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加纳北部24至59个月儿童麻疹风疹全程免疫接种率及预测因素:麻疹疫情后评估

Coverage and predictors of full measles-rubella immunization among children aged 24-59 months in Northern Ghana: a post measles outbreak assessment.

作者信息

Mohammed Abdul Gafaru, Nukpezah Ruth Nimota, Mwin Pascal Kingley, Abdul-Manan Sumani, Baiden-Laryea Eunice, Kenu Ernest

机构信息

Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana.

School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana.

出版信息

BMC Public Health. 2025 May 9;25(1):1717. doi: 10.1186/s12889-025-22940-9.

Abstract

INTRODUCTION

Vaccination plays a critical role in ensuring the health, survival, and well-being of children worldwide. It is one of the most cost-effective and scientifically proven public health interventions that protect children from severe and life-threatening diseases. Despite efforts to improve measles vaccination coverage in the five Northern regions of Ghana, less than 70% complete vaccination coverage leaves these areas vulnerable to outbreaks. To fill this gap, our study explores the predictors of complete measles immunization coverage among children aged 24-59 months in Northern Ghana.

METHODS

A community-based cross-sectional study was conducted from June to September 2023. Data was collected from caregivers of children aged 24-59 months. A sample size of 636 children with a multistage sampling technique was used. We collected data from the caregivers using a semi-structured questionnaire and a data abstraction tool. Logistic regression was used to assess the factors associated with measles vaccine uptake at a 5% significance level.

RESULTS

Among the 617 children, 61.1% (0.57-0.65) were fully vaccinated against measles. The first dose of the measles-rubella vaccine was received by 87.7% (95% CI: 0.84-0.90) of the children. After adjusting for potential confounders, regression models showed that the awareness (aOR = 2.91, 95% CI:1.35-6.25), high knowledge level (aOR = 8.27, 95% CI:3.02-22.71), ANC (aOR = 2.48, 95% CI:1.11-5.52), side effects (aOR = 0.04, 95% CI:0.02-0.08) and receiving other childhood vaccines (aOR = 3.27, 95%CI:1.80-5.94) were significantly associated with the uptake of measles-rubella vaccines in Northern Ghana.

CONCLUSION

The uptake of the second dose of the measles-rubella vaccine in Northern Ghana was below the recommended 95% by the WHO. Awareness of the vaccine, knowledge level, ANC attendance, receiving other vaccines, and perceived side effects were the main predictors of measles vaccine uptake in the region. Ghana Health Service should intensify sensitization and awareness creation at the community level.

摘要

引言

疫苗接种在保障全球儿童的健康、生存和福祉方面发挥着关键作用。它是最具成本效益且经过科学验证的公共卫生干预措施之一,可保护儿童免受严重及危及生命的疾病侵害。尽管加纳北部五个地区努力提高麻疹疫苗接种覆盖率,但不到70%的全程接种覆盖率使这些地区容易爆发疫情。为填补这一空白,我们的研究探讨了加纳北部24至59个月大儿童麻疹全程免疫覆盖率的预测因素。

方法

于2023年6月至9月开展了一项基于社区的横断面研究。从24至59个月大儿童的照料者处收集数据。采用多阶段抽样技术选取了636名儿童作为样本。我们使用半结构化问卷和数据提取工具从照料者处收集数据。采用逻辑回归在5%的显著性水平下评估与麻疹疫苗接种相关的因素。

结果

在617名儿童中,61.1%(0.57 - 0.65)已完成麻疹全程接种。87.7%(95%置信区间:0.84 - 0.90)的儿童接种了第一剂麻疹风疹疫苗。在对潜在混杂因素进行调整后,回归模型显示,意识(调整后比值比 = 2.91,95%置信区间:1.35 - 6.25)、高知识水平(调整后比值比 = 8.27,95%置信区间:3.02 - 22.71)、产前护理(调整后比值比 = 2.48,95%置信区间:1.11 - 5.52)、副作用(调整后比值比 = 0.04,95%置信区间:0.02 - 0.08)以及接种其他儿童疫苗(调整后比值比 = 3.27,95%置信区间:1.80 - 5.94)与加纳北部麻疹风疹疫苗的接种显著相关。

结论

加纳北部麻疹风疹疫苗第二剂的接种率低于世界卫生组织建议的95%。疫苗意识、知识水平、产前护理就诊情况、接种其他疫苗情况以及感知到的副作用是该地区麻疹疫苗接种的主要预测因素。加纳卫生服务部门应加强社区层面的宣传和提高意识工作。

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Strengthening routine immunization through measles-rubella elimination.通过消除麻疹和风疹来加强常规免疫。
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