Drought and child vaccination coverage in 22 countries in sub-Saharan Africa: A retrospective analysis of national survey data from 2011 to 2019
| Autor: | Kyle T. Ganson, Jason M. Nagata, Tarik Benmarhnia, Sheri D. Weiser, Adrienne Epstein |
|---|---|
| Přispěvatelé: | Bassat, Quique |
| Rok vydání: | 2021 |
| Předmět: |
Male
Viral Diseases Atmospheric Science and promotion of well-being Vaccination Coverage Rain Psychological intervention Neurodegenerative Logistic regression Pediatrics Medical and Health Sciences Geographical Locations Polio vaccine Medical Conditions Medicine and Health Sciences Medicine Public and Occupational Health Pediatric Vaccines Child Health General Medicine Middle Aged Vaccination and Immunization Poliomyelitis Droughts Vaccination Infectious Diseases 3.4 Vaccines Female Infection Research Article Adult Infectious Disease Control Adolescent Immunology Measles complex mixtures Odds Vaccine Related Young Adult Meteorology General & Internal Medicine Humans Africa South of the Sahara Retrospective Studies Drought business.industry Prevention Ecology and Environmental Sciences Biology and Life Sciences Infant medicine.disease Prevention of disease and conditions Health Surveys Polio Vaccination Good Health and Well Being People and Places Africa Earth Sciences Immunization Preventive Medicine business Demography |
| Zdroj: | PLoS medicine, vol 18, iss 9 PLoS Medicine, Vol 18, Iss 9, p e1003678 (2021) PLoS Medicine |
| Popis: | Background Extreme weather events, including droughts, are expected to increase in parts of sub-Saharan Africa and are associated with a number of poor health outcomes; however, to the best of our knowledge, the link between drought and childhood vaccination remains unknown. The objective of this study was to evaluate the relationship between drought and vaccination coverage. Methods and findings We investigated the association between drought and vaccination coverage using a retrospective analysis of Demographic and Health Surveys data in 22 sub-Saharan African countries among 137,379 children (50.4% male) born from 2011 to 2019. Drought was defined as an established binary variable of annual rainfall less than or equal to the 15th percentile relative to the 29 previous years, using data from Climate Hazards Group InfraRed Precipitation with Station (CHIRPS) data. We evaluated the association between drought at the date of birth and receipt of bacillus Calmette–Guérin (BCG), diphtheria–pertussis–tetanus (DPT), and polio vaccinations, and the association between drought at 12 months of age and receipt of measles vaccination. We specified logistic regression models with survey fixed effects and standard errors clustered at the enumeration area level, adjusting for child-, mother-, and household-level covariates and estimated marginal risk differences (RDs). The prevalence of drought at date of birth in the sample was 11.8%. Vaccination rates for each vaccination ranged from 70.6% (for 3 doses of the polio vaccine) to 86.0% (for BCG vaccination); however, only 57.6% of children 12 months and older received all recommended doses of BCG, DPT, polio, and measles vaccinations. In adjusted models, drought at date of birth was negatively associated with BCG vaccination (marginal RD = −1.5; 95% CI −2.2, −0.9), DPT vaccination (marginal RD = −1.4; 95% CI −2.2, −0.5), and polio vaccination (marginal RD = −1.3; 95% CI −2.3, −0.3). Drought at 12 months was negatively associated with measles vaccination (marginal RD = −1.9; 95% CI −2.8, −0.9). We found a dose–response relationship between drought and DPT and polio vaccinations, with the strongest associations closest to the timing of drought. Limitations include some heterogeneity in findings across countries. Conclusions In this study, we observed that drought was associated with lower odds of completion of childhood BCG, DPT, and polio vaccinations. These findings indicate that drought may hinder vaccination coverage, one of the most important interventions to prevent infections among children. This work adds to a growing body of literature suggesting that health programs should consider impacts of severe weather in their programming. Jason M. Nagata and colleagues investigate the association between drought and child vaccination coverage in 22 countries in sub-Saharan Africa, using Demographic and Health Survey data from 2011 to 2019. Author summary Why was this study done? Extreme weather events, including droughts, are associated with food insecurity and poor health outcomes, but the link between drought and childhood vaccination has not been studied, to the best of our knowledge. Potential mechanisms linking drought to lower childhood vaccination include food insecurity, increased human migration, and erosion of the public health infrastructure. What did the researchers do and find? We combined national survey data from 22 countries in sub-Saharan Africa with publicly available historical rainfall data to estimate drought exposure among 137,379 children born from 2011 to 2019 and estimated the association between drought and childhood vaccination completion. Drought was associated with lower odds of completion of childhood bacillus Calmette–Guérin (BCG), diphtheria–pertussis–tetanus (DPT), and polio vaccinations. We found a dose–response relationship between drought and DPT and polio vaccinations, with the strongest associations closest to the timing of drought. What do these findings mean? These findings indicate that drought may hinder vaccination coverage, one of the most important interventions to prevent infections among children. Public health programs should be prepared to address drought and adverse weather events as a barrier to childhood vaccination efforts in the face of a changing climate. |
| Databáze: | OpenAIRE |
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