Abstract
BackgroundInadequate immunization coverage remains a public health problem in Africa. In Togo, only 62% of children under one year of age were fully immunized in 2013. This study aimed to estimate the immunization coverage among children aged 12–23 months, and to identify factors associated with incomplete immunization status in Togo.MethodsA cross-sectional survey was conducted in the six health regions of Togo. Children aged 12 to 23 months who were living with one of their parents or guardians from selected households were recruited for the study. Data was collected using a pre-tested questionnaire through face-to-face interviews. Multilevel logistic regression analyses were performed to assess factors associated with incomplete immunization coverage.ResultsA total of 1261 households were included. Respondents were predominantly women (91.9%) and 22.8% had secondary or higher education level. Immunization cards were available for 85.3% of children. Complete immunization coverage was 72.3%, 95% confidence interval (CI): [69.7–74.8]). After controlling for both individual and contextual level variables, children whose mothers attended secondary school or above were 33% (adjusted Odds Ratio (aOR) = 0.67, CI [0.47–0.94]) less likely to have an incomplete immunization coverage compared to those with no education. The likelihood of incomplete immunization in children decreased with the increase in household’s income (aOR = 0.73, 95% CI [0.58–0.93]), children who did not have an immunization card (aOR = 13.41, 95% CI [9.19–19.57]) and those whose parents did not know that children immunization was free of charge (aOR = 1.82, 95% CI [1.00–3.30]) were more likely to have an incomplete immunization. Finally, children whose parents had to walk half an hour to one hour to reach a healthcare center were 57% (aOR = 1.57, 95% CI [1.15–2.13]) more likely to have an incomplete immunization coverage than those whose parents had to walk less than half an hour.ConclusionThe goal of 90% coverage at the national level has not been achieved in 2017. Innovative strategies such as using electronic cards and strengthening sensitization activities must be initiated in order to attain a complete immunization coverage in Togo.
Highlights
Inadequate immunization coverage remains a public health problem in Africa
The reasons for incomplete immunization among children have been grouped into three categories: reasons relating to the parents, those relating to healthcare system and healt hcare providers [4, 5, 9,10,11]
Since our study focused on children aged between 12 and 23 months, the definition of vaccination coverage was based on the immunization schedule adopted by the Expanded Program on Immunization (EPI) in Togo and the data available on immunization card or recall of parents/guardians
Summary
Inadequate immunization coverage remains a public health problem in Africa. In Togo, only 62% of children under one year of age were fully immunized in 2013. Complete immunization of children under one year of age remains one of the most cost-effective strategies to reduce child mortality and to help achieve Sustainable Development Goals (SDG) [1]. Every child should benefit equitably from the administration of all routine vaccines and the World Health Organization (WHO) recommends that complete immunization coverage should reach at least 90% of children at country level and 80% at district level [2, 3]. Global coverage has increased since the implementation of the Expanded Program on Immunization (EPI), in 2016, only 86% of children worldwide received 3 doses of vaccine containing diphtheria-tetanus-pertussis (DTP3) during their first year of life. In sub-Saharan Africa countries, global immunization coverage remains low and vaccinepreventable diseases constitute a major contributor to high child mortality rates [7, 8]. The reasons for incomplete immunization among children have been grouped into three categories: reasons relating to the parents, those relating to healthcare system and healt hcare providers [4, 5, 9,10,11]
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