Mamo Habtie Getnet, Melaku Mequannent Sharew, Aychiluhm Setognal Birara
Department of Statistics, College of Natural and Computational Science, Samara University, Samara, Ethiopia.
Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
Front Public Health. 2025 Apr 25;13:1433606. doi: 10.3389/fpubh.2025.1433606. eCollection 2025.
In Ethiopia, 16% of deaths among children aged less than 5 years are attributable to diseases that can be prevented through vaccination. However, studies carried out in Ethiopia to date have not investigated how community- and individual-level factors affect children who receive no vaccine at all. Hence, this study aimed to assess the factors associated with unimmunized children in Ethiopia.
This study is a secondary analysis of Demographic and Health Survey (DHS) data. A weighted sample of 6,219 children aged less than 5 years was included after a stratified two-stage cluster sampling. To determine the factors that influence unimmunized children, a multivariable multilevel logistic regression model was developed. In addition, adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to select variables that have statistically significant effects on unimmunized children.
The prevalence of unimmunized children aged less than 5 years in Ethiopia was 22.45% (95% CI: 21.4-23.5). In the multivariable multilevel analysis, individual-level factors associated with increased odds of having unimmunized children included no media exposure (AOR 1.33, 95 CI: 1.02-1.63), place of delivery (AOR 1.5, CI: 1.22-1.91), and the child's relationship to the household head-specifically between the household head and a daughter (AOR 1.5, 95 CI: 1.05-2.41) or categorized as others (AOR 1.8, 95, CI: 1.15-2.74). Community-level predictors associated with unimmunized children included place of residence (AOR 1.8, 95, CI: 1.12-2.58), distance from the health facility (AOR 1.32, 95, CI: 1.09-1.60), and community poverty level (AOR 1.4, 95, CI: 1.05-1.78).
In Ethiopia, approximately one-fourth of children could not get basic vaccinations. Media exposure, place of delivery, relationship with the household head, place of residence, distance from the health facility, and community poverty were found to be factors significantly associated with unimmunized children.
在埃塞俄比亚，5岁以下儿童死亡中有16%归因于可通过疫苗预防的疾病。然而，迄今为止在埃塞俄比亚开展的研究尚未调查社区和个体层面的因素如何影响完全未接种疫苗的儿童。因此，本研究旨在评估埃塞俄比亚未接种疫苗儿童的相关因素。
本研究是对人口与健康调查（DHS）数据的二次分析。经过分层两阶段整群抽样后，纳入了6219名5岁以下儿童的加权样本。为确定影响未接种疫苗儿童的因素，建立了多变量多水平逻辑回归模型。此外，使用调整后的优势比（AOR）及95%置信区间（CI）来选择对未接种疫苗儿童有统计学显著影响的变量。
埃塞俄比亚5岁以下未接种疫苗儿童的患病率为22.45%（95%CI：21.4 - 23.5）。在多变量多水平分析中，与未接种疫苗儿童几率增加相关的个体层面因素包括没有媒体接触（AOR 1.33，95%CI：1.02 - 1.63）、分娩地点（AOR 1.5，CI：1.22 - 1.91）以及儿童与户主的关系——特别是户主与女儿之间（AOR 1.5，95%CI：1.05 - 2.41）或归类为其他情况（AOR 1.8，95%CI：1.15 - 2.74）。与未接种疫苗儿童相关的社区层面预测因素包括居住地点（AOR 1.8，95%CI：1.12 - 2.58）、与医疗机构的距离（AOR 1.32，95%CI：1.09 - 1.60）以及社区贫困水平（AOR 1.4，95%CI：1.05 - 1.78）。
在埃塞俄比亚，约四分之一的儿童无法获得基本疫苗接种。发现媒体接触、分娩地点、与户主的关系以及居住地点、与医疗机构的距离和社区贫困是与未接种疫苗儿童显著相关的因素。
