Exploring spatial variation in BCG vaccination among children 0–35 months in Ethiopia: spatial analysis of Ethiopian Demographic and Health Survey 2016

Agegnehu, Chilot Desta; Alem, Adugnaw Zeleke

doi:10.1136/bmjopen-2020-043565

Cited by 6 publications

(6 citation statements)

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“…Regional coverage variations are also found in Brazil and other countries. Such differences result from significant geographic, social, and cultural discrepancies between and within regions 16,[46][47][48][49][50] . Brazil and Minas Gerais, for example, have large territories with unequal socioeconomic effects among their population groups 51 .…”

Section: Discussionmentioning

confidence: 99%

Spatial behavior of hepatitis A, MMR, and varicella vaccination coverage in the state of Minas Gerais, 2020

Oliveira

Arroyo

Vimieiro

et al. 2023

Rev. bras. epidemiol.

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Objective: To analyze the spatial behavior of hepatitis A, measles, mumps, and rubella (MMR), and varicella vaccination coverage in children and its relationship with socioeconomic determinants in the state of Minas Gerais. Methods: This ecological study investigated records of doses administered to children, extracted from the Immunization Information System of 853 municipalities in Minas Gerais, in 2020. We analyzed the vaccination coverage and socioeconomic factors. Spatial scan statistics were used to identify spatial clusters and measure the relative risk based on the vaccination coverage indicator and the Bivariate Moran Index, and thus detect socioeconomic factors correlated with the spatial distribution of vaccination. We used the cartographic base of the state and its municipalities and the ArcGIS and SPSS software programs. Results: Hepatitis A (89.0%), MMR (75.7%), and varicella (89.0%) showed low vaccination coverage. All vaccines analyzed had significant clusters. The clusters most likely to vaccinate their population were mainly located in the Central, Midwest, South Central, and Northwest regions, while the least likely were in the North, Northeast, and Triângulo do Sul regions. The municipal human development index, urbanization rate, and gross domestic product were spatially dependent on vaccination coverage. Conclusions: The spatial behavior of hepatitis A, MMR, and varicella vaccination coverage is heterogeneous and associated with socioeconomic factors. We emphasize that vaccination records require attention and should be continuously monitored to improve the quality of information used in services and research.

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Section: Discussionmentioning

confidence: 99%

Spatial behavior of hepatitis A, MMR, and varicella vaccination coverage in the state of Minas Gerais, 2020

Oliveira

Arroyo

Vimieiro

et al. 2023

Rev. bras. epidemiol.

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“…Moreover, low predicted BCG vaccination coverage was observed in Afar, Benishangul, Gambela, and Somali regions [ 32 ]. Spatial clustering of TB was reported in these parts of the country in previous studies [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Mapping BCG vaccination coverage in Ethiopia between 2000 and 2019

et al. 2022

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Introduction The Bacille-Calmette–Guerin (BCG) vaccination remains the primary strategy to prevent severe disseminated TB in young children, particularly in high TB-burden countries such as Ethiopia. Accurate knowledge of vaccination coverage in small geographical areas is critically important to developing targeted immunization campaigns. Thus, this study aimed to investigate the spatiotemporal distributions and ecological level determinants of BCG vaccination coverage in Ethiopia. Method Bacille-Calmette–Guerin immunization coverage and geographical information data were obtained from five different Demographic and Health Surveys, conducted in Ethiopia between 2000 and 2019. Data for independent variables were obtained from publicly available sources. Bayesian geostatistical models were used to predict the spatial distribution of BCG vaccination coverage in Ethiopia. Result The overall national BCG vaccination coverage between 2000 and 2019 was 65.5%. The BCG vaccine coverage was 53.5% in 2000, 56.9% in 2005, 64.4% in 2011, 79.6% in 2016, and 79.0% in 2019. BCG vaccination coverage increased by 47.6% in Ethiopia from 2000 to 2019, but substantial geographical inequalities in BCG coverage remained at sub-national and local levels. High vaccination coverage was observed in northern, western, and central parts of Ethiopia. Climatic and demographic factors such as temperature, altitude, and population density were positively associated with BCG vaccination coverage. Whereas, healthcare access factors such as distance to health facilities and travel time to the nearest cities were negatively associated with BCG vaccine coverage in Ethiopia. Conclusion Despite substantial progress in national BCG vaccination coverage, marked spatial variation in BCG coverage persists throughout the country at sub-national and local levels. Healthcare access and climatic and demographic factors determined the spatial distribution of BCG vaccination coverage. Maintaining a high level of vaccination coverage across geographical areas is important to prevent TB in Ethiopia.

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“…Most published works featuring spatial analyses of EDHS data suffer from one or more flaws, including 1) application of bi-or multi-variate global (countrywide) OLS regression to a spatially autocorrelated response variable (y) (Seid, Melese & Alemu, 2021, Defar, Okwaraji, Tigabu, Persson, & Alemu, 2016Agegnehu, & Alem, 2021), 2) lack of testing for multicollinearity of the chosen independent variables (x), 3) combining the use of spatial and non-spatial statistical methods (Seid, Melese & Alemu, 2021), and 4) publishing contradictory results from different spatial statistical applications, namely, ArcMap (or ArcGIS Pro) and SatScan, in the same paper (Seid, Melese & Alemu, 2021). One such example is the analysis of domestic violence in Ethiopia with the authors highlighting its spatial clustering and yet proceeding to conduct global OLS regression (Seid, Melese & Alemu, 2021).…”

Section: Existing Spatial Analyses Of the Edhs Datamentioning

confidence: 99%

“…One such example is the analysis of domestic violence in Ethiopia with the authors highlighting its spatial clustering and yet proceeding to conduct global OLS regression (Seid, Melese & Alemu, 2021). A global OLS regression was chosen for the analysis of places of childbirth data (Awol & Jemal, 2023) and BCG vaccination among children 0-35 months (Agegnehu, & Alem, 2021) despite findings of spatially clustered service delivery. Linear regression was applied to places of birth data (Gudayu, 2022) despite findings of spatially clustered home births.…”

Section: Existing Spatial Analyses Of the Edhs Datamentioning

confidence: 99%

The Social Geography of Women’s Attitudes toward Wife-beating in Ethiopia: A Contribution Towards Proper Application of Spatial Statistics

Adugna

2023

JGG

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Spatial statistical measures have been applied to Ethiopia’s Demographic and Health Survey data (EDHS), mostly at the national level. However, there is concern that most applications violate basic principles of statistics regarding autocorrelation, or are not cognizant of the first law of geography which states that all things are related but near things are more related. This study investigates local variations in attitudes toward wife-beating in Ethiopia with education as the main correlate. It does so by using a spatial measure known as the geographically weighted regression (GWR) which is more appropriate in conditions of geographic non-stationarity than the ordinary least squares regression (OLS). Equally importantly, it examines the appropriateness of existing OLS-based spatial studies of EDHS data. We found that most studies inappropriately applied OLS despite findings of spatially autocorrelated data. The GWR model showed an association between acceptance of wife-beating and educational status. It also generated a list of twelve sampling clusters where most women respondents stated that wife-beating was acceptable while admitting to having had no formal education, and where local R2s exceeded 0.5 in GWR modeling involving 72 nearest neighbors per sampling cluster. An education-focused bi-variate rather than multi-variate GWR avoided issues of multicollinearity while keeping the model simple and its results actionable. Although the majority of the twelve sampling clusters are in Harari Wereda and Kilil, which got their name from members of the Harari ethnic group that are predominantly Muslim, it is difficult to pinpoint which factor or set of factors can be cited as causally associated with characteristics that placed them on the list. The study makes methodological contributions to spatial studies of sociodemographic characteristics of populations, especially those in developing countries such as Ethiopia where local factors show significant geographic variations. It also adds to the literature on applied geographically weighted regression.

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Exploring spatial variation in BCG vaccination among children 0–35 months in Ethiopia: spatial analysis of Ethiopian Demographic and Health Survey 2016

Cited by 6 publications

References 25 publications

Spatial behavior of hepatitis A, MMR, and varicella vaccination coverage in the state of Minas Gerais, 2020

Spatial behavior of hepatitis A, MMR, and varicella vaccination coverage in the state of Minas Gerais, 2020

Mapping BCG vaccination coverage in Ethiopia between 2000 and 2019

The Social Geography of Women’s Attitudes toward Wife-beating in Ethiopia: A Contribution Towards Proper Application of Spatial Statistics

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