Comparing full immunisation status of children (0–23 months) between slums of Kampala City and the rural setting of Iganga District in Uganda: a cross-sectional study

Abstract

Background Immunisation remains the most cost-effective public health intervention in preventing morbidity and mortality due to Vaccine-Preventable Diseases (VPDs). The study aims to compare the differences in immunisation coverage amongst children aged 0 to 23 months living in slums of Kampala city and Iganga as rural districts in Uganda. Methods This study utilises data from a cross-sectional survey done in 2019 in the slums of Kampala City and the rural district of Iganga within the Health and Demographic Surveillance Site (HDSS). It included 1016 children aged 0–23 months and their parents. A logistic regression model was used to analyse the relationship between multiple independent variables and the binary dependent variables (fully immunised) using Stata statistical software. The measures of association were odds ratios reported with a corresponding 95% confidence interval. Results Out of the 1016 participants, 544 participants live in the rural area and 472 participants in the slums. Slums had 48.9% (n = 231) of fully immunised children whilst rural areas had 43.20% (n = 235). The multivariate analysis showed that children living in slums are more likely to be fully immunised as compared to their counterparts in rural areas (Odds ratio:1.456; p = 0.033; CI:1.030–2.058). Immunisation coverage for BCG (98.9%), Polio 0 (88.2%), Penta1 (92.7%), and Pneumo1 (89.8%) were high in both settlements. However, the dropout rate for subsequent vaccines was high 17%, 20% and 41% for Penta, pneumococcal and rota vaccines respectively. There was poor uptake of the new vaccines with slums having 73.4% and 47.9% coverage for pneumococcal and rota vaccines respectively and rural areas had 72.1% and 7.5% for pneumococcal and rota vaccines respectively. Conclusion The low full immunisation status in this study was attributed to the child’s residence and the occupation of the parents. Lack of education and poor access to messages on immunisation (inadequate access to mass media) are other contributing factors. Educational messages on the importance of immunisation targeting these underserved populations will improve full immunisation coverage.

Assessment of Maternal Knowledge, Attitudes, and Practices towards Childhood Immunisation: A Cross-sectional Study at Hoima Regional Referral Hospital

“…Through the Child Care Programme, the Ministry of Health increased its efforts to educate and teach people about the value of immunisations, make use of the Village Health Teams, disseminate information on primary care through various media, and give health talks to carers [12]. Despite this, there was still a continuous lack of vaccine uptake in the area, and the causes of this lack of immunisation uptake are not well understood [18].…”

“…Despite being a developing nation, Uganda's health fell behind many other nations but was on par with those in the WHO's Africa area [10]. In 2017, there was a 5.5 percent chance that a child would die before turning five (55 deaths for every 1,000 live births), and in 2015, total health spending as a percentage of GDP was 9.8%, which sparked discussions about immunisation, health education, and eventual uptake [12]. According to Uganda's health information management system (HMIS), only 55% of children between the ages of 12 and 23 months were found to have had all recommended vaccinations, with coverage being somewhat greater in urban (61%) than rural areas (50%) [13].…”

Factors Influencing DPT Immunization Completion among Children: Insights from Nakawa Division, Kampala, Uganda

“…The Expanded Program of Immunization (EPI) was launched by the World Health Organization (WHO) in 1974 [4], and in Uganda, the Uganda National Expanded Program on Immunization (UNEPI) was established in 1983 [5]. The global immunization target was to reach 90% national coverage for all vaccines by 2020 [6]. However, the goal is still not achieved, and vaccine-preventable diseases remain a major cause of child illnesses and deaths, particularly in low-income countries.…”

“…The Uganda Health Management Information System reports a high full vaccination coverage of over 90% for Kampala city. However, surveys in Nakawa Division show a decline in full vaccination coverage from 77% in 2010 to 51% in 2016 and 48% in 2017 [6]. This indicates the need for research on the DPT immunization completion status and the associated factors among children aged 4-23 months from selected parishes in Nakawa Division, Kampala, Uganda.…”

“…This indicates the need for research on the DPT immunization completion status and the associated factors among children aged 4-23 months from selected parishes in Nakawa Division, Kampala, Uganda. According to Shahid et al [14], a child is considered fully immunized if he or she has received the BCG vaccine at birth, the Polio vaccine at (0,6,10,14) weeks, the DPT-Hep B-Hib vaccine at (6,10,14) weeks, the PCV vaccine at (6,10,14) weeks, the Rota vaccine at (6,10) weeks, and the IPV vaccine at 14 weeks. Based on this requirement, the general immunization coverage of 90% would be the acceptable point at which we would say a nation or a given region has attained complete immunization coverage.…”