撒哈拉以南非洲34个国家12-23个月儿童的区域、分区域和国家一级全面疫苗接种覆盖率:利用人口与健康调查数据进行的全球分析

IF 6.1 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
David Jean Simon, Vénunyé Claude Kondo Tokpovi, Kassoum Dianou, Osaretin Christabel Okonji, Ann Kiragu, Comfort Z Olorunsaiye, Emmanuel Juakaly Wayisovia, Adama Ouedraogo, Patrice Ngangue, Habib Tchoubou Foba, Serge Madjou
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引用次数: 0

摘要

目的:本研究估计了撒哈拉以南非洲(SSA) 12-23个月大的儿童完全接种疫苗的比例,探讨了分区域和国家之间的地理差异,并确定了与完全接种疫苗(FV)相关的国家级因素。设计:横断面研究。设置:SSA。参与者:12-23个月的儿童。主要结局:FV。方法:本研究的数据来自2012年至2023年间在34个SSA国家进行的最新人口与健康调查(DHS)。该研究包括69,218名儿童的加权样本。进行单变量分析以描述参与者的社会人口学概况,并估计FV的比例以及8种疫苗(BCG、DTP1、DTP2、DPT3、脊髓灰质炎1、脊髓灰质炎2、脊髓灰质炎3、麻疹1)在区域一级的比例。进行了双变量和空间分析,以审查区域、分区域和国家收入水平上的现有差距。采用多变量logistic回归分析确定与FV相关的国家级因素。结果:SSA地区54.1% (95% CI 53.7% ~ 54.5%)的12-23月龄儿童完全接种了疫苗。此外,从几内亚的23.9%到卢旺达的95.5%,各国之间的FV覆盖率出现了严重的不平等。在8种疫苗中观察到相同的模式。调查结果还显示,在家中分娩的3级及以上出生的儿童接受不到4次产前检查,来自贫困家庭和5人以上家庭,其母亲年龄在25岁以下,受过小学及以下教育,没有创收活动,则不太可能充分接种疫苗。结论:为了实现世卫组织在《可持续发展战略》中到2030年全球疫苗接种覆盖率达到90%的目标,疫苗接种规划必须考虑到区域、次区域和国家的不平等。我们的研究结果还强调了针对每个SSA国家的社会文化背景量身定制干预措施的必要性。伦理考虑:不需要伦理批准,因为这是对公开数据的二次分析。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Regional, subregional and country-level full vaccination coverage in children aged 12-23 months for 34 countries in sub-Saharan Africa: a global analysis using Demographic and Health Survey data.

Objective: This study estimated the proportion of children aged 12-23 months who were fully vaccinated in sub-Saharan Africa (SSA), explored geographical disparities across subregions and countries, and identified country-level factors associated with full vaccination (FV).

Design: Cross-sectional study.

Setting: SSA.

Participants: Children aged 12-23 months.

Primary outcome: FV.

Methods: Data for this study were extracted from the most recent Demographic and Health Survey (DHS) conducted in 34 SSA countries between 2012 and 2023. The study included a total weighted sample of 69 218 children. Univariate analyses were performed to describe the socio-demographic profile of the participants and estimate the proportion of FV and the proportion for each of the eight vaccines (BCG, DTP1, DTP2, DPT3, Polio1, Polio2, Polio3, Measles1) at regional level. Bivariate and spatial analyses were produced to examine existing disparities at regional, subregional and countries' income levels. A multivariate logistic regression analysis was fitted for identifying country-level factors associated with FV.

Results: 54.1% (95% CI 53.7% to 54.5%) children aged 12-23 months in SSA were fully vaccinated. In addition, substantial inequalities emerged in FV coverage across countries ranging from 23.9% in Guinea to a high of 95.5% in Rwanda. The same pattern was observed for the eight vaccines. Findings also showed that children of birth order 3 and above, who were delivered at home, had received less than four antenatal visits, from poor households and households with more than 5 members, whose mothers were under 25, had primary education level and below, and had no income-generating activities were less likely to be fully vaccinated.

Conclusion: To achieve WHO's global vaccination coverage target of 90% by 2030 in SSA, vaccination programmes must take account of regional, subregional and national inequities. Our findings also underline the need for interventions tailored to each SSA country's socio-cultural context.

Ethical consideration: Ethical approval was not required as this is a secondary analysis of publicly available data.

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来源期刊
BMJ Global Health
BMJ Global Health Medicine-Health Policy
CiteScore
11.40
自引率
4.90%
发文量
429
审稿时长
18 weeks
期刊介绍: BMJ Global Health is an online Open Access journal from BMJ that focuses on publishing high-quality peer-reviewed content pertinent to individuals engaged in global health, including policy makers, funders, researchers, clinicians, and frontline healthcare workers. The journal encompasses all facets of global health, with a special emphasis on submissions addressing underfunded areas such as non-communicable diseases (NCDs). It welcomes research across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialized studies. The journal also encourages opinionated discussions on controversial topics.
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