Geospatial variation in measles vaccine coverage through routine and campaign strategies in Nigeria: Analysis of recent household surveys

Utazi, C. Edson; Wagai, John; Pannell, Oliver; Cutts, Felicity; Rhoda, Dale A.; Ferrari, Matthew J.; Dieng, Boubacar; Oteri, Joseph; Danovaro-Holliday, M. Carolina; Adeniran, Adeyemi; Tatem, Andrew J.

doi:10.1016/j.vaccine.2020.02.070

Cited by 50 publications

(93 citation statements)

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“…Six of the eight studies produced estimates for at least three countries and only two failed to report uncertainty measures. The granularity pursued was also very high, having three studies at 1x1km [ 108 – 110 ], three studies at 5x5km [ 31 , 111 , 112 ] and one at 10x10km [ 113 ]. Perhaps due to being the first, Pramanik et al [ 114 ] was the only vaccination study which focused in a single country, aimed at lower administrative units rather than gridded estimates, and one of the two studies that did not report uncertainty measures.…”

Section: Discussionmentioning

confidence: 99%

Geospatial estimation of reproductive, maternal, newborn and child health indicators: a systematic review of methodological aspects of studies based on household surveys

et al. 2020

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Background Geospatial approaches are increasingly used to produce fine spatial scale estimates of reproductive, maternal, newborn and child health (RMNCH) indicators in low- and middle-income countries (LMICs). This study aims to describe important methodological aspects and specificities of geospatial approaches applied to RMNCH coverage and impact outcomes and enable non-specialist readers to critically evaluate and interpret these studies. Methods Two independent searches were carried out using Medline, Web of Science, Scopus, SCIELO and LILACS electronic databases. Studies based on survey data using geospatial approaches on RMNCH in LMICs were considered eligible. Studies whose outcomes were not measures of occurrence were excluded. Results We identified 82 studies focused on over 30 different RMNCH outcomes. Bayesian hierarchical models were the predominant modeling approach found in 62 studies. 5 × 5 km estimates were the most common resolution and the main source of information was Demographic and Health Surveys. Model validation was under reported, with the out-of-sample method being reported in only 56% of the studies and 13% of the studies did not present a single validation metric. Uncertainty assessment and reporting lacked standardization, and more than a quarter of the studies failed to report any uncertainty measure. Conclusions The field of geospatial estimation focused on RMNCH outcomes is clearly expanding. However, despite the adoption of a standardized conceptual modeling framework for generating finer spatial scale estimates, methodological aspects such as model validation and uncertainty demand further attention as they are both essential in assisting the reader to evaluate the estimates that are being presented.

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Section: Discussionmentioning

confidence: 99%

Geospatial estimation of reproductive, maternal, newborn and child health indicators: a systematic review of methodological aspects of studies based on household surveys

et al. 2020

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“…The 2018 PMCCS confirmed that SIAs reach much higher coverage than routine in much of Nigeria and importantly, SIA coverage among previously MCV zero-dose children was high [51], suggesting that lack of acceptance of vaccination is not a major barrier. A mixedmethods study in two Nigerian states found that receipt of MCV was related to awareness of vaccination, parental education, maternal participation in decision-making, presence of a government vaccination facility, and lack of barriers such as having to pay for vaccination [52].…”

Section: Discussionmentioning

confidence: 80%

“…Nonetheless, SIA coverage was below that required for measles elimination and in some survey clusters fewer than 25% of children in the coverage survey had received the SIA dose. Although cluster-level results are not statistically significant in a typical household survey, this imprecise suggestion of geospatial variation in SIA coverage was confirmed in separate formal analyses that were possible because geographic coordinates were obtained in the Nigeria surveys [51]. While geospatial differences in coverage were much smaller for doses given in SIAs than in RI, SIA implementation needs further improvement as well as greatly strengthening RI to approach Nigeria's measles elimination goal [27].…”

Section: Discussionmentioning

confidence: 99%

Implementing WHO Guidance on Conducting and Analysing Vaccination Coverage Cluster Surveys: Two Examples from Nigeria

Wagai¹,

Rhoda²,

Prier³

et al. 2020

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In 2015, the World Health Organization substantially revised its guidance for vaccination coverage cluster surveys (revisions were finalized in 2018) and has since developed a set of accompanying resources, including definitions for standardized coverage indicators and software (named the Vaccination Coverage Quality Indicators - VCQI) to calculate them. The current WHO vaccination coverage survey manual was used to design and conduct two nationally representative vaccination coverage surveys in Nigeria – one to assess routine immunization and one to measure post-measles campaign coverage. The primary analysis for both surveys was conducted using VCQI. In this paper, we describe those surveys and highlight some of the analyses that are facilitated by the new resources. In addition to calculating coverage of each vaccine-dose by age group, VCQI analyses provide insight into several indicators of program quality such as crude coverage versus valid doses, vaccination timeliness, missed opportunities for simultaneous vaccination, and, where relevant, vaccination campaign coverage stratified by several parameters, including the number of previous doses received. The VCQI software furnishes several helpful ways to visualize survey results. We show that routine coverage of all vaccines is far below targets in Nigeria and especially low in northeast and northwest zones, which also have highest rates of dropout and missed opportunities for vaccination. Coverage in the 2017 measles campaign was higher and showed less geospatial variation than routine coverage. Nonetheless, substantial improvement in both routine program performance and campaign implementation will be needed to achieve disease control goals.

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“…Studies (Odusanya et al 2008;Adedire et al 2016) on vaccination coverage in Nigeria have focused on predictors of vaccination uptake in specific communities, requiring collection of detailed data but with limited national policy relevance. Few studies (Antai 2009;Olorunsaiye and Degge 2016;Utazi et al 2020) which have used nationally representative data did not examine the spatial heterogeneity of uptake of each basic vaccine component but focused on determinants of full vaccination.…”

Section: Introductionmentioning

confidence: 99%

Geospatial Analysis of Vaccination Coverage and Predictors of Non- and Under-Vaccination of Children Aged 12–23 Months in Nigeria

Akinyemi

2020

Papers in Applied Geography

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This study (1) examines the spatial variation of uptake for each dose of basic vaccine and (2) identifies the predictors of non-and incomplete vaccine uptake among children aged 12-23 months in 2018 using data from NDHS. Spatial statistical techniques and multinomial logistic regression analyses were employed. Findings indicate wide variation of coverage at regional, urban/rural, and district levels. Coverage for all the vaccines exhibited statistically significant spatial dependence nationally. Locally, vaccination coverage hotspot for all the vaccines clustered among 16 states in the south while cold spots were in seven northern states. Of the 6059 children, 25, 56, and 9 percent were fully vaccinated, under-vaccinated, and non-vaccinated, respectively. Children who did not receive postnatal care, had no health card, resided in poorer households, and whose mothers did not receive tetanus injection had higher odd of being non-vaccinated. Children, who were delivered at home, did not receive postnatal care, whose mothers could not read and lived in poorest, poorer, and middle households had increased risk of being under-vaccinated. Findings suggest that increased access to immunization, community-level health education and communication are required particularly in rural and northern districts.

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Geospatial variation in measles vaccine coverage through routine and campaign strategies in Nigeria: Analysis of recent household surveys

Cited by 50 publications

References 23 publications

Geospatial estimation of reproductive, maternal, newborn and child health indicators: a systematic review of methodological aspects of studies based on household surveys

Geospatial estimation of reproductive, maternal, newborn and child health indicators: a systematic review of methodological aspects of studies based on household surveys

Implementing WHO Guidance on Conducting and Analysing Vaccination Coverage Cluster Surveys: Two Examples from Nigeria

Geospatial Analysis of Vaccination Coverage and Predictors of Non- and Under-Vaccination of Children Aged 12–23 Months in Nigeria

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