Vaccine preventable diseases remain a concern in Cameroon. According to WHO, seven Wild Polio Virus-1 cases have been reported from West, North West, Centre and Adamaoua Regions, with onset of paralysis ranging from 1 October 2013 to 31 January 2014. This outbreak of polio is the first reported in Cameroon since 2009. The Expanded Programme on Immunization (EPI) is part of the primary health care system since 1982; the cameroonian immunization plan currently provides: BCG and OPV at birth; three doses of DTwPHibHepB together with three doses of OPV at 6th, 10th, and 14th weeks of life; measles and yellow fever vaccines at 9 months of life. Our study was performed in November 2013 in Dschang, West Cameroon, in order to estimate the immunization coverage and to identify risk factors for incomplete vaccination among children aged 12-23 months. We conducted a cross-sectional survey using the modified EPI coverage cluster survey design. A sample of 60 clusters of 9 children each, for a total sample size of 540 children aged 12-23 months was determined by using the Intracluster Correlation Coefficient. An interviewer-administered questionnaire was used to obtain information from consenting parents, during a 3-weeks survey period. All interviewers were trained on the questionnaire use and EPI-style random walk. Descriptive statistics were calculated to evaluate the population characteristics and the immunization coverage “by card plus history” and “by card only”. A multilevel logistic regression model was performed to calculate adjusted odds ratios (AOR) of determinants of incomplete immunization status. A child was defined as fully vaccinated if he/she completed all the recommended vaccines included in the cameroonian immunization plan. 3,248 households were visited and 502 children divided in 65 clusters were enrolled. Children fully vaccinated were 85.9% and 84.5% according to card plus parent’s history and card only respectively. Unvaccinated children were not found. 26.6% had not completed the recommended vaccines within one year of life. In the final model, the characteristics significantly associated with incomplete children immunization status, were: having the vaccination card (AOR 7.89; 95% CI 1.08-57.37), being the 3rd or more born children in the family (AOR 425.47; 95% CI 9.62-18808.11), having a mother <24 years-old (AOR 49.55; 95% CI 1.59-1544.58;), having a mother who did ≤2 pre-natal visits (AOR 8.25; 95% CI 1.07-63.75), having parents with negative attitudes towards vaccination (AOR 20.20; 95% CI 1.46-278.91) and who do not regularly receive information about immunization (AOR 28.07; 95% CI 2.26-348.13). Distance from the vaccination centers was just at the limit of statistical significance (AOR 6.44; 95% CI 1.00-41.39) Despite high coverage, 1 of 7 children had incomplete vaccination status and 1 of 4 did not complete vaccinations within 1 year of age. In order to increase the coverage and proper (timely) vaccine administration is necessary to strengthen prenatal care and delivery services, improve parents’ information and attitude towards immunization targeting younger parents and families living far away from vaccination centers by appropriate communication strategies to favor this evidence-based intervention.
Vaccine coverage and determinants of incomplete vaccination in children aged 12-23 months in Dschang, West Cameroon / Russo, Gianluca; Miglietta, A.; Biguioh, R. M.; Sanou Sobze, M.; Stefanelli, P.; Vullo, Vincenzo; Pezzotti, P.; Rezza, G.. - ELETTRONICO. - (2014), pp. 85-85. (Intervento presentato al convegno ESCAIDE (European Scientific Conference on Applied Infectious Disease Epidemiology) tenutosi a Stockholm, Sweeden nel 5-7 Nov 2014).
Vaccine coverage and determinants of incomplete vaccination in children aged 12-23 months in Dschang, West Cameroon.
RUSSO, Gianluca;A. Miglietta;VULLO, Vincenzo;
2014
Abstract
Vaccine preventable diseases remain a concern in Cameroon. According to WHO, seven Wild Polio Virus-1 cases have been reported from West, North West, Centre and Adamaoua Regions, with onset of paralysis ranging from 1 October 2013 to 31 January 2014. This outbreak of polio is the first reported in Cameroon since 2009. The Expanded Programme on Immunization (EPI) is part of the primary health care system since 1982; the cameroonian immunization plan currently provides: BCG and OPV at birth; three doses of DTwPHibHepB together with three doses of OPV at 6th, 10th, and 14th weeks of life; measles and yellow fever vaccines at 9 months of life. Our study was performed in November 2013 in Dschang, West Cameroon, in order to estimate the immunization coverage and to identify risk factors for incomplete vaccination among children aged 12-23 months. We conducted a cross-sectional survey using the modified EPI coverage cluster survey design. A sample of 60 clusters of 9 children each, for a total sample size of 540 children aged 12-23 months was determined by using the Intracluster Correlation Coefficient. An interviewer-administered questionnaire was used to obtain information from consenting parents, during a 3-weeks survey period. All interviewers were trained on the questionnaire use and EPI-style random walk. Descriptive statistics were calculated to evaluate the population characteristics and the immunization coverage “by card plus history” and “by card only”. A multilevel logistic regression model was performed to calculate adjusted odds ratios (AOR) of determinants of incomplete immunization status. A child was defined as fully vaccinated if he/she completed all the recommended vaccines included in the cameroonian immunization plan. 3,248 households were visited and 502 children divided in 65 clusters were enrolled. Children fully vaccinated were 85.9% and 84.5% according to card plus parent’s history and card only respectively. Unvaccinated children were not found. 26.6% had not completed the recommended vaccines within one year of life. In the final model, the characteristics significantly associated with incomplete children immunization status, were: having the vaccination card (AOR 7.89; 95% CI 1.08-57.37), being the 3rd or more born children in the family (AOR 425.47; 95% CI 9.62-18808.11), having a mother <24 years-old (AOR 49.55; 95% CI 1.59-1544.58;), having a mother who did ≤2 pre-natal visits (AOR 8.25; 95% CI 1.07-63.75), having parents with negative attitudes towards vaccination (AOR 20.20; 95% CI 1.46-278.91) and who do not regularly receive information about immunization (AOR 28.07; 95% CI 2.26-348.13). Distance from the vaccination centers was just at the limit of statistical significance (AOR 6.44; 95% CI 1.00-41.39) Despite high coverage, 1 of 7 children had incomplete vaccination status and 1 of 4 did not complete vaccinations within 1 year of age. In order to increase the coverage and proper (timely) vaccine administration is necessary to strengthen prenatal care and delivery services, improve parents’ information and attitude towards immunization targeting younger parents and families living far away from vaccination centers by appropriate communication strategies to favor this evidence-based intervention.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
