Urban-rural differences in immunisation status and associated demographic factors among children 12-59 months in a southwestern state, Nigeria.

Ibidolapo T Ijarotimi,Olufemi Ajumobi,Akinola A Fatiregun,Oluwapelumi A Adebiyi,Olayinka S Ilesanmi,Olalekan Uthman

doi:10.1371/journal.pone.0206086

Abstract

Vaccine preventable diseases (VPDs) are a leading course of child under-five mortality in sub-Saharan Africa. A target of 95% immunization coverage is necessary for the sustained control of VPDs. This study aims to determine the immunization status and its associated demo-graphic factors among children 12–59 months old in Akinyele Local Government area (LGA), Oyo State, Nigeria. A community-based cross-sectional study was carried out in one urban and one rural ward of Akinyele LGA. Fourhundred and forty-four (449) Under-five children were selected by multistage sampling technique. Data were collected from caregivers using interviewer administered questionnaires. Odds ratios at 95% CIand Chi square at 5% significant level were computed to identify the factors associated with non or partial immunisation. Multiple logistics regression at 5% significance level was done to determine the socio-demographic determinants of immunisation status. Overall, 449 children aged 12–59 months were surveyed of which 213(47.4%) were males and 236(52.6%) were from urban area. Overall, 365(81.3%) was fully immunized, 75(16.7%) was partially immunized and 9(2.0%) had never been immunized. Predictors of a child being partially or un-immunised were being in the fourth wealth quintile (AOR 7.9; 95%CI: 2.7–18.0), poorest wealth quintile (AOR 14.5; 95%CI 4.2–20.5), having a mother with no education (AOR 6.4; 95%CI: 2.9–14.1) and a mother that practiced Islam (AOR: 2.2; 95%CI: 1.3–3.7). Immunisation coverage was somewhat high but still suboptimal among the study population. Strategies that improve female literacy and those that target religious institutions may be effective in improving immunisation uptake.

Highlights

Childhood immunization has proved to be the most important child survival strategy
There was a significant difference in educational attainment among fathers between the urban and rural areas with 141(59.7%) having completed secondary education and 89(37.7%) having completed tertiary education in urban area, while only 98 (46.0%) completed secondary education and 4(1.9%) completed tertiary education among fathers in the rural area (p-
We found thatthat though children living in rural areas were more likely to be partially or unimmunised, location was not a predictor of immunisation status

Summary

Introduction

Estimated to prevent between 2 and 3 million deaths each year [1], it is one of the most essential and cost-effective strategies to reduce childhood morbidity and mortality [2]. It is one of the key elements of primary health care [3]. According to WHO estimation in 2008, 1.5 million deaths or 17% of global mortality in children under 5 years were due to only 6 Vaccine Preventable Diseases (VPDs) [4]. About 60% of these children, live in 10 countries: Angola, Brazil, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Iraq, Nigeria, Pakistan and South Africa [1]

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Conclusion