Immunization Status Of Children Research Articles

Determination of immunisation status of children between 2-5 years of age who attending to teaching institute with concern to both national immunization schedule and optional vaccines

Background: In order to know the causes for non-immunisation, search for societal reasons for primary immunisation along with evaluating coverage. Aim of this current study is to determine the immunisation status of children between 2-5 years of age who are attending teaching health care centre with concern to both National Immunisation Schedule and Optional vaccines. Methods: Study analysed the children's immunisation status, factors affecting their immunisation coverage, and reasons for partial or incomplete immunisation. The information was obtained from the parents using a questionnaire. Information such as socio-demographic variables, immunisation status, causes of their partial immunisation and lack of immunisation. The "vaccination card and the recall" approach was used to determine the recipient's immunisation status. Results: Study found that 70.4% of children had received all recommended vaccinations. Lack of information and ignorance are significant contributors to under-immunization. Other statistically significant contributing factors for the low immunisation coverage include female gender, rural background, low socioeconomic status, born at home, lower mother age, and being from a joint household. BCG vaccination coverage was higher than pentavalent vaccine coverage, probably because of multiple doses needed. Only 77% of kids received vitamin A solution. Conclusions: Paediatrician should mention the next vaccination date and dose at each appointment in order to lower the vaccination dropouts. Parents should be informed regarding the date of vaccination of their child through SMS message, calls, and social media groups.

Actions speak louder than words; pediatricians, gynecologists, nurses, and other mothers' perspectives on the human papillomavirus vaccine: an Istanbul multicenter study.

Gynecologists and pediatricians have an essential duty to prevent cervical cancer. In this study, we compared the compliance of gynecologists (n = 22) and pediatricians (n = 49) with nurse/midwife (n = 66) and non-medical moms (n = 120) with regards to cervical cancer precautions. A questionnaire was used to gather data on their demographics, personal vaccination and screening practices, children's immunization status, and awareness of cervical cancer prevention. The findings demonstrated that gynecologists and pediatricians were better than others at understanding the risk factors and prevention of cervical cancer. It was noted that compared to other groups, physician mothers and their offspring had higher vaccination rates (n = 13, 18.3%; n = 10, 29.4%, respectively). Medical professionals typically provided thorough and accurate answers to informational questions. More frequent Pap smear tests were performed by gynecologists. It was noted that mothers who worked as pediatricians and nurses/midwives neglected their own screening needs. This questionnaire survey sought to ascertain Istanbul's health professionals' present opinions regarding HPV vaccination. Healthcare professionals should be the first to receive information on HPV vaccination and cervical cancer incidence reduction. The public could then readily use them as an example.

Child immunization status according to number of siblings and birth order in 85 low- and middle-income countries: a cross-sectional study

Identification of unvaccinated children is important for preventing deaths due to infections. Number of siblings and birth order have been postulated as risk factors for zero-dose prevalence. We analysed nationally representative cross-sectional surveys from 85 low and middle-income countries (2010-2020) with information on immunisation status of children aged 12-35 months. Zero-dose prevalence was defined as the failure to receive any doses of DPT (diphtheria-pertussis-tetanus) vaccine. We examined associations with birth order and the number of siblings, adjusting for child's sex, maternal age and education, household wealth quintiles and place of residence. Poisson regression was used to calculate zero-dose prevalence ratios. We studied 375,548 children, of whom 13.7% (n=51,450) were classified as zero-dose. Prevalence increased monotonically with birth order and with the number of siblings, with prevalence increasing from 11.0% for firstborn children to 17.1% for birth order 5 or higher, and from 10.5% for children with no siblings to 17.2% for those with four or more siblings. Adjustment for confounders attenuated but did not eliminate these associations. The number of siblings remained as a strong risk factor when adjusted for confounders and birth order, but the reverse was not observed. Among children with the same number of siblings, there was no clear pattern in zero-dose prevalence by birth order; for instance, among children with two siblings, the prevalence was 13.0%, 14.7%, and 13.3% for firstborn, second, and third-born, respectively. Similar results were observed for girls and boys. 9513 families had two children aged 12-35 months. When the younger sibling was unvaccinated, 61.9% of the older siblings were also unvaccinated. On the other hand, when the younger sibling was vaccinated, only 5.9% of the older siblings were unvaccinated. The number of siblings is a better predictor than birth order in identifying children to be targeted by immunization campaigns. Zero-dose children tend to be clustered within families. Gavi, the Vaccine Alliance.

An evaluation of primary immunization coverage among 12-23 months children in an urban area of western Maharashtra: a community based cross sectional study

Background: Infectious diseases are major cause of morbidity and mortality in children. One of the most cost effective and easy methods for the child survival is immunization. Objective was to determine the immunization coverage and find out the various factors and its reasons for partial or non-immunization of child. Methods: A cross-sectional study was carried out for the assessment of immunization coverage in the field practice area of the urban health training center using WHO 30×7 clusters sampling method during March 2021 to October 2022. A total of seven children aged 12-23 months were interviewed from each cluster on pretested, predesigned schedule, thus giving us the sample size of 210. Chi square test was applied for statistical analysis. Results: A total of 210 children aged 12-23 months were included in the study. It was found that 158 (75.24%) of the children were found to be fully immunized. While 49 (23.34%) and 3 (1.42%) nonimmunized respectively. Most common reason for partial and non-immunization of children was found to be obstacles and lack of motivation on the part of parents. There is only statistically significant association between education of mothers and immunization status of children. Conclusions: Increasing the knowledge and understanding of the caretakers of the young children abouts the essentiality and benefits of routine immunization would be a strong step forward in achieving the goals.

Effect of Covid pandemic on immunization status of children in tertiary care Hospital of North India: reason for partial and non-immunization a cross-sectional study

BackgroundLow immunization coverage in India attributes to many factors including sociodemographic factors and people’s behavior. COVID-19 pandemic resulted in disruptions in achieving optimum availability and utilization of immunization services. This study was carried out to find out the immunization status of children in the post COVID era and various factors responsible for non-immunization during the pandemic.MethodsThis cross-sectional study included parents of 225 admitted children aged 1–6 years were interviewed using a semi-structured open-ended questionnaire. Children were classified as completely immunized, partially immunized and unimmunized on the basis of vaccines missed given under first year of life. Reasons for non-immunization and delay/missed vaccination during COVID-19 pandemic were recorded.ResultsOf the 225 children, 162 (72%; 95% CI 66–78%) were completely immunized, 55 (24.4%; 95% CI 19–30%) were partially immunized and 8 (3.6%; 95% CI 1–6%) were unimmunized. Parents with hospital deliveries, higher education level and lesser birth order were more likely to have children with better immunization status (p < 0.05). First dose of measles scheduled at 9 months and 3rd dose of pentavalent vaccine/OPV/Rotavirus vaccine scheduled at 14 weeks were most commonly missed vaccines among partially immunized. Lack of awareness (n = 36, 57.1%; 95% CI 45–70%) was the common reason for partial and non-immunization followed by illness of child (n = 21, 33.3%; 95% CI 21–45%) and COVID-19 pandemic (n = 11, 17.4%; 95% CI 8–27%). Pandemic was reason for delay in 50 (22.2%; 95% CI 17–28%) children. Restrictions of movement (64%; 95% CI 50–78%), fear of being exposed to COVID-19 (52%; 95% CI 38–66%) were the most common reasons for delay during the pandemic. Of the 50 children who had delay due to pandemic, 39 children (17.3%; 95% CI 12–22%) received their catch-up immunization after the pandemic. No child remained completely unimmunized due to COVID-19 pandemic.ConclusionsAlthough COVID-19 pandemic resulted in disruptions in routine immunization services, sociodemographic factors such as awareness for immunization, parental education and various beliefs for immunization were responsible for the children remaining unimmunized or partially immunized after the pandemic.

Current vaccination status and safety of children with peripheral neuroblastoma in the real-world.

peripheral neuroblastic tumors (pNT) have high incidence and mortality, and infants are prone to various infectious diseases. The purpose of this study is to understand the immunization status of children with pNT in the real-world and the incidence of adverse reactions after vaccination, and to evaluate the feasibility of vaccination and the influencing factors of vaccination. Children with pNT treated in the Children's Hospital Affiliated to Zhejiang University from January 1, 2011 to December 1, 2021 were included. By referring to medical records, the vaccination history of the national immunization program (NIP) vaccines and the occurrence of adverse events following immunization(AEFI), current status and safety of immunization in children with pNT in the real-world were analyzed. Among 784 children with pNT, 394 were able to obtain the history of vaccination. The overall vaccination rate of NIP vaccines was 71.49% before chemotherapy and 37.67% after chemotherapy, and the recovery time of vaccination after treatment was 16.00 (6.00,24.00) months. Age, time of tumor diagnosis and disease classification were significantly correlated with vaccination. AEFI reported an incidence of 0.23‰. The vaccination rate of children with pNT is generally low, especially the vaccination rate after chemotherapy. The vaccination safety is good, children should be encouraged to immunize.

Immunization Status of Children 12-36 Months Age of Migrant Workers and Factors Associated with it in Urban Areas of Bangalore East.

Immunization is a cost-effective weapon against vaccine preventable diseases. Children of migrant workers suffer from lack of immunization because of frequent shift of places, poor knowledge, and low socioeconomic status. To assess the immunization status of children 12-36 months of age of migrant workers and factors associated it. To identify the reasons for non-immunization or partial immunization among these children. A cross-sectional study was conducted among 500 migrant workers' children aged 12-36 months residing in Urban Bangalore east from February 2019 to August 2020. A cluster sampling method was incorporated. The data were collected using pre-tested semi-structured questionnaire. Data were analyzed using Epi-info™ Version 7.2.1 and SPSS version-21. Data were summarized in percentages, mean, standard deviation, and logistic regression. The mean age of the children was 25.2340 ± 8.42 months. Out of 500 children, 88.60% were fully immunized, 11.40% were partially immunized, and no child was unimmunized. Significant predictors of immunization status of children were education of father and immunization card. Common reasons for dropout were inconvenient time (80.70%), unaware of need (77.19%), and busy schedule of parents (75.44%). The dropout rate of BCG to MR-1, Penta-1 to Penta-3, and Penta1to MR-1 was 6.49%, 0.85%, and 2.12%, respectively. Immunization coverage in the present study was 88.60%. Inconvenient time was the main reason behind partial immunization.

Predictors of Uptake of Rotavirus Vaccination Amongst Disadvantaged Communities in Pakistan.

Introduction. Pakistan has the highest childhood mortality associated with diarrheal diseases. The objective of this study is to identify underlying factors contributing to lack of knowledge among mothers regarding vaccine's efficacy in the prevention of diarrhea. Methodology. Secondary data was analyzed from a cross-sectional household survey in Northern Pakistan of eligible households having under-2-year children. Univariate and multivariate logistic regression analyses were carried out. Results. Only 30% of the mothers had knowledge regarding diarrhea prevention by vaccine. The main factors found significantly correlated with this knowledge were mother's education, distance of households from EPI centers, immunization status of children, counseling regarding clean drinking water and hygiene, provision of ORS, and antenatal care services by LHWs. Conclusion. Women's literacy, access to care and LHW services are important for improving awareness and acceptance of vaccines for vaccine preventable diseases including diarrhea. Policy makers need to focus on improved monitoring and reprioritization of undermined services by LHWs.

Coverage and determinants of childhood vaccination during the COVID-19 pandemic in Fortaleza, Northeastern Brazil: a longitudinal analysis.

Brazil has seen a decrease in vaccination coverage since 2016. This study analyzes the immunization status of children born during the COVID-19 pandemic in Fortaleza, Northeastern Brazil. This is a longitudinal analysis that included vaccination data of 313 children aged 12 and 18 months. Vaccination cards were checked for dose application considering the schedule of immunization recommended by the Brazilian Ministry of Health. Factors associated with no retention of vaccination cards and incomplete immunization by 18 months were identified by Tobit regression analysis. About 73% of mothers presented their child's vaccination card. Non-availability of vaccination cards was associated with maternal age < 25 years and mothers with paid jobs. Only 33% and 45% of the children aged 12 and 18 months had all vaccines up to date, respectively. For 3-dose vaccines, the delay rate was around 10% for the first dose application, but 40% for the third dose. Despite delays, most children with available vaccine cards had coverage above 90% by 18 months of age. Adjusted factors associated with incomplete vaccination included living in a household with more than one child (p = 0.010) and monthly income of less than one minimum wage (p = 0.006). Therefore, delays in child vaccine application were high during the COVID-19 pandemic but a considerable uptake by 18 months of age was found. Poorer families with more than one child were particularly at risk of not fully immunizing their children and should be the target of public policies.

Mothers/caregivers’ knowledge of routine childhood immunization and vaccination status in children aged, 12-23 months in Ilorin, Nigeria

Background: Immunization has averted millions of hospitalizations and deaths from vaccine-preventable diseases. It is a strong public health tool for childhood infection control and prevention. Many mothers are aware of routine immunization but with doubtable knowledge.Objectives: This study determined the mothers/caregivers’ knowledge of routine childhood immunization and vaccination status of their children, aged 12-23 months in Ilorin East Area of Kwara State, Nigeria. It also identified some of the socio-demographic factors associated with good knowledge status of the mothers/caregivers.Methods: This was a community-based cross-sectional study, carried out between December, 2019 and January, 2020, among 456 mothers / caregivers-children’s pairs. Subjects were recruited using multistage cluster sampling technique. Data were collected using a pretested, semi-structured, interviewer-administered questionnaire.Results: Up to 98.0% of the respondents were aware of childhood immunization with healthcare providers (92.1%) being their major source of information. Majority of the respondents (85.3%) had good knowledge of immunization, defined by a score ≤6 out of the 10 questions tested. There was a significant relationship between respondents’ knowledge and full vaccination status of the children (p=0.001). The significant factors associated with good knowledge from binary logistic regression were mothers / caregivers’ age &gt;30 years, antenatal clinic attendance and at least secondary education (OR, p value = 10.60, 0.013; 8.50, &lt;0.001; and 3.98, &lt;0.001 respectively).Conclusion: Mothers / caregivers’ knowledge on immunization was good and this positively affected the full vaccination status of their children. There is a need to sustain female education and encourage antenatal clinic attendance, as tools to improve childhood immunization.

T-cell immunity status of children with combined infection with SARS-CoV-2 and human herpesviruses

There is an opinion that COVID-19 may be the cause of the reactivation of herpesviruses. Purpose. To study the state of the cellular link of adaptive immunity in the combined course of herpesvirus infections and COVID-19, to describe the clinical and laboratory characteristics of such conditions. Material and methods. In 2022–2023 a cross-sectional study was conducted. 71 patients aged from 1 month to 16 years were selected. Inclusion criteria: presence of signs of acute respiratory disease associated with SARS-CoV-2 and/or mononucleosis-like syndrome associated with active herpesvirus infection. All patients underwent a standard laboratory examination, determined by nosology, and an additional assessment of the cellular link of adaptive immunity (CD3+, CD4+, CD8+, CD3+HLA-DR+, CD3- CD16+CD56+ and CD20+) on a flow cytometer using monoclonal antibodies. Results and conclusion. The clinical pattern of the combined course of herpesvirus infection and SARS-CoV-2 differs little from monoinfections. Only at the first encounter with the Epstein-Barr virus, lymphoproliferative syndrome and hepatomegaly were more often recorded (p&lt;0.05). Comparing the nature of the cellular immune response in patients with COVID-19 and herpesvirus infection, we observed pronounced differences. In patients with primary herpesvirus infection, the T-cell immune response was an order of magnitude higher than in acute COVID-19, herpesvirus reactivation, and co-infection, and this was true for all studied lymphocyte subpopulations. With SARS-CoV-2, a decrease in the total number of T-lymphocytes, T-helpers, and cytotoxic lymphocytes was observed. This condition, of course, cannot be called immunosuppression, but some parallel is clearly traced. And even with the combined course of SARS-CoV-2 and herpesvirus infection, the absolute values of T-cell immunity indicators do not reach the same indicators in patients without COVID-19. It is likely that this reason underlies the phenomenon of reactivation of persistent herpesviruses in patients infected with SARS-CoV-2.

Influence of maternal factors on the immunization status of under- five in Ebonyi state

Background: Poor delivery of childhood immunization with the interacting factors has been a significant public health challenge especially in the sub-Saharan Africa. Nigeria has been presented as one the countries with the worst under-five mortality rates, and factors affecting childhood immunization including maternal factors are poorly understood. The study determined the influence of maternal characteristics and immunization status of under-five children in Ebonyi State. Methods: Data were collected using an Immunization Status Checklist (ISC). The population of the study was 572,955 under-five children in Ebonyi State from which 2865 was sampled. Data were analyzed using percentages and chi-square. Results: The findings of the study revealed that 83.01% of under-5 children were fully immunized. The chi-square analysis shows a significant influence of mothers’ parity at (p&lt;0.05), mothers’ occupation at (p&lt;0.05) and mothers’ use of antenatal services at (p&lt;0.05). Conclusions: The study concluded that immunization status of under-five children in Ebonyi State was high and maternal characteristics had significant influence on immunization status of under-five children. Thus, recommended that government should provide tangible incentives to mothers who fully immunized their children and promulgate a law to prevent children without immunization cards showing full immunization from registering in public and private primary schools.

Retrospective review of empyema and parapneumonic effusions in hospitalized children in Ghana

Objectives: Empyema and parapneumonic effusions (PPEs) are common complications of community-acquired pneumonia in children. Both contribute to prolonged hospital stay, increased morbidity, and less frequent mortality. This study aimed to describe the demographics, immunization status, clinical profile, etiology, and outcomes in children admitted with empyema and PPE to the Komfo Anokye Teaching Hospital. Materials and Methods: This was a retrospective cross-sectional study that reviewed folders and electronic records of children admitted from January 2016 to December 2020. Information on demographic characteristics, immunization status, clinical profile, date of admission, and discharge or death were documented. Information was extracted using Microsoft Excel. Data was then analysed with Stata statistical software package version 16. Results: Records were available for 51 out of 65 children, the median age was 42 months interquartile range (IQR) (22.5–96) and 68.6% (n = 35) of the children were males. Three of the children 5.9% did not have a chest drain inserted. In all, 60.8% (n = 31) of the children had received all doses of the pneumococcal conjugate vaccine (PCV) up-to-date for age. Four children (7.8%) had oxygen saturation &lt;90%, whereas 43.9% (n = 18) had axillary temperature &gt;38°C. Blood cultures were done for 72.6% (n = 37) of patients, Staphylococcus aureus was isolated in 5 patients (13.5%, n = 5/37) and Streptococcus pneumoniae was isolated in 1 patient (2.7%, n = 1/37). While the rest, 83.8% (n = 31) had no bacterial growth. The pleural aspirate culture was done in 64.7% (n = 33) of the patients and 6 (18.1%) had S. aureus isolated. Common antibiotics administered were amoxicillin clavulanic acid in 33.3% (n = 17) of the patients, and ceftriaxone in 31.4% (n = 16) of the patients. Three (5.9%) children died. The median length of hospital stay was 9 days IQR (7–14). Conclusion: Empyema and PPE occurred more commonly in children older than 1 year, with a low mortality rate among the children. Most children with empyema were full immunised with PCV-13.

41 Evaluating Immunization Status and Barriers to Immunization for Patients Admitted to the Stollery Children's Hospital

Abstract Introduction/Background Routine immunization is an effective public health intervention. Despite this, immunization coverage in Alberta remains below national targets. While vaccine hesitancy is a frequently cited barrier, underimmunization is likely multifactorial. Previous research has shown that hospitalization presents an opportunity to “catch-up” children who are underimmunized. Unfortunately, this is not readily available at the Stollery Children’s Hospital (SCH), a paediatric tertiary care facility serving a large catchment area. Objectives The primary objective of this study was to assess the immunization status of children admitted to paediatric clinical teaching units (CTUs) at SCH. Our secondary objective was to assess potential barriers caregivers face while attempting to immunize their children. Design/Methods Between July 2021 and October 2022, we prospectively gathered the immunization status of children aged 2 months to 18 years admitted to paediatric clinical teaching units (CTUs) at SCH. Two hundred and fifty children and their caregivers were enrolled in the research study. Demographic data and immunization records were documented, and immunization status of each participant was classified as up-to-date or not-up-to-date based on the Alberta Routine Childhood Immunization Schedule. Caregivers completed a standardized survey, Searching for Hardships and Obstacles to Shots (SHOTS), to assess potential barriers they face while attempting to immunize their children, including three subscales (access to shots, concerns about shots and importance of shots). Results Of the 250 children enrolled, immunization data was available for 240 children. Of these, 142 (59%) were up-to-date on their immunizations. Assessment of demographic data revealed no difference in immunization status between urban and rural addresses. When evaluating barriers that families face when approaching immunization, concerns about immunization were most commonly cited as barriers for all patients. However, caregivers whose children were not up-to-date on immunizations scored higher on all subscales compared to those whose children were up-to-date. Conclusion The immunization status of children admitted to paediatric CTUs at SCH falls far below national targets. Due to logistical issues, it is challenging to access routine immunizations during hospitalization. Caregivers of children who are underimmunized also identify a higher rate of barriers to immunization. These underimmunized patients represent a missed opportunity, and improving access to routine immunization while in hospital could improve the overall immunization rates for both hospitalized children and the broader community.

Child Morbidity in Eastern Indonesia: Does Education and Smoking Behavior of Parents Influence it?

Child health is important, as it contributes to the child’s future. Indonesia was ranked second after India as a country with the highest tuberculosis (TB) cases. Well-educated parents must care for their children and maintain their health. At the same time, provinces in Eastern Indonesia have the lowest percentage of non-smoking areas (KTR) implementation. In this study, we analyzed the level of morbidity that focuses on respiratory disease, namely coughing and breathlessness in children. In addition, this study also analyzed the education and parents’ smoking behavior focused in Eastern Indonesia. The study analyzes child morbidity according to several affecting factors. Data used were cross-section data collected from secondary data from Indonesia Family Life Survey East (IFLS-East) in 2012. By applying the logistic regression analysis by logit and probit analysis, we figured out that parents’ education, children’s age, health service availability, and domicile area significantly influenced child morbidity. Fathers’ education played a crucial role, as the higher their education, the lower their children’s morbidity. Besides, we also found out that parents’ smoking habits, child immunization status, sex, and health insurance ownership did not significantly influence child morbidity. Fulfillment of educational aspects is required to the maximum until reaching adulthood, especially for unmarried individuals. Apart from that, parents of smokers and non-smokers need to be educated effectively on the dangers of smoking in order to create a healthy environment and the importance of tobacco or cigarette control policies in the Eastern part of Indonesia.

The Relationship between Socio-Culture and Family Support with the Status of Complete Basic Immunization in Children in the Working Area of Handil Baru Health Center 2023

The target for achieving complete basic immunization at the Handil Baru Health Center in 2021 is 51.78%, with 450 children aged 1 year. Mothers with children aged 1 year are of the opinion that children do not get complete immunizations because the specified time has passed, the child is sick and afraid that the child will have a fever when given immunizations. The aim is to find out the relationship between socio-cultural and family support with complete basic immunization status in children. This type of research is an analytic survey using a cross-sectional design. The population is mothers who have children aged 1 year at the working area Handil Baru Health Center in 2021 adding up to 450 individuals, utilizing the Slovin recipe an example of 82 individuals is gotten. Simple random sampling and proportional random sampling are used in the sampling process. Chi-Square analysis of the data. Most of the respondents were aged between 20-35 years (97.6%), graduated from high school (56.1%) and worked as housewives (46.3%). Socio-cultural conditions were mostly good (61%), family support was balanced (50%) and complete basic immunization status was mostly incomplete (58.5%). There is a socio-cultural relationship with complete basic immunization status (p value : 0.008 &lt; α : 0.05) and there is a relationship between family support and complete basic immunization status (p value : 0.014 &lt; α : 0.05)

Innovative approach in assessing the children's immunization status when it cannot be documented.

During surveys, it is recommended that children immunization status should be based on immunization documents. It has been noted that in some communities, a number of children are claimed to be vaccinated but have no evidence of vaccination. This work is proposed to estimate routine immunization coverage in children based on both documented vaccination and the tracking of undocumented immunization. It was a community-based survey targeting children aged 0-59 months in which the immunization status of children was assessed based on vaccination documents and based on a questionnaire tracking immunization sites and period for children with undocumented vaccination. The vaccination coverage and completeness were estimated from data collected in immunization cards and re-estimated after tracking the immunization status of children with no immunization cards. Of 1435 children reached in households, 1430 (99.7%) were included. Of 1072 children aged 12-59 months, 194 (18.1%) received DPT-Hi+Hb 3 with evidence and 399 (37.2%) with evidence and tracking. In the same age group, the dropout rate from DPT-Hi+Hb 1 (157 doses administered) to DPT-Hi+Hb 3 (127 doses administered) with evidence was 19.1% and 42.4% with evidence and tracking. The tracking of immunization status in children with no evidence of vaccination allows to determine their immunization status and to improve the reliability of the estimated vaccination coverage. This strategy could be adopted to be part of the planning and implementation of vaccination coverage surveys of EPI vaccines.

Contextual factors influencing incomplete immunization and investigation of its geospatial heterogeneity in Pakistan: a cross-sectional study based on PDHS (2017–18)

BackgroundImmunization is one of the most effective public health initiatives, saving millions of lives and lowering the risk of diseases such as diphtheria, tetanus, influenza, and measles. Immunization saves an estimated 2–3 million lives per year. A study of the regional variations in incomplete immunization will be useful in identifying gaps in the performance of immunization programs that are not noticed by standard vaccination programs monitoring. The primary goal of this study was to identify factors influencing child immunization status and to examine regional variations in incomplete immunization among children aged 12 to 23 months in Pakistan.MethodsFor the current study, the data were taken from the Demographic and Health Survey for Pakistan (PDHS 2017–2018). Ever-married women who had children aged 12–23 months were included in this study. The immunization status of children was used as an outcome variable. In order to determine the effects of different factors on incomplete immunization, multilevel logistic model was used. To study the geographical variation of incomplete immunization, hotspot analysis was done using ArcGIS 10.7 and SaTScan software and to identify significant predictors of incomplete immunization, GWR 4 software was used.ResultsPlace of delivery, gender of child, mother’s educational level and region were identified as significant determinants of incomplete immunization of children in Pakistan. Chances of incomplete immunization of children were found significantly lower for educated mothers (AOR = 0.52, 95% CI 0.34–0.79) and mothers who had delivered children in the health facilities (AOR = 0.51, 95% CI 0.32–0.83). Female children were more likely (AOR = 1.44, 1.95% CI 1.04–1.99) to be incompletely immunized as compared to male children. FATA (AOR = 11.19, 95% CI 4.89–25.6), and Balochistan (AOR = 10.94, 95% CI 5.08–23.58) were found at the highest risk of incomplete immunization of children as compared to Punjab.The significant spatial heterogeneity of incomplete immunization was found across Pakistan. The spatial distribution of incomplete immunization was clustered all over Pakistan. The high prevalence of incomplete immunization was observed in Balochistan, South Sindh, North Sindh, South KPK, South FATA, Gilgit Baltistan, Azad Jammu Kashmir, South and East Punjab. Drang and Harcho were identified as hotspot areas of incomplete immunization in Gilgit Baltistan. Secondary clusters with a high risk of incomplete immunization were found in regions Balochistan, Sindh and FATA.ConclusionGender biasedness towards female children, regarding complete immunization of children prevailed in Pakistan. Spatial heterogeneity was also found for incomplete immunization of children. To overcome the problem access to health facilities is the foremost step. Government should target hotspot areas of incomplete immunization of children to provide primary health care facilities by opening health care units in these areas. The government in collaboration with the media should launch awareness campaigns in those areas to convince people that complete immunization is the right of every child regardless of gender.

Comparing full immunisation status of children (0–23 months) between slums of Kampala City and the rural setting of Iganga District in Uganda: a cross-sectional study

BackgroundImmunisation remains the most cost-effective public health intervention in preventing morbidity and mortality due to Vaccine-Preventable Diseases (VPDs). The study aims to compare the differences in immunisation coverage amongst children aged 0 to 23 months living in slums of Kampala city and Iganga as rural districts in Uganda.MethodsThis study utilises data from a cross-sectional survey done in 2019 in the slums of Kampala City and the rural district of Iganga within the Health and Demographic Surveillance Site (HDSS). It included 1016 children aged 0–23 months and their parents. A logistic regression model was used to analyse the relationship between multiple independent variables and the binary dependent variables (fully immunised) using Stata statistical software. The measures of association were odds ratios reported with a corresponding 95% confidence interval.ResultsOut of the 1016 participants, 544 participants live in the rural area and 472 participants in the slums. Slums had 48.9% (n = 231) of fully immunised children whilst rural areas had 43.20% (n = 235). The multivariate analysis showed that children living in slums are more likely to be fully immunised as compared to their counterparts in rural areas (Odds ratio:1.456; p = 0.033; CI:1.030–2.058). Immunisation coverage for BCG (98.9%), Polio 0 (88.2%), Penta1 (92.7%), and Pneumo1 (89.8%) were high in both settlements. However, the dropout rate for subsequent vaccines was high 17%, 20% and 41% for Penta, pneumococcal and rota vaccines respectively. There was poor uptake of the new vaccines with slums having 73.4% and 47.9% coverage for pneumococcal and rota vaccines respectively and rural areas had 72.1% and 7.5% for pneumococcal and rota vaccines respectively.ConclusionThe low full immunisation status in this study was attributed to the child’s residence and the occupation of the parents. Lack of education and poor access to messages on immunisation (inadequate access to mass media) are other contributing factors. Educational messages on the importance of immunisation targeting these underserved populations will improve full immunisation coverage.

A cross-sectional study of anthropometry and immunization coverage of Anganwadi children in a rural area of Karnataka.

Children are a supreme asset to a nation. Beginning six years of life is pivotal for the social, emotional, cognitive, physical, motor, and psychological upbringing of the child. National Family Health Survey (NFHS) 5 data shows 41.9% of children die before the age of five years, with greater mortality in the rural areas (45.7%). The present study was conducted to assess the anthropometric profile and immunization status of children in Anganwadi centers. A community-based cross-sectional study was conducted in 21 Anganwadi centers in a rural area in South India. The anthropometry (height, weight, mid-upper arm circumference), morbidity profile, and immunization status of the enrolled and available children were assessed with the help of WHO growth charts, Salter scale, clinical examination, immunization cards, and data from Anganwadi registers. Data were compiled and analyzed using SPSS software version 20. Descriptive data were interpreted as mean and percentages and associations were tested with the Chi-square test, and Fisher's exact test. A P value of <0.05 was considered to be statistically significant. Around 400 children, aged 0-6 years, participated in the study. The mean age of the study population was 42.08 ± 12.55 months. The overall prevalence of underweight, stunting, and wasting was 52%, 54%, and 47.5% respectively. The most common morbidity was upper respiratory tract infection (11.5%). A majority (97.5%) of children were found to be immunized appropriately as per age. The prevalence of malnutrition was alarmingly high which warrants urgent referral and follow-up. The ICDS services, although substantially beneficial, need focal strengthening with regard to the nutritional status of enrolled children.