Vaccine coverage and determinants of incomplete vaccination in children aged 12-23 months in dschang, west region, cameroon: a cross-sectional survey during a polio outbreak

Inadequate immunization coverage with increased risk of vaccine preventable diseases outbreaksremains a problem in Africa. Moreover, different factors contribute to incomplete vaccination status. This study wasperformed in Dschang (West Region, Cameroon), during the polio outbreak occurred in October 2013, in order toestimate the immunization coverage among children aged 12–23 months, to identify determinants for incompletevaccination status and to assess the risk of poliovirus spread in the study population.Methods:A cross-sectional household survey was conducted in November-December 2013, using the WHOtwo-stage sampling design. An interviewer-administered questionnaire was used to obtain information fromconsenting parents of children aged 12–23 months. Vaccination coverage was assessed by vaccination card andparents’recall. Chi-square test and multilevel logistic regression model were used to identify the determinants ofincomplete immunization status. Statistical significance was set atp< 0.05.Results:Overall, 3248 households were visited and 502 children were enrolled. Complete immunization coveragewas 85.9 % and 84.5 %, according to card plus parents’recall and card only, respectively. All children had receivedat least one routine vaccination, the OPV-3 (Oral Polio Vaccine) coverage was >90 %, and 73.4 % children completedthe recommended vaccinations before 1-year of age. In the final multilevel logistic regression model, factorssignificantly associated with incomplete immunization status were: retention of immunization card (AOR: 7.89;95 % CI: 1.08–57.37), lower mothers’utilization of antenatal care (ANC) services (AOR:1.25; 95 % CI: 1.07–63.75),being the≥3rdborn child in the family (AOR: 425.4; 95 % CI: 9.6–18,808), younger mothers’age (AOR: 49.55;95 % CI: 1.59–1544), parents’negative attitude towards immunization (AOR: 20.2; 95 % CI: 1.46–278.9), and poorerparents’exposure to information on vaccination (AOR: 28.07; 95 % CI: 2.26–348.1). Longer distance from the vaccinationcenters was marginally significant (p=0.05).Conclusion:Vaccination coverage was high; however, 1 out of 7 children was partially vaccinated, and 1 out of 4 didnot complete timely the recommended vaccinations. In order to improve the immunization coverage, it is necessary tostrengthen ANC services, and to improve parents’information and attitude towards immunization, targeting youngerparents and families living far away from vaccination centers, using appropriate communication strategies. Finally, theestimated OPV-3 coverage is reassuring in relation to the ongoing polio outbreak