Abstract
BackgroundImmunization is one of the most effective health interventions averting an estimated 2–3 million deaths every year. In Nepal, as in most low-income countries, infants are immunized with standard WHO recommended vaccines. However, 16.4 % of children did not receive complete immunization by 12 months of age in Nepal in 2011. Studies from different parts of the world showed that incomplete immunization is even higher in slums. The objective of this study was to identify the predictors of incompletion of immunization among children aged 12–23 months living in the slums of Kathmandu Valley, Nepal.MethodsThe unmatched case-control study was conducted in 22 randomly selected slums of Kathmandu Valley. The sampling frame was first identified by complete enumeration of entire households of the study area from which 59 incompletely immunized children as cases and 177 completely immunized children as controls were chosen randomly in 1:3 ratio. Data were collected from the primary caretakers of the children. Backward logistic regression with 95 % confidence interval and adjusted odds ratio (AOR) were applied to assess the factors independently associated with incomplete immunization.ResultTwenty-six percent of the children were incompletely vaccinated. The coverage of BCG vaccine was 95.0 % while it was 80.5 % for measles vaccine. The significant predictors of incomplete immunization were the home delivery of a child, the family residing on rent, a primary caretaker with poor knowledge about the schedule of vaccination and negative perception towards vaccinating a sick child, conflicting priorities, and development of abscess following immunization.ConclusionReduction of abscess formation rate can be a potential way to improve immunization rates. Community health volunteers should increase their follow-up on children born at home and those living in rent. Health institutions and volunteers should be influential in creating awareness about immunization, its schedule, and post-vaccination side effects.
Highlights
Immunization is one of the most effective health interventions averting an estimated 2–3 million deaths every year
In most low-income countries including Nepal, infants are immunized with the standard World Health Organization (WHO) recommended vaccines that protect against eight diseases: Bacille Calmette-Guerin (BCG) vaccine which is given once at birth or in first contact to health worker, the measles vaccine given after the completion of 9 months, and the pentavalent (Diphtheria, Pertussis, Tetanus, Hepatitis B, and Haemophilus Influenza B (DPT-HepB-Hib)) vaccine as well as Oral Polio Vaccine (OPV) given three times in 6, 10 and 14 weeks of age [3, 5]
Study on factors associated with BCG versus Measles dropout in Nepal showed greater dropout rate among those living in rented house [29]
Summary
Immunization is one of the most effective health interventions averting an estimated 2–3 million deaths every year. In Nepal, as in most low-income countries, infants are immunized with standard WHO recommended vaccines. 16.4 % of children did not receive complete immunization by 12 months of age in Nepal in 2011. In most low-income countries including Nepal, infants are immunized with the standard World Health Organization (WHO) recommended vaccines that protect against eight diseases: Bacille Calmette-Guerin (BCG) vaccine which is given once at birth or in first contact to health worker, the measles vaccine given after the completion of 9 months, and the pentavalent (Diphtheria, Pertussis, Tetanus, Hepatitis B, and Haemophilus Influenza B (DPT-HepB-Hib)) vaccine as well as Oral Polio Vaccine (OPV) given three times in 6, 10 and 14 weeks of age [3, 5]. The incompletely vaccinated children remain at risk for vaccine-preventable morbidity and mortality [7]
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