Incomplete Immunization Research Articles

Estimating the optimal age for infant measles vaccination.

The persistence of measles in many countries demonstrates large immunity gaps, resulting from incomplete or ineffective immunization with measles-containing vaccines (MCVs). MCV impact is determined, in part, by vaccination age. Infants who receive dose 1 (MCV1) at older ages have a reduced risk of vaccine failure, but also an increased risk of contracting infection before vaccination. Here, we designed a new method-based on a mathematical transmission model incorporating realistic vaccination delays and age variations in MCV1 effectiveness-to capture the MCV1 age risk trade-off and estimate the optimal age for recommending MCV1. We applied this method to a range of synthetic populations representing lower- and higher-income populations. We predict a large heterogeneity in the optimal MCV1 ages (range: 6-20 months), contrasting the homogeneity of observed recommendations worldwide. Furthermore, we show that the optimal age depends on the local epidemiology of measles, with a lower optimal age predicted in populations having lower vaccination coverage or suffering higher transmission. Overall, our results suggest the scope for public health authorities to tailor the recommended schedule for better measles control.

Evaluation of immunisation coverage and its determinants among children aged 12–23 months in urban slum areas of Jhalawar city

ABSTRACT Background: Immunisation services does not reach over one third of urban poor children. There is clear cut difference of children completely immunised in the low as compared to high standard of living index in urban areas. This difference is more marked in low performing states like Rajasthan and this difference as compared to better performing states like Kerala. Such inter-state differentials indicate the importance of extra focus on low performing states like Rajasthan. Methodology: A cross-sectional study was conducted among 550 children aged 12–23 months in an urban slum of a district in southern Rajasthan. Along with the immunisation coverage, determinants associated with incomplete immunisation was assessed. The child’s immunisation was ascertained using the immunisation cards/Mamta cards or in whom cards not available WHO recall method was used. The Chi-square test was used to find out statistical significance. Results: Of 550 children studied, 417 (75.8%) were fully immunised, 117 (21.3%) were partially immunised and 16 of them were non immunised (2.9%). When the determinants of incomplete immunisation were assessed, all were found statistically significant. Conclusion: The present study concluded that immunisation coverage is lower than that of the target. The factors thought to have influenced immunisation such as religion, family composition, education of mother and gender of child were discovered to be statistically significant.

Faktor-Faktor Yang Mempengaruhi Pemberian Imunisasi Dasar Lengkap Pada Bayi di UPTD Puskesmas Sungai Raya Aceh Timur Tahun 2024

Accination actively seeks to create/enhance a person's immunity to disease. Vaccination protects children from several immunisation-preventable diseases (VPDs). Some of the infectious diseases included in VPDs are tuberculosis, diphtheria, tetanus, hepatitis B, whooping cough, measles, polio, and meningitis. Vaccinated children will be protected from dangerous diseases that can cause injury or death. This study is included in analytical observational research, which does not conduct treatment on research subjects with the aim of providing a clearer picture of the problem in the subject. This type of research is a type of survey with a cross sectional design or where the data collection process is carried out at the same time between independent variables, namely factors that influence the provision of complete basic immunisation in infants. Based on the table, it can be seen that the majority of mothers have a high school education as many as 30 people, the majority of mothers who work as housewives as many as 46 people, the majority of mothers have less knowledge as many as 52 people, the majority of mothers with incomplete basic immunisation as many as 56 people.

Immunization Status of Children in Urban Slums of Rawalpindi and Barriers to Immunization

Objective: To determine immunization status of children residing in urban slums of Rawalpindi and identify the barriers to immunization. Study Design: Cross sectional study. Place and Duration of Study: Slums of Takht Pari, Rawalpindi Pakistan, from Jan to Mar 2020. Methodology: Children, aged 12-23 months, residing at Takht Pari were enrolled. Two sessions of a free medical camp were arranged at Takht Pari by Department of Community Medicine, Foundation University, Islamabad. Data was collected from parents visiting the medical camp with the mother labelled as the primary respondent. Immunization cards and mother’s recall were used to assess the immunization status of children. Results: Two hundred ninety-one (72.9%) children were completely immunized, partially immunized were 106(26.6%) while 2(0.5%) were unimmunized. Three hundred eighty-eight (97.2%) children were vaccinated through government centers while those who received vaccination through private clinics were 9(2.3%). Factors associated with incomplete immunization were education of parents (p<0.001), number of children (p<0.001), gender of child (p=0.001), access to TV or Radio (p<0.001), and site of immunization (government/private) (p<0.001). Conclusion: Immunization status of 73% shows that unremitting efforts are essential for attaining universal coverage of immunization with extra attention to underprivileged areas. Planning and placement of public facilities for preventive services needs to be an urgent priority improving service utilization and enhancing coverage as people tend to follow ease of accessibility for using immunization services.

Contributing Risk Factors to Pneumonia in Children Under Five Years in Madhesh Province of Nepal

Introduction: Pneumonia is the significant cause of morbidity and mortality in under five year children worldwide. In Nepal, pneumonia is the second most common cause of childhood mortality. Exclusive breastfeeding and basic immunization in preventing pneumonia cannot be underestimated. This study aims to assess the contributing risk factors associated with childhood pneumonia among children aged 16 months to under-5 year.  Methods: A case-control study was conducted from January to July 2022 including children under 5 years visiting the pediatric out-patient department of JMCTH. A total of 200 subjects aged 16–59 months were enrolled, in which ‘cases’ included 100 patients diagnosed with pneumonia and ‘controls’ included 100 patients with non-pneumonia illnesses, matched by age and setting. The WHO guideline was followed for the diagnosis of pneumonia. The data on contributing risk factors were collected from both cases and controls via interview method from their parents.  Results: The study showed non-exclusive breastfeeding [odds ratio (OR) =7.82 in 95% confidence interval (CI)], indoor air pollution [OR=7.47 in 95% CI], incomplete basic immunization [OR= 4.44 in 95% CI], low birth weight [OR=3.11 in 95% CI] and severe acute malnutrition i.e. high degree of wasting [OR=2.70 in 95% CI] were the major contributing factors of pneumonia in children under age five in the Madhesh Province of Nepal. However, nutritional status (height-for-age z score), age, sex, and educational status of mother did not appear to be contributing risk factors for pneumonia.  Conclusion: This study highlights non-exclusive breastfeeding, indoor air pollution, incomplete basic immunizations, low birth weight, and severe acute malnutrition significantly increase the risk of childhood pneumonia. Exclusive breastfeeding plays a vital role, while gender seems to influence the relationship between exclusive breastfeeding and pneumonia incidence.

Factors of Child Growth Failure Based on the Composite Index of Anthropometric Failure in West Sulawesi Province

Background: The composite index of anthropometric failure (CIAF) provides a comprehensive measure of growth failure through various child anthropometric indicators. In regions with a high prevalence of stunting, several factors may contribute to the occurrence of growth failure in children under five years. Objectives: This study aims to analyze the factors influencing the incidence of child growth failure based on the CIAF in a province with high stunting prevalence in Indonesia. Methods: The cross-sectional study used the 2022 Indonesian Nutrition Status Survey (SSGI) data. The sample comprised children aged 0-23 months from West Sulawesi Province, totaling 1,573 children. The number of samples analyzed was 1,327 children, excluding incomplete data and outliers that were values outside a certain range and treated as missing values based on the World Health Organization (WHO). Multivariate analysis was conducted using logistic regression with a complex sample facility. Results: This study found that 24.9% of children experienced growth failure based on the CIAF. Factors associated with the incidence of growth failure based on the CIAF were older age between 12-23 months (OR=4.5; CI=2.36-8.43; p=0.000), birth weight less than 2,500 g (OR=6.85; CI=3.85-12.21; p=0.000), boys (OR=1.56; CI=1.13-2.15; p=0.000), incomplete immunization status (OR=1.8; CI=1.31-2.77; p=0.001), and poor economic status in quintile 1 (OR=2.1; CI=1.08-3.99; p=0.028). Conclusions: The risk factors for child growth failure based on the CIAF included older age, male sex, low birth weight, incomplete immunization status, and low economic status.

Vaccinations in Paediatric Solid Organ Transplant Candidates and Recipients.

Solid organ transplant (SOT) candidates and recipients are a fragile population, in which the presence of a pre-transplant disease leading to organ insufficiency and the post-transplant immunosuppressive treatment expose them to an increased risk of infectious diseases. The best intervention to guarantee efficient prevention of infections, with optimal cost-benefit ratio, is represented by vaccination programs; however, the response to vaccines needs that the immune system maintains a good function. This is even more relevant at paediatric age, when specific immunological conditions make transplant candidates and recipients particularly vulnerable. Paediatric patients may be naïve to most infections and may have incomplete immunization status at the time of transplant listing due to their age. Moreover, the unaccomplished development of a mature immune system and the immunosuppressive regimen adopted after transplant might affect the efficacy of post-transplant vaccinations. Therefore, every effort should be made to obtain the widest vaccination coverage before the transplantation, whenever possible. This review reports the most relevant literature, providing information on the current approach to the vaccinations in paediatric SOT candidates and recipients.

Immunization coverage and factors associated with immunization status in an urban area of Imphal East district: a cross-sectional study

Background: Despite many initiatives undertaken by the government of India, many children remain unvaccinated or under vaccinated, and vaccine preventable diseases are still a leading cause of morbidity and mortality. The present study was done to assess the immunization coverage of children aged 6 to 23 months in an urban area of Imphal East district and to determine the factors associated with immunization gap. We also determined the association of immunization status with some socio-demographic variables. Methods: A cross-sectional study was carried out in all the thirteen villages under urban primary health centre (UPHC), Kshetrigao among mothers or primary caregiver of children aged 6-23 months. Data were collected using semi-structured questionnaires by face to face interview. Results: The total number of respondents was 206. The prevalence of fully immunized, immunized up to date, partial and non immunized were found to be 73%, 59%, 37%, and 3% respectively. Child being sick was the main reason for incomplete immunization. Mother belonging to older age group were found to have significantly higher immunized up to date children than younger mother (p=0.02). Conclusions: The prevalence of immunized up to date children was low. Effective strategy of raising awareness among communities regarding routine vaccination and clarifying their misconceptions related to vaccines is the need of the hour.

The Battle against Diphtheria: Nigeria's Ongoing Struggle

Abstract:: Corynebacterium diphtheriae is a Gram-positive, rod-shaped, nonmotile bacillus. Lysogenic strains carry the diphtheria toxin gene (tox) on corynebacteriophages. It's categorized into biotypes and lysotypes based on colony morphology and phage sensitivity. The disease involves the upper respiratory tract, causing symptoms like fever and painful throat, with severe cases forming airway-blocking pseudomembranes [1-3]. Different types of diphtheria exist; incomplete immunization and poor healthcare facilities increase the risk. Diphtheria is treated with diphtheria antitoxin administered intravenously or intramuscularly, along with antibiotics. Timely treatment improves outcomes and reduces transmission. Lifetime immunity is achieved through a three-dose primary series during infancy and booster shots during childhood and adolescence [4]. : Since epidemiological week 26, concluding on July 2, 2023, Nigeria has witnessed a significant surge in diphtheria cases spanning multiple states. Between June 30 and August 31, 2023, 5,898 suspected cases were documented across 59 Local Government Areas (LGAs) in 11 states. In week 34, ending on August 27, 2023, 234 suspected cases were reported from 20 LGAs in five states, with one laboratory-confirmed case out of 22 samples collected. Among these cases, 18 were linked through epidemiological analysis, and 141 were categorized as clinically compatible [5]. Diphtheria incidence has decreased due to widespread DTaP vaccination in children, but declining childhood immunity necessitates booster shots. Recent outbreaks in some nations emphasize the need to maintain high vaccination rates. In Nigeria, a 2022 outbreak resulted in over 600 tragic deaths and around 14,000 suspected cases, a stark contrast to the 2011 outbreak with only 98 reported cases [6]. : In response to the ongoing diphtheria outbreak in Nigeria, the country has implemented several strategies and precautions to combat the disease. Here are the key measures being taken

Mapping geographical inequalities of incomplete immunization in Ethiopia: a spatial with multilevel analysis.

Immunization is one of the most cost-effective interventions, averting 3.5-5 million deaths every year worldwide. However, incomplete immunization remains a major public health concern, particularly in Ethiopia. The objective of this study is to investigate the geographical inequalities and determinants of incomplete immunization in Ethiopia. A secondary analysis of the mini-Ethiopian Demographic Health Survey (EDHS 2019) was performed, utilizing a weighted sample of 3,865 children aged 12-23 months. A spatial auto-correlation (Global Moran's I) statistic was computed using ArcGIS version 10.7.1 to assess the geographical distribution of incomplete immunization. Hot-spot (areas with a high proportion of incomplete immunization), and cold spot areas were identified through Getis-Ord Gi* hot spot analysis. Additionally, a Bernoulli probability-based spatial scan statistics was conducted in SaTScan version 9.6 software to determine purely statistically significant clusters of incomplete immunization. Finally, a multilevel fixed-effects logistic regression model was employed to identify factors determining the status of incomplete immunization. Overall, in Ethiopia, more than half (54%, 95% CI: 48-58%) of children aged 12-23 months were not fully immunized. The spatial analysis revealed that the distribution of incomplete immunization was highly clustered in certain areas of Ethiopia (Z-score value = 8.379419, p-value < 0.001). Hotspot areas of incomplete immunization were observed in the Afar, Somali, and southwestern parts of Ethiopia. The SaTScan spatial analysis detected a total of 55 statistically significant clusters of incomplete immunization, with the primary SaTScan cluster found in the Afar region (zones 1, 3, and 4), and the most likely secondary clusters detected in Jarar, Doola, Korahe, Shabelle, Nogob, and Afdar administrative zones of the Somali region of Ethiopia. Indeed, in the multilevel mixed-effect logistic regression analysis, the respondent's age (AOR: 0.92; 95% CI: 0.86-0.98), residence (AOR: 3.11, 95% CI: 1.36-7.14), living in a pastoralist region (AOR: 3.41; 95% CI: 1.29-9.00), educational status (AOR: 0.26; 95% CI: 0.08-0.88), place of delivery (AOR: 2.44; 95% CI: 1.15-5.16), and having PNC utilization status (AOR: 2.70; 95% CI: 1.4-5.29) were identified as significant predictors of incomplete immunization. In Ethiopia, incomplete immunization is not randomly distributed. Various factors at both individual and community levels significantly influence childhood immunization status in the country. It is crucial to reduce disparities in socio-demographic status through enhanced collaboration across multiple sectors and by bolstering the utilization of maternal health care services. This requires concerted efforts from stakeholders.

Challenges in assessing the immunization status of adults in Germany—lessons from a population-based VACCELERATE survey on polio vaccination

PurposeConsidering the re-emergence of poliomyelitis (PM) in non-endemic regions, it becomes apparent that vaccine preventable diseases can rapidly develop epi- or even pandemic potential. Evaluation of the current vaccination status is required to inform patients, health care providers and policy makers about vaccination gaps.MethodsBetween October 28 2022 and November 23 2022, 5,989 adults from the VACCELEREATE Volunteer Registry completed an electronic case report form on their previous PM vaccine doses including number, types/-valencies and the time of administration based on their vaccination records. A uni-/multivariable regression analysis was performed to assess associations in participant characteristics and immunization status.ResultsAmong German volunteers (n = 5,449), complete PM immunization schedule was found in 1,981 (36%) participants. Uncertain immunization, due to unknown previous PM vaccination (n = 313, 6%), number of doses (n = 497, 9%), types/-valencies (n = 1,233, 23%) or incoherent immunization schedule (n = 149, 3%) was found in 40% (n = 2,192). Out of 1,276 (23%) participants who reported an incomplete immunization schedule, 62 (1%) never received any PM vaccine. A total of 5,074 (93%) volunteers reported having been vaccinated at least once and 2,087 (38%) indicated that they received vaccination within the last ten years. Female sex, younger age, as well as availability of first vaccination record were characteristics significantly associated with complete immunization (p < 0.001).ConclusionFull PM immunization schedule was low and status frequently classified as uncertain due to lack of details on administered doses. There is an obviousneed for improved recording to enable long-term access to detailed vaccination history in the absence of a centralized immunization register.

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.

Evaluation and outcome of hearing in meningitis patients

Background: Meningitis remains the most common cause of acquired severe to profound SNHL in childhood. Likewise, deafness is the most common long-term neurological sequelae of the disease. Important consideration following meningitis is the development of labyrinthitis ossificans in which there is new bone formation within the lumen of the otic capsule. Ossification of the labyrinth can develop within a few days of meningitis which can make cochlear implantation difficult. Every newborn should be promptly screened for any hearing deficit along with the patients having meningitis. The most easily available investigation are OAE and BERA. Methods: Our ambispective study of 25 patients was undertaken in a duration of 2 years in ENT department of civil hospital, Ahmedabad. All the patients underwent a detailed clinical examination and all routine audiological, and radiological investigations. Results: The prevalence of hearing loss in post meningitis pediatric age group is 40%. Females are affected more than males. Median age group of presentation with hearing deficit is 4 years. Patients with complete immunization history have lower incidence of hearing loss associated with meningitis than incomplete immunization. Ossification of the cochlea can develop as early as 6 days from the development of first symptom. Conclusions: Ossification of the cochlea can develop as early as 6 days from the development of first symptom. These are the candidates who should be prioritized for cochlear implant surgery. Patients with mild hearing loss recovered completely whereas those with profound hearing loss underwent cochlear implant surgery and were benefited with it.

Prediction of incomplete immunization among under-five children in East Africa from recent demographic and health surveys: a machine learning approach

The World Health Organization as part of the goal of universal vaccination coverage by 2030 for all individuals. The global under-five mortality rate declined from 59% in 1990 to 38% in 2019, due to high immunization coverage. Despite the significant improvements in immunization coverage, about 20 million children were either unvaccinated or had incomplete immunization, making them more susceptible to mortality and morbidity. This study aimed to identify predictors of incomplete vaccination among children under-5 years in East Africa. An analysis of secondary data from six east African countries using Demographic and Health Survey dataset from 2016 to the recent 2021 was performed. A total weighted sample of 27,806 children aged (12–35) months was included in this study. Data were extracted using STATA version 17 statistical software and imported to a Jupyter notebook for further analysis. A supervised machine learning algorithm was implemented using different classification models. All analysis and calculations were performed using Python 3 programming language in Jupyter Notebook using imblearn, sklearn, XGBoost, and shap packages. XGBoost classifier demonstrated the best performance with accuracy (79.01%), recall (89.88%), F1-score (81.10%), precision (73.89%), and AUC 86%. Predictors of incomplete immunization are identified using XGBoost models with help of Shapely additive eXplanation. This study revealed that the number of living children during birth, antenatal care follow-up, maternal age, place of delivery, birth order, preceding birth interval and mothers’ occupation were the top predicting factors of incomplete immunization. Thus, family planning programs should prioritize the number of living children during birth and the preceding birth interval by enhancing maternal education. In conclusion promoting institutional delivery and increasing the number of antenatal care follow-ups by more than fourfold is encouraged.

Incomplete immunization uptake and associated factors among children aged 12–23 months in sub-Saharan African countries; multilevel analysis evidenced from latest demography and health survey data, 2023

BackgroundIn 1974, the World Health Organization (WHO) established the Expanded Program on Immunization to control vaccine-preventable diseases, saving millions of lives annually. However, the coverage of basic vaccines recommended by the WHO in Africa was only 75%, which fell short of the goal of 90% by 2015. To formulate effective policies and implementation programs to reduce incomplete vaccination rates, it is important to conduct a study to determine the factors contributing to incomplete immunization among children aged 12–23 months.MethodsThe study was conducted in 16 sub-Saharan African countries, using data extracted from the latest DHS data. It was a community-based cross-sectional survey that used two-stage stratified probability sampling sample designs. The vaccination coverage was assessed using vaccination cards and mother recalls. Multilevel multivariable logistic regression was used to determine the extent of incomplete immunization and the individual and community-level factors associated with partial immunization among children aged 12–23 months. Variables with a p-value less than 0.05 were considered statistically significant predictors of incomplete immunization.ResultA total of 35, 193 weighted samples were used to determine the pooled prevalence of partial immunization. The pooled prevalence of incomplete immunization was 36.06%. In the final model factors significantly associated were: being uneducated mother(AOR:1.75;95%CI:1.48,2.05), being an unemployed mother (AOR:1.16;95%CI:1.09,1.23), no history of family planning utilization (AOR: 1.71; 95% CI: 1.61, 1.84), non-antenatal care (AOR: 1.79; 95% CI: 1.58, 2.04), non-postnatal care (AOR: 1.25; 95%CI: 1.17, 1.35), rural residence(AOR:1.50;95%CI:1.37,1.63), home delivery (AOR: 2.04; 95%CI:1.89, 2.21), having children more than five (AOR: 1.56; 95%CI: 1.13, 2.17), and non-utilization of health insurance (AOR: 1.74; 95%CI: 1.48, 2.05).ConclusionThe pooled prevalence of incomplete immunization was found to be high in this investigation. Based on the findings of the study we recommended that policymakers and stakeholders prioritize enhancing prenatal and postnatal care, contraception, and reducing home birth rates to minimize the rate of incomplete immunization.

Rational Use of Antibiotics in Childhood Pneumonia: A review

Inappropriate antibiotic treatment in childhood pneumonia may lead to greater expense, antibiotic resistance, toxic side effects, or even death. Important risk factors are infant and young children, low birth weight, nonexclusive breastfeeding, malnutrition, vitamin A deficiency, incomplete immunization and exposure to polluted air. Common organisms involved in pneumonia in neonatal periods are gram negative rods, group B streptococcus and staphylococcus. Beyond the neonatal period S. pneumoniae, H. influenzae, staphylococcus and mycoplasma are common. MRSA, gram negative rods and Legionella spp are commonly involved in nosocomial pneumonia. Rational use of antibiotic for bacterial pneumonia is based on probable organism, age, vaccination and clinical status of the child. Children who do not require hospitalization should have high doses of amoxicillin 90 mg/kg/day orally divided twice daily, alternatives include cefuroxime and amoxicillin/clavulanate. For schoolaged children when mycoplasma is suspected, azithromycin is generally preferred, alternatives clarithromycin can be given. Fully immunized against H. influenzae type b and S. pneumoniae children who are not severely ill should give ampicillin or penicillin G. For children who do not meet these criteria: ceftriaxone or cefotaxime should be given. If clinical features suggest staphylococcal pneumonia (pneumatocele or empyema), then include oxacillin or vancomycin. Vancomycin and meropenem are the initial treatment of choice for nosocomial pneumonia. Pneumonia in neonatal period should have ampicillin plus gentamicin or ceftazidime plus amikacin. Antibiotics should be continued until the patient has been afebrile for 72 hours, and the total duration should be 10 days. Selection of appropriate antibiotic in childhood pneumonia considering age of the child, risk factor, probable organism, immunization status and clinical severity are paramount important. BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 102-109

THE INFLUENCE OF MOTHER'S KNOWLEDGE AND ATTITUDE ON BASIC IMMUNIZATION COVERAGE

Background: Basic Immunization is the administration of vaccines to infants aged 0-18 months. The success of the basic immunization program in infants is supported by the important role of parents who are responsible for their babies Objective: To determine the influence of mothers' knowledge and attitudes on basic immunization coverage. Methods: The research design used was correlational analysis with a cross sectional approach. The sampling technique used is total sampling. The population and sample of all babies aged 12-59 months at the Mande Health Center in September 2023 amounted to 58 people. The instruments used are questionnaires and leaflets. Analyze data with Chi Square. Results: 58 mothers who had babies were obtained in 14 babies with incomplete immunization status, there were 3 (21.4%) mothers who had less knowledge and 11 (78.6%) mothers who had good knowledge. Meanwhile, in 44 mothers with complete immunization status, 42 (95.5%) mothers have a confident attitude towards immunization, while 2 (4.5%) mothers have an unsure attitude towards immunization. Conclusion: There is an influence of maternal knowledge and attitudes with basic immunization status in Jamali Village.

IJCM_322A: A Study on Nutritional Status and its Determinants among Under-Five Children in Brick-kilns of a Rural Area of Hooghly District, West Bengal

Background: Brick-kiln workers’ children face elevated malnutrition risk from limited healthcare, poor facilities, poverty, infections, nutritional deficits, and awareness gaps, complicating intervention efforts due to their migratory work. Objectives: 1. To assess the nutritional status of under-5 children in brick kilns of a rural area of Hooghly district, West Bengal 2. To find out the factors associated with the nutritional status of the study participants. Methodology: A setting based cross-sectional study was conducted with simple two-stage cluster sampling in selected brick kilns of a rural area of Singur, Hooghly district, West Bengal from June to December 2023 among 162 participants. Participants were interviewed after obtaining informed consent about socio demography, Immunisation, WASH practices (WHO/ UNICEF JMP), dietary diversity (IDDS) and Household Food insecurity (HFIAS). Quantitative analysis was done using SPSS v16. Thematic analysis was done for qualitative strand and is still under process. Ethical approval was taken from Institutional Ethics Committee of AIIH&amp;PH, Kolkata. Results: One-third of the children were more than 2 years old while male: female ratio was 1:1. 60% caregivers were illiterate. Stunting, underweight and Wasting was found to be 64%, 45%, 26% respectively. WASH practices were found inadequate for water practices (20%), sanitary practices (41%) &amp; hygiene (50%). Still one-fourth of the participants were not fully immunised. Food diversity was absent in half of the participants while two-third participants were found to be food insecure. Maternal malnutrition, unimproved sanitary &amp; hygiene practices, incomplete immunization, dietary diversity and household food insecurity were found to be significant (p value &lt;0.05). Conclusion: The study revealed poor immunization status, malnutrition in children of Brick kiln workers. There is an urgent need for strengthening the health and nutritional interventional programmes for children of migratory population.

Faktor-Faktor Penyebab Kejadian Stunting pada Balita Usia 12-24 Bulan di Desa Karya Mulya, Provinsi Riau

The factors that cause stunting in toddlers include incomplete immunization of toddlers, failure to provide exclusive breastfeeding or early weaning, and inappropriate provision of Complementary feeding (MP-ASI). The research aims to analyze the factors causing the incidence of stunting in toddlers aged 12–24 months in Karya Mulya Village in 2023. The type of research is quantitative with a cross-sectional design. The research was conducted in April 2023 with a sample size of 52 mothers of toddlers aged 12–24 months using a total sampling technique. Data were collected using questionnaires, Maternal Child Health books, and body length measurements. The data analysis used was univariate and bivariate analysis with the Fisher Exact Test. The results of the univariate analysis showed that 9 toddlers (17.3%) experienced stunting, 21 toddlers (40.4%) did not give exclusive breast milk at the age of 0–6 months, 27 toddlers (51.9%) gave complementary feeding incorrectly. The Fisher Exact Test results found that there was no relationship between complete immunization and the incidence of stunting (p-value=1.000), there was a relationship between exclusive breastfeeding and the incidence of stunting (p-value=0.002), there was a relationship between giving complementary feeding and the incidence of stunting (p-value=0.025). The conclusion is that there is no significant relationship between the completeness of immunization in toddlers, but there is a significant relationship between exclusive breastfeeding and Complementary feeding and the incidence of stunting in toddlers aged 12–24 months in Karya Mulya Village in 2023. It is hoped that mothers of toddlers will continue to monitor the growth of toddlers every month, providing routine immunizations, exclusive breastfeeding, and MP-ASI by guidelines to prevent stunting.&#x0D;

Knowledge regarding immunization among mothers of under-five children in Uttarakhand

Background: Immunization is one of the most impactful and cost-effective health investments globally that helps in reducing the burden of infectious diseases keeping children safe. Mothers are the major role players with regard to their children’s immunization. Methods: A descriptive cross-sectional study was conducted to assess knowledge regarding immunization among mothers of under-five children in the Doiwala block of Dehradun, Uttarakhand. A total of one hundred mothers of under-five children were conveniently selected through door-to-door survey. A structured knowledge questionnaire on under-five immunization was administered through the interview technique to assess the knowledge of the mothers. Results: Among 100 mothers of under-five children 13% had poor knowledge, 63% had average knowledge and 24% had good knowledge regarding under-five immunization. There was significant association between age, education status and socioeconomic status of mothers with knowledge score regarding under-five immunization. Conclusions: There is a strong need to increase awareness and knowledge about immunization among children; its benefits and importance. There is also a need to educate people especially mothers regarding harmful consequences of incomplete immunization of children.