院(比值比=2.4;95%置信区间:1.3 - 4.3)或健康中心出生的儿童(比值比=4.0;95%置信区间:2.2 - 7.4)、获得疫苗接种服务的机会增加(比值比=2.5;95%置信区间:1.5 - 4.3)、年龄在1至4岁(比值比=3.1;95%置信区间:1.7 - 5.5)和5至9岁(比值比=3.8;95%置信区间:2.1 - 7.1)的儿童乙肝疫苗接种覆盖率更高。

结论

本研究中乙肝疫苗的完全接种覆盖率低于世界卫生组织对发展中国家的建议。因此,加强对设施分娩的推广并确保疫苗易于获取对于提高儿童疫苗接种覆盖率至关重要。

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