Childhood vaccination timeliness following maternal migration to an informal urban settlement in Kenya.

Autor: Porth JM; Department of Epidemiology, School of Public Health, University of Michigan, USA; Global Institute for Vaccine Equity, University of Michigan, USA. Electronic address: jmporth@umich.edu., Wagner AL; Department of Epidemiology, School of Public Health, University of Michigan, USA; Global Institute for Vaccine Equity, University of Michigan, USA., Treleaven E; Institute for Social Research, University of Michigan, USA., Fleischer NL; Department of Epidemiology, School of Public Health, University of Michigan, USA., Mutua MK; African Population and Health Research Center, Kenya., Braun TM; Department of Biostatistics, School of Public Health, University of Michigan, USA., Boulton ML; Department of Epidemiology, School of Public Health, University of Michigan, USA; Global Institute for Vaccine Equity, University of Michigan, USA; Department of Internal Medicine, Division of Infectious Disease, University of Michigan Medical School, USA.
Jazyk: angličtina
Zdroj: Vaccine [Vaccine] 2022 Jan 28; Vol. 40 (4), pp. 627-639. Date of Electronic Publication: 2021 Dec 21.
DOI: 10.1016/j.vaccine.2021.12.017
Abstrakt: Introduction: Timely receipt of recommended vaccines is a proven strategy to reduce preventable under-five deaths. Kenya has experienced impressive declines in child mortality from 111 to 43 deaths per 1000 live births between 1980 and 2019. However, considerable inequities in timely vaccination remain, which unnecessarily increases risk for serious illness and death. Maternal migration is a potentially important driver of timeliness inequities, as the social and financial stressors of moving to a new community may require a woman to delay her child's immunizations. This analysis examined how maternal migration to informal urban settlements in Nairobi, Kenya influenced childhood vaccination timeliness.
Methods: Data came from the Nairobi Urban Health and Demographic Surveillance System, 2002-2018. Migration exposures were migrant status (migrant, non-migrant), migrant origin (rural, urban), and migrant type (first-time, circular [previously resided in settlement]). Age at vaccine receipt (vaccination timeliness) was calculated for all basic vaccinations. Accelerated failure time models were used to investigate relationships between migration exposures and vaccination timeliness. Confounding was addressed using propensity score weighting.
Results: Over one-third of the children of both migrants and non-migrants received at least one dose late or not at all. Unweighted models showed the children of migrants had shorter time to OPV1 and DPT1 vaccine receipt compared to the children of non-migrants. After accounting for confounding only differences in timeliness for DPT1 remained, with the children of migrants receiving DPT1 significantly earlier than the children of non-migrants. Timeliness was comparable among migrants with rural and urban origins and among first-time and circular migrants.
Conclusion: Although a substantial proportion of children in Nairobi's informal urban settlements do not receive timely vaccination, this analysis found limited evidence that maternal migration and migration characteristics were associated with delays for most doses. Future research should seek to elucidate potential drivers of low vaccination timeliness in Kenya.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: