刚果民主共和国难民和境内流离失所者中接种疫苗次数为零和不足的儿童的特征。

IF 2.4 Q3 INFECTIOUS DISEASES
Marcellin Mengouo Nimpa, Aimé Cikomola Mwana-Wabene, John Otomba, Jean-Crispin Mukendi, M Carolina Danovaro-Holliday, Franck-Fortune Mboussou, Dieudonné Mwamba, Leandre Kambala, Dolla Ngwanga, Cedric Mwanga, Sume Gerald Etapelong, Issaka Compaoré, Moise Désiré Yapi, Daniel Katuashi Ishoso
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引用次数: 0

摘要

背景:刚果民主共和国(DRC)是世界上未接种疫苗和接种疫苗不足的儿童人数最多的国家之一,同时也是难民和境内流离失所者(IDP)人数最多的国家之一。本研究旨在确定和比较刚果(金)难民和国内流离失所者中零剂量(ZD)和接种不足(UV)儿童的比例和特征,以及疫苗接种计划不完整的原因:数据来自 2022 年 9 月 10 日至 2023 年 7 月 3 日对刚果民主共和国 12 个省的难民和境内流离失所者进行的滚动疫苗接种覆盖率调查。未接种ZD是指12-23个月的儿童未接种过任何剂量的五价疫苗白喉-百日咳-破伤风-乙肝(通过卡或召回),未接种UV是指未接种过第三剂五价疫苗。本报告采用逻辑回归模型列出了未接种和接种不足的比例以及与之相关的因素。使用世界卫生组织免疫行为和社会驱动因素概念框架描述了这些儿童未接种疫苗的原因,并使用 Pearson's Chi2 检验进行了比较:在纳入分析的 692 名 12 至 23 个月大的儿童中,9.3%(95% CI:7.2-11.7%)为 ZD,40.9%(95% CI:95%:37.2-44.6%)为 UV。Penta1/Penta3的辍学率为34.9%。经调整后,ZD 儿童有明显的家庭或道路分娩史。尿毒症患儿的母亲/照顾者年龄在 40 岁以下、未受过教育、农民、牧场主、受雇者、农村居民,以及在家或路上分娩都与尿毒症有关。与人们的看法和感受有关的原因在浙大(50.0%)比在紫外(38.3%)更常被提及。与社会原因有关的原因,ZD(40.6%)比 UV(35.7%)更多。与 "计划和实际问题 "有关的原因,零起点儿童(90.5%)的提及率低于普通儿童(97.1%):结论:在刚果(金)的难民和境内流离失所者营地中,ZD儿童和UV儿童占很大比例。结论:在刚果(金)的难民和境内流离失所者营地中,ZD 和 UV 儿童所占比例很大,但 ZD 儿童的比例低于全国儿童,而 UV 儿童的比例与全国儿童相当,这反映在极高的辍学率上。与对刚果(金)普通人群的研究类似,零接种儿童辍种的原因主要与照顾者接种疫苗的积极性有关,而未接种儿童辍种的原因则更多地与卫生系统的计划和实际问题有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characterizing zero-dose and under-vaccinated children among refugees and internally displaced persons in the Democratic Republic of Congo.

Background: The Democratic Republic of Congo (DRC) has one of the highest numbers of un and under-vaccinated children as well as number of refugees and internally displaced persons (IDPs) in the world. This study aims to determine and compare the proportion and characteristics of zero-dose (ZD) and under-vaccinated (UV) children among refugees and IDPs in the DRC, as well as the reasons for incomplete vaccination schedules.

Methods: Data from a rolling vaccination coverage survey conducted from September 10, 2022, to July 03, 2023, among refugees and IDPs in 12 provinces of the DRC. ZD was defined as a child aged 12-23 months who had not received any dose of pentavalent vaccine DTP-Hib-Hep B (by card or recall) and UV as a child who had not received the third dose of pentavalent vaccine. The proportions of non and under-vaccination and the associated factors using a logistic regression model are presented for ZD and UV children. The reasons for non-vaccination of these children are described using the WHO-Immunization behavioral and social-drivers-conceptual framework and compared using Pearson's Chi2 test.

Results: Of 692 children aged 12 to 23 months included in the analysis, 9.3% (95% CI: 7.2-11.7%) were ZD and 40.9% (95% CI: 95%: 37.2-44.6%) UV. The Penta1/Penta3 drop-out rate was 34.9%. After adjustment, ZD children had a significant history of home or road birth. And UV children were significantly associated with mothers/caregivers being under 40, uneducated, farmers, ranchers, employed, rural residents, as well as with home or road births. Reasons linked to people's perceptions and feelings were cited much more often for ZD (50.0%) than for UV (38.3%). Those related to social reasons were cited much more often by ZD (40.6%) than by UV (35.7%). Reasons related to "programmatic and practical issues" were cited less for ZD (90.5%) than for UV (97.1%).

Conclusions: ZD and UV children represent significant proportions in refugee and IDPs sites in the DRC. However, the proportion of ZD is less than for the entire country, while the proportion of UV is comparable, reflected in a very high drop-out rate. Similarly to studies in the general population in DRC, the reasons for ZD children were mainly linked to challenges in caregiver motivation to vaccinate, while for UV children, they were more often linked to pro-grammatic and practical problems of the health system.

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来源期刊
CiteScore
5.20
自引率
0.00%
发文量
25
审稿时长
17 weeks
期刊介绍: Tropical Diseases, Travel Medicine and Vaccines is an open access journal that considers basic, translational and applied research, as well as reviews and commentary, related to the prevention and management of healthcare and diseases in international travelers. Given the changes in demographic trends of travelers globally, as well as the epidemiological transitions which many countries are experiencing, the journal considers non-infectious problems including chronic disease among target populations of interest as well as infectious diseases.
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