Vaccination timeliness among newborns and infants in Ethiopia.

Autor: Boulton ML; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America.; Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, Michigan, United States of America., Carlson BF; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America., Wagner AL; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America., Porth JM; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America., Gebremeskel B; Center for International Reproductive Health Training, University of Michigan, Ann Arbor, Michigan, United States of America., Abeje Y; Department of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2019 Feb 19; Vol. 14 (2), pp. e0212408. Date of Electronic Publication: 2019 Feb 19 (Print Publication: 2019).
DOI: 10.1371/journal.pone.0212408
Abstrakt: Background: We characterize the risk factors for delayed polio dose 1, diphtheria-tetanus-pertussis (DTP) dose 1, pentavalent dose 1, and measles dose 1 in Ethiopian infants. We also examine the interaction between institutional delivery and demographic factors on the birth doses of the BCG and polio vaccines to better understand factors influencing vaccination.
Methods: Using the 2011 Ethiopia Demographic and Health Survey, we calculated the distribution of the study population across different demographic and vaccination characteristics. We computed acceleration factors using a multivariable accelerated failure time model with a Weibull distribution to account for left and right censoring. For the birth doses, we further specified an interaction term between institutional delivery and every other a priori specified independent variable to test whether institutional delivery modifies sociodemographic disparities in vaccination timeliness.
Results: Low wealth status, home delivery, and ethnicity are risk factors for delayed vaccination of polio 1, DPT 1, pentavalent 1, and measles 1. Religion is a risk factor for measles 1 vaccination delay and rural residence are risk factors for delayed DPT1 and polio 1 doses. For birth doses of polio and BCG, institutional delivery attenuated many sociodemographic disparities in vaccination delay, except for urbanicity, which showed rural dwellers with more delay than urban dwellers with an institutional vs home birth.
Conclusions: Less delayed vaccination among children with institutional deliveries highlights the importance of perinatal care and the potential for promoting healthy behaviors to parents. Persistent disparities between urban and rural residents, even among those with institutional births, can be targeted for future interventions. Timely vaccination is key to prevention of unnecessary childhood mortality.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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