Abstract
BackgroundVaccination has been shown to reduce mortality and morbidity due to vaccine-preventable diseases. However, these diseases are still responsible for majority of childhood deaths worldwide especially in the developing countries. This may be due to low vaccine coverage or delay in receipt of age-appropriate vaccines. We studied the timeliness of routine vaccinations among children aged 12–59 months attending infant welfare clinics in semi-urban areas of The Gambia, a country with high vaccine coverage.MethodsA cross-sectional survey was conducted in four health centres in the Western Region of the Gambia. Vaccination dates were obtained from health cards and timeliness assessed based on the recommended age ranges for BCG (birth–8 weeks), Diphtheria-Pertussis–Tetanus (6 weeks–4 months; 10 weeks–5 months; 14 weeks–6 months) and measles vaccines (38 weeks–12 months). Risk factors for delay in age-appropriate vaccinations were determined using logistic regression. Analysis was limited to BCG, third dose of Diphtheria-Pertussis -Tetanus (DPT3) and measles vaccines.ResultsVaccination records of 1154 children were studied. Overall, 63.3 % (95 % CI 60.6–66.1 %) of the children had a delay in the recommended time to receiving at least one of the studied vaccines. The proportion of children with delayed vaccinations increased from BCG [5.8 % (95 % CI 4.5–7.0 %)] to DPT3 [60.4 % (95 % CI 57.9 %-63.0 %)] but was comparatively low for the measles vaccine [10.8 % (95 % CI 9.1 %–12.5 %)]. Mothers of affected children gave reasons for the delay, and their profile correlated with type of occupation, place of birth and mode of transportation to the health facilities.ConclusionDespite high vaccination coverage reported in The Gambia, a significant proportion of the children’s vaccines were delayed for reasons related to health services as well as profile of mothers. These findings are likely to obtain in several countries and should be addressed by programme managers in order to improve and optimize the impact of the immunization coverage rates.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1015-9) contains supplementary material, which is available to authorized users.
Highlights
Vaccination has been shown to reduce mortality and morbidity due to vaccine-preventable diseases
Study setting This study was conducted from January to June 2011 at the infant welfare clinics (IWC) of Fajikunda, Serrekunda and Sukuta Health Centres and Jammeh Foundation for Peace Hospital in the Western Region of The Gambia
This study identified that about two-thirds of children aged between 12 and 59 months attending the health centres in the Western Region of The Gambia for immunization had experienced delay in the receipt of at least one of their vaccines
Summary
Vaccination has been shown to reduce mortality and morbidity due to vaccine-preventable diseases. These diseases are still responsible for majority of childhood deaths worldwide especially in the developing countries. This may be due to low vaccine coverage or delay in receipt of age-appropriate vaccines. Vaccine-preventable diseases are still responsible for over three million childhood deaths each year globally especially in low income countries [7, 8]. Some of the major factors that determine this trend include: low proportion of population immunized which is responsible for herd immunity, challenges with cold chain logistics and gaps in the timing of the vaccine administration which create a period of inadequate protection to the child. Researchers assessing timeliness of vaccination in some low and middle-income countries reported substantial delay in the receipt of age-appropriate vaccinations [4, 10]
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