Multilevel Analysis of Individual and Contextual Factors Associated with Polio Non-Vaccination in Africa: Further Analyses to Enhance Policy and Opportunity to Save More Lives

Uthman, Olalekan A.; Ndwandwe, Duduzile; Uthman, Muhammed Mubashir B; Yaya, Sanni; Wiysonge, Charles Shey

doi:10.3390/vaccines9070683

Cited by 4 publications

(6 citation statements)

References 25 publications

(27 reference statements)

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“…MV receipt was related both to socio-economic variables and access to media, birth order, health insurance, and bednet ownership. Children who had a birth order above two were less likely to receive MV, signalling that even though older mothers were more likely to have their children vaccinated, this propensity could change with subsequent births [ 13 , 14 , 16 , 58 , 62 , 63 ]. Health insurance and bednet ownership could reflect both wealth and a positive attitude to health care.…”

Section: Discussionmentioning

confidence: 99%

Multilevel analysis of predictors of multiple indicators of childhood vaccination in Nigeria

et al. 2022

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Background Substantial inequalities exist in childhood vaccination coverage levels. To increase vaccine uptake, factors that predict vaccination coverage in children should be identified and addressed. Methods Using data from the 2018 Nigeria Demographic and Health Survey and geospatial data sets, we fitted Bayesian multilevel binomial and multinomial logistic regression models to analyse independent predictors of three vaccination outcomes: receipt of the first dose of Pentavalent vaccine (containing diphtheria-tetanus-pertussis, Hemophilus influenzae type B and Hepatitis B vaccines) (PENTA1) (n = 6059) and receipt of the third dose having received the first (PENTA3/1) (n = 3937) in children aged 12–23 months, and receipt of measles vaccine (MV) (n = 11839) among children aged 12–35 months. Results Factors associated with vaccination were broadly similar for documented versus recall evidence of vaccination. Based on any evidence of vaccination, we found that health card/document ownership, receipt of vitamin A and maternal educational level were significantly associated with each outcome. Although the coverage of each vaccine dose was higher in urban than rural areas, urban residence was not significant in multivariable analyses that included travel time. Indicators relating to socio-economic status, as well as ethnic group, skilled birth attendance, lower travel time to the nearest health facility and problems seeking health care were significantly associated with both PENTA1 and MV. Maternal religion was related to PENTA1 and PENTA3/1 and maternal age related to MV and PENTA3/1; other significant variables were associated with one outcome each. Substantial residual community level variances in different strata were observed in the fitted models for each outcome. Conclusion Our analysis has highlighted socio-demographic and health care access factors that affect not only beginning but completing the vaccination series in Nigeria. Other factors not measured by the DHS such as health service quality and community attitudes should also be investigated and addressed to tackle inequities in coverage.

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Section: Discussionmentioning

confidence: 99%

Multilevel analysis of predictors of multiple indicators of childhood vaccination in Nigeria

et al. 2022

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“…Similarly, a study in Japan aimed to analyze the correlation between BCG immunization and healthy houses with ndings of pediatric tuberculosis, emphasizing the multifaceted nature of vaccination coverage (Ambarwati, 2019). These ndings align with the broader context of vaccination efforts, as evidenced by a study in Africa, which aimed to examine the individual-, neighborhood-, and country-level factors associated with non-vaccination against polio, emphasizing the need for a multilevel analysis to enhance policy and save more lives (Uthman et al, 2021).…”

Section: Social and Demographic Characteristicsmentioning

confidence: 99%

Factors Influencing Childhood Immunization Coverage in Juba County, South Sudan: A Cross-Sectional Survey

Mwanje

2023

Preprint

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Introduction: The study aimed to investigate the immunization status of children aged 1 to 2 years in Juba County, South Sudan, and to identify factors associated with their immunization coverage. Methods: A cross-sectional survey design was employed, with Juba being purposively sampled and the Payams in Juba being stratified, followed by the random sampling of villages within these Payams. Data was collected through structured interviews and analyzed using SPSS v22, incorporating descriptive and inferential statistics. Findings: The study revealed that more than three-quarters of the children had received all the recommended vaccines, with the BCG vaccine being the most commonly received, while the measles vaccine was the least received. The study identified several factors associated with immunization coverage, including parental age, religious affiliation, knowledge of the benefits of immunization, maternal economic activity, and perceived flexibility of immunization services provided at healthcare facilities. Notably, the prevalence of reception of all vaccines was lower among children whose parents were aged 18–25 years and born-again Christians, while it was higher among children whose parents recognized the benefits of immunization. Additionally, children whose mothers were engaged in economic activities were less likely to receive all primary vaccines. Furthermore, the study found that the flexibility of immunization services at healthcare facilities was associated with lower immunization coverage. Conclusion: The study highlighted that while the proportion of children in Juba receiving all vaccines is relatively high, it still falls below the global standard of 90%. The immunization status of children in Juba was found to be primarily influenced by parental characteristics, with institutional characteristics playing a smaller role. These findings underscore the importance of targeted interventions to address specific parental and institutional factors that may hinder optimal immunization coverage in Juba County, South Sudan.

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“…Poliovirus cases had reduced by over 99% since 1988, from a projected 350,000 cases in more than 125 endemic countries to 179 described cases in two countries in 2019 [9]. As a result of global eradication efforts, polio is now only endemic in Afghanistan, Nigeria, and Pakistan [10,11]. However, countries with low vaccination rates continue to be at risk for re-introduction of the virus due to imported cases resulting from travel.…”

Section: Introductionmentioning

confidence: 99%

“…However, countries with low vaccination rates continue to be at risk for re-introduction of the virus due to imported cases resulting from travel. Unvaccinated travelers, especially children, pregnant women, and those with weakened immune system going to areas with polio outbreaks are at risk [11]. However, countries that have been cleared of the wild poliovirus, but at low vaccination rates and with weak and porous surveillance systems, continue to be at risk for re-introduction of the virus due to imported cases [12].…”

Section: Introductionmentioning

confidence: 99%

“…Ethiopia has been realizing EPI free of charge aiming to immunize all children between the ages of 0 and 23 months against oral polio [16]. The findings of a recent study on factors associated with non-vaccination against polio has awakened the need for research to understand the vaccination status of children against polio in specific countries in Africa [11]. An extensive search of the literature on childhood vaccination in Ethiopia, where polio constitutes a major cause of death among children under five, shows that most studies conducted on childhood vaccination focused on the basic childhood vaccines together to determine whether a child was fully vaccinated or not.…”

Section: Introductionmentioning

confidence: 99%

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Bayesian Analysis of Predictors of Incomplete Vaccination against Polio among Children Aged 12–23 Months in Ethiopia

Chikako

Seidu

Hagan

et al. 2021

IJERPH

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Background: The re-introduction of polio among children aged 12–23 months is likely to occur in Ethiopia due to the low vaccination rates against poliovirus. The study sought to examine the predictors of incomplete vaccination against polio among children aged 12–23 months in Ethiopia. Methods: The data used were obtained from the 2016 Ethiopia Demographic and Health Survey. Binary and Bayesian logistic regressions were used for the data analysis, with parameters estimated using classical maximum likelihood and the Bayesian estimation method. Results: The results revealed that 43.7% of the children were not fully vaccinated against polio in Ethiopia. Maternal age, educational level, household wealth index, exposure to mass media, place of residence, presence of nearby healthy facility, counseling on vaccination, and place of delivery were significant determinants of incomplete polio vaccination among children aged between 12 and 23 months in Ethiopia. Conclusion: Considerable numbers of children are not fully vaccinated against polio in Ethiopia. Individual and contextual factors significantly contributed to incomplete polio vaccination among children in the country. Therefore, the government and other stakeholders should pay particular attention to maternal education to increase mothers’ educational level in all regions and give training and counseling in all urban and rural parts of the country on child vaccination to overcome the problem of children’s incomplete polio vaccination and/or vaccination dropout.

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Multilevel Analysis of Individual and Contextual Factors Associated with Polio Non-Vaccination in Africa: Further Analyses to Enhance Policy and Opportunity to Save More Lives

Cited by 4 publications

References 25 publications

Multilevel analysis of predictors of multiple indicators of childhood vaccination in Nigeria

Multilevel analysis of predictors of multiple indicators of childhood vaccination in Nigeria

Factors Influencing Childhood Immunization Coverage in Juba County, South Sudan: A Cross-Sectional Survey

Bayesian Analysis of Predictors of Incomplete Vaccination against Polio among Children Aged 12–23 Months in Ethiopia

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