Prevalence and Factors Associated with "Zero-Dose" in Children 12 to 23 Months in Togo

Abstract

: One of the priorities of the Immunization Agenda 2030 is to identify “zero-dose” children, and to adapt strategies in order to recover them. The study aimed to estimate the prevalence of “zero-dose” in children aged 12-23 months and determine the associated factors in Togo. This was a cross-sectional study which consisted in carrying out secondary analyzes of the databases of the Multiple Indicator Cluster Survey conducted in Togo in 2017. This study population consisted of children aged 12-23 months that had been successfully investigated during this survey. The dependent variable was the child's vaccination status (0 ="Vaccinated" vs 1 ="Zero-dose"). As for the explanatory variables, they were related to the child, the child’s mother, the household and the environment. Geospatial analyzes of child prevalence at “zero-dose” were performed using Arc GIS 10.5 software. Factors associated with “zero-dose” were identified through multivariate logistic regression. A total of 933 children under five were included in the study. The prevalence of “zero-dose” in children aged 12-23 months was 26.88% (95% CI= 23.50-30.55). We note that the factors associated with "zero-dose" in children aged 12-23 months in Togo were: the birth order of the child, the age, the level of education, the ethnicity, the religion of the head of household and the region of residence. Finally, our results can guide efforts to identify and reach children who have not received any vaccine. “Zero-dose” children can be avoided by joint interventions by the competent authorities at different levels, in particular parents, government authorities and technical and financial partners.