Incomplete Immunization Research Articles

Factors Influencing the Coverage of Complete Basic Immunization in Toddlers

The coverage of complete basic immunization is still low in the working area of Mentawai Regency, which is 59.8%. The national target achievement is 95%, indicating a gap of 35.2%. The aim of this research was to identify the factors influencing the completion of basic immunization. The research method used is analytical research with a cross-sectional study approach. The sample in this research consists of children aged more than 9 months until 5 years, totaling 132 respondents. The respondents were selected using simple random sampling. The analysis includes univariate, bivariate, and multivariate analyses. The findings revealed that more than half of the respondents did not complete their basic immunization (63.2%), and more than half of them had a low level of knowledge (60%). Support from father was also lacking for more than half of the respondents (63.3%), and there were concerns about inadequate sociocultural factors (57.8%). There was a significant relationship between family support, sociocultural factors, and knowledge level with the completeness of basic immunization (P<0.001). The multivariate analysis indicated that having low father support resulted in a 7.3 times higher likelihood of incomplete immunization compared to having high father support. Therefore, the suggestion for this study is to improve not only the knowledge level of mothers but also to increase the knowledge of fathers, so that they can provide full support for their child's health.

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.

Correlation between basic measles immunization historical and nutritional status on toddler: factorial stunting prevalence

Introduction: The problem of nutritional status on toddlers is still one of the world’s problems that must continue to be resolved, such as stunting. Stunting, or being too short for one’s age, is defined as below -2 standard deviations from the median height-for-age z-score. Stunting can directly be affected by infectious disease and incomplete immunization such as basic measles immunization. Objectives: This research aims to determine and analyze the correlation between giving basic measles immunization and nutritional status, especially the incidence of stunting on toddlers. Methods: This research was an observational analytic study using a cross-sectional approach with non-probability sampling. The samples were 134 toddlers who were 12-36 months, were not sick, and have the KIA/KMS book. Basic measles immunization and nutritional status were dependent variables whereas stunting prevalence was an independent variable. Data analysis used the Spearman’s Rho correlation test with α = 0.05. Results: The results showed the majority of toddlers experienced nutritional status problems especially stunting (51.5%) and the majority of toddlers had received basic measles immunization (67.9%). Based on the Spearman’s Rho statistical test, obtained p-value = 0.003 (p-value < 0.05) with correlation coefficient (r) = -0.251. Conclusions: There is a significant correlation between basic measles immunization and nutritional status, especially in the incidence of stunting. This finding suggests that the local government should initiate an innovative program of health education focusing on knowledge and prevent the increasing stunting such as by collaborating with the nursing profession which can act as a good educator and caregiver.

Relationship between nutritional status, vitamin A administration, immunization status, exclusive breastfeeding with the incidence of respiratory infections in toddlers aged 0-59 months in the working area of the Nambo Health Center, Kendari City, 2023

Background: Acute respiratory infection (ARI) is an infectious disease that is often experienced by toddlers. Several efforts can be made to reduce the risk of ARI, Including nutritional status, administration of vitamin A, immunization status, and exclusive breastfeeding. The incidence of ARI in toddlers in the working area of ​​the Nambo Health Center, Kendari City, is one of the most common diseases compared to other diseases. The aim of the study was to determine the relationship between nutritional status, administration of vitamin A, immunization status, and exclusive breastfeeding with the incidence of ARI in toddlers aged 0-59 months. Method: Quantitative research with a cross-sectional study design. The sample in this study were toddlers aged 0-59 months totaling 254 respondents obtained by accidental sampling technique. Nutritional status is assessed based on anthropometric data in the form of body weight/age and is interpreted with a Z-score according to WHO standards. Data was collected from respondents using a questionnaire. Data analysis was performed with the chi-square statistical test. Result: that most of the infants aged 0-59 months had normal nutritional status 87.0%, incomplete vitamin A administration 53.1%, incomplete immunization status 56.7%, exclusive breastfeeding was not given 55.9%, and most toddlers 0-59 months suffer from ISPA incidence of 57.1%. Analysis of the variable relationship obtained a p value of 0.000 (p <0.05) that statistically there was no significant relationship between nutritional status and the incidence of ARI, there was a significant relationship between vitamin A administration, immunization status and exclusive breastfeeding on the incidence of ARI in toddlers 0 -59 months in the working area of ​​the Nambo Health Center. Conclusion: There is no relationship between nutritional status and the incidence of ARI, there is a relationship between vitamin A administration and the incidence of ARI, there is a relationship between the immunization status and the incidence of ARI, there is a relationship between exclusive breastfeeding and the incidence of ARI.

Clinical recovery time for Sars-Cov-2 Infection in healthcare workers with full and booster vaccination

The increase of infections at the end of 2021 and January 2022 due to the Omicron variant in Ecuador, raises doubts regarding the effectiveness of booster vaccination, which questions the protection provided by booster vaccination and how often to apply it. A sample of 419 cases is taken and compared with the personnel that have complete (58% with third dose) and incomplete (42%) immunization schedules as of December 2021 and January 2022, and the time of symptomatic recovery after SARS infection is determined afterwards. The results show no difference in the recovery time in patients within the two groups and similar symptoms were observed. It is concluded that, given the results, there is no evidence of the need for a third dose in general, but rather, it would be reasonable to focus the efforts of a second booster only in specific vulnerable populations, thus avoiding unnecessary adverse effects that are becoming more frequent, and even allowing the existing vaccines available in countries where they are really needed.

The Incomplete Basic Immunization for Infants During the Covid-19 Pandemic in the Work Area of the Bandar Petalangan Health Center, Pelalawan Regency

Achievement of complete basic immunization at Puskesmas bandar Petalangan was only 77.7%. There are various causes for the low achievement of Complete Basic Immunization such as remote and difficult to reach immunization service locations, irregular service schedules and incompatible with community activities, unavailability of immunization cards (MCH handbook), low public awareness and knowledge of benefits. The research objective was to know the timeliness of the implementation of basic immunization in infants during the Covid-19 pandemic in the work area of the Bandar Petalangan Community Health Center, Pelalawan Regency in 2020. The research method used a cross sectional design with a population of mothers who had babies aged 3-12 months, totaling 257 people with a sample. totaled 161 people. The sampling technique used accidental sampling. Data analysis was performed using univariate, bivariate and multivariate multiple logistic regression. The results showed that there were 54 mothers (33.5%) who were not on time in basic immunization, variables related to the timeliness of basic immunizations were maternal education (POR = 2.9), affordability of immunization sites (POR = 3.6) and family support (POR = 3.3). It is recommended that BLUD Puskesmas bandar Petalangan be able to increase and equalize posyandu service facilities, increase information and education communication (KIE) efforts to mothers and families about the importance of basic immunization in infants and increase the role of volunteer health.

Edukasi Gizi Isi Piringku dan Perilaku Hidup Bersih dan Sehat (PHBS) Sebagai Upaya Penurunan dan Pencegahan Stunting Di Desa Suka Menanti Kecamatan Bukit Kemuning Kabupaten Lampung Utara

Stunting is a condition of failure to thrive in children under five due to chronic malnutrition. Stunting occurs due to multifactors, namely household and family factors such as knowledge, upbringing, food availability and poor sanitation, inadequate breastfeeding and complementary breastfeeding, infection factors such as history of malaria, diarrhea and incomplete immunization, as well as community and social factors such as economic conditions, health services and culture, so efforts to reduce stunting are not only a task for the health sector, but also across sectors.
 The purpose of this Community Service Implementation is to increase the knowledge of mothers, prospective brides, pregnant women and cadres about stunting prevention through education on Fill My Plate and PHBS. Target activities for pregnant women, prospective brides and mothers with children under five, and family companions.
 The method used is counseling about stunting and demonstrations of the contents of my plate and PHBS. The results obtained by all participants increased knowledge and awareness about stunting and participants were able to practice My Plate Fill and PHBS. It is hoped that the village government can carry out periodic outreach and monitor and assist stunting toddlers. Health workers are also expected to improve health services for prospective brides, pregnant women, babies and toddlers by providing support to catin to get education about health, pregnant women to check their pregnancies regularly, encouraging exclusive breastfeeding and providing additional food. The community also needs to contribute to preventing stunting by adopting a clean and healthy lifestyle.

Association Between Stunting and Anemia Among Toddlers: Stratified by Characteristic of Family and Immunization Status in Mlonggo District, Jepara Regency

Background: The risk of anemia in stunted toddlers is higher than in normal toddlers. There is limited research on anemia in children under 3 years old in the community and there is a need for supporting research to prove the possibility of controlling stunting and anemia together. Previous studies have shown that family characteristics and immunization status are associated with the stunting and anemia.Objective: This study aims to analyze the association between anemia and stunting in toddlers that are stratified by characteristics of family and Immunization status.Methods: This study used a cross-sectional design study and was conducted on September-October 2020 in the Mlonggo District, Jepara Regency. One hundred two respondents were selected by cluster random sampling technique. The questionnaire was applied to collect the data on stunting, anemia, immunization status, age, mother's occupation and education status, SCREEM score, and APGAR score. This study used the Chi-Square statistic test.Results: The anemia status was measured by the Hb meter. The characteristics of stunting status (stunting = 17.7%, no stunting= 82.3%), anemia status (Yes = 63.7%, No = 36.3%). The association between stunting and anemia was stratified by the child age (6-23 months) (PR=1.667; 95%; CI=1.103-2.519; P=0.123), employed mother (PR=1.593; 95%CI=1.265-2.005; P=0.154), incomplete and inappropriate immunization status (PR=1.636; 95%CI= 1.132-2.366; P=0.133) and highly internal family function; (PR=1.512; 95% CI=1.270-1.799; P=0.029).Conclusion: There was an association between stunting and anemia in toddlers from child age of 6-23 months, employed mother, incomplete and inappropriate immunization, and highly family function groups.

Disease profile, HIV prevalence and vaccination status of HIV-infected children admitted at a hospital complex, Northern Cape Province, South Africa

Despite the availability of vertical transmission prevention, treatment, and immunisation programmes for better health outcomes, children are still infected and affected by HIV/AIDS. Those accessing treatment are either virally unsuppressed or have severe forms of diseases, while others have missed opportunities for vaccination. HIV infected children are vulnerable to infections, re-hospitalisation, and missing vaccinations. The study determined the disease profile, HIV prevalence, readmission, and immunisation status of children admitted to Robert Mangaliso Sobukwe Hospital in Northern Cape Province, South Africa. This was a retrospective review of 328 medical records of children less than 14 years, admitted from January 2017 to January 2018. The mean age was 3.6 years, and the majority were females. Most children presented with appetite loss and fatigue, and the most common admission diagnoses were lower respiratory tract infection and acute gastroenteritis. The prevalence of HIV in this group was 24%. Over 50% were readmitted, and 17% of those were HIV positive. Most HIV positive children (62%) had missed vaccinations, predominantly measles, and pneumococcal conjugate vaccines. Older children, those infected with HIV, and those who had missed the measles vaccine were significantly associated with readmission. Children of mothers with higher educational status who were either single or married were less likely to be readmitted compared to those with a lower education level and divorced parents. The rate of readmission is relatively high; therefore, improving care and scaling up catch-up immunisations for children, especially among HIV-infected, may offer them better protection and outcomes against vaccine-preventable diseases considering their risk for incomplete immunisation and infectious diseases.

Association of Educational Status of Mothers and Incomplete Immunization in Children

Objective: To determine the association of educational status of mothers and incomplete immunization in children presented at Tertiary Care Hospital, Karachi. Methods: This Case-control study was conducted at Pediatric department, Abbasi Shaheed Hospital, Karachi; from July 2018 to January 2019. The data were prospectively collected from 434 subjects with consent out of which 217 had an incomplete vaccination status and 217 had completed vaccination status. Case group included unvaccinated children whose mothers were uneducated (mothers were labeled un-educated who were never enrolled in school, madrasa and received primary education), whereas control group included vaccinated children whose mothers were educated (mothers were labeled educated who were enrolled in school, madrasa and received primary education).Quantitative data were presented as simple descriptive statistics giving mean and standard deviation and qualitative variables were presented as frequency and percentages. Chi-square test was applied to compare both groups and the odds ratio was calculated. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable. Using post-stratification chi-square test, a p-value of ?0.05 was considered as significant. Results: A total of 434 (217 cases and 217 controls) were included in this study. The mean age was 3.27±1.79 years (case) and 3.49±1.40 years (controls). Educational status of mothers was assessed verbally. Uneducated mothers are defined as those who did not receive formal education of any level, while educated mothers are defined as those who were enrolled in school or madarsa and received primary education or more. On the basis of which the uneducated mothers in case group were 144 (66.4%) while in control group was 52 (24%).Children with incomplete immunization were 6.25 times more likely to have uneducated mothers than those with complete immunization, after controlling for the other factors. Conclusion: This study has strengthened the value of maternal education in context of complete childhood immunization because acquisition of literacy and health-seeking behavior enhance vaccine uptake for their children.

Factors Affecting Mothers on Basic Immunization Status in Infants Aged 12-24 Months in Baruara Village

Immunization is an act of providing immunity to children against diseases that could have been prevented by immunization before they were 12 months old, namely tuberculosis, polio, hepatitis B, diphtheria, pertussis, tetanus, and measles. Complete and regular basic immunization by getting all types of basic immunization when a child is less than 11 months old can reduce the morbidity and mortality of children under five by around 80-95%. Incomplete basic immunization can only provide maximum protection of 25-40%. The role of a mother in the immunization program is very important, because the use of health facilities by infants/children is related to factors that affect the mother. The purpose of this study was to determine the relationship between the factors that influence the mother's basic immunization status in infants aged 12-24 months. This study used a descriptive correlation design with a cross sectional approach. The number of samples in this study were 40 people. Sampling using the total population. This research was conducted in Baruara Village, Balige District, Toba Regency in March-May 2023. The instrument in this research was a questionnaire. Data analysis used chi-square. From the results of the study it was concluded that there was a significant relationship between maternal age with p=0.001, education with p=0.004, employment with p=0.001, number of children with p=0.000, and knowledge with p=0.000 to basic immunization status. From this research it is hoped that health workers will improve the quality of health services, health promotion efforts in the form of social support, namely improving the quality of health education, providing motivation in utilizing health services, especially immunization.

Faktor Determinan Kejadian Stunting pada Balita di Provinsi Kalimantan Barat (Studi Data Riskesdas Tahun 2018)

Stunting toddlers is a chronic nutritional problem caused by many factors, such as socioeconomic conditions, maternal nutrition during pregnancy, illness in infants, and a lack of nutritional intake in infants. West Kalimantan has a high prevalence of stunting compared to the national prevalence of 36.5%. The purpose of this study was to determine the determinants associated with the incidence of stunting in West Kalimantan. This type of research uses a quantitative approach with a cross-sectional study design. The population is 2,064 people, and the sample in this study is 335 respondents by random sampling. The statistical test used was chi-squared with a 95% confidence level. The results showed that there was no relationship between PMT (p-value of 1.000), history of breastfeeding (p-value of 0.052), history of immunization (p-value of 0.640), history of infection (p-value of 0.474), and access to health services with stunting events (p-value of 0.902) in West Kalimantan. Suggestions for the government and health agencies: it is expected to increase awareness, dissemination, and information to the public regarding incomplete immunization history with a risk factor of 1.704 and a history of non-exclusive breastfeeding with a 1.326 times greater risk of influencing stunting.

Experiences of migrant mothers attending vaccination services at primary healthcare facilities.

Migration to South Africa is currently dominated by women and children, for socio-economic and refugee reasons or to utilise the healthcare system for various services. Migrants and refugees are at risk of vaccine-preventable diseases, and many of their children have an incomplete or unknown immunisation status. This study aimed to explore the experiences of migrant mothers in utilising child immunisation services in primary healthcare facilities. Ten primary healthcare facilities that were providing immunisation services, located in the Buffalo City Metropolitan Municipality, Eastern Cape province, South Africa. A qualitative research design, making use of in-depth interviews (IDIs) from 18 purposefully selected migrant women, was used for data collection. Thematic content analysis was used to analyse the recorded data of the experiences of study participants in their access to immunisation services. From the IDIs, four themes were identified: difficulty in communicating with the healthcare workers because of language barriers, access challenges, interpersonal barriers and interpersonal relationships were identified in this study, which influenced the utilisation of immunisation services by migrant mothers. The findings of this study support and reinforce the duty of the South African government and healthcare facilities to work together to improve migrant women's access to immunisation services. A positive relationship between healthcare workers and migrant mothers while accessing immunisation services should contribute to reducing child mortality in South Africa and achieving Sustainable Development Goal 3 by the year 2030.

IMMUNIZATION STATUS OF CHILDREN IN THE AGE GROUP OF 12-23 MONTHS: A CROSS SECTIONAL STUDY AMONG TEA TRIBE POPULATION IN A BLOCK OF JORHAT DISTRICT, ASSAM.

Aims and Objectives: To assess the immunization status of children in the age group of 12-23 months children in tea tribe population of Jorhat, Assam. To identify and analyze the factors responsible for incomplete and non-immunization among children in the age group of 12-23 months in the selected block of tea tribe population. A cross sectional study was c Materials and Methods: arried out among the 250 participants of the tea tribe population using a pre-designed and pre-tested proforma. Parents were explained the purpose of the study and Mother-Child Protection (MCP) cards were used to obtain the vaccination dates. Of the total 250 parti Results: cipants, 176(70.4%) were fully immunized and 74(29.6%) were partially immunized. Detailed study has been done among the factors affecting the immunization status of the participants like socioeconomic conditions, religion of the parents, literacy rate of both the parents etc. An association between place of delivery, socio-economic status, occupation status of parents and immunization status was found signicant. Imm Conclusions: unization coverage was found to be reasonably good when compared to National Family Health Surveys but still there is a lot of scope for improvement to achieve the national target of 100% immunization coverage. The reasons for incomplete immunization were domestic issues and mother being too busy to take the child for vaccination followed by sickness of the child. Efforts are still required to raise the awareness about importance of immunization

THE RELATIONSHIP OF PROVISION OF BASIC IMMUNIZATION WITH THE GROWTH OF BABY GROWTH IN PUSKESMAS DISTRICT SAWAH BESAR IN 2021

According to the World Health Organization (WHO), the infant mortality rate (IMR) has decreased in recent years. In 2017, the infant mortality rate was 29 deaths per 1000 live births. According to the Central Statistics Agency (BPS), the Infant Mortality Rate (IMR) in DKI Jakarta in 2012 was 22 per 1000 live births, and in 2015 the infant mortality rate was 18 per 1000 live births.2 Basic immunization is very important. given to infants aged 0-12 months to provide immunity from diseases that can be prevented by immunization (PD3I), including Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Hepatitis B and Measles. The occurrence of growth and development can be caused because development is closely related to the maturation of individual organ functions. Therefore, this study examines whether there is a relationship between immunization and infant growth and development. This type of research uses a quantitative descriptive method with a cross sectional approach. The population in this study was the total number of infants who were given basic immunization at the Sawah Besar District Health Center. The sampling technique is by random sampling. The results showed that the percentage of basic immunization for infants was 85.7%, incomplete immunization was 14.3%. The percentage of good growth and development is 91.6%, growth is not good 8.6%. The conclusion that there is a relationship with the provision of basic immunization with infant growth and development P(0.000).

Exploring the Relationship Between Immunization and Stunting: Understanding the Impact of Vaccinations on Child Growth and Development

The study aimed to investigate the relationship between stunting and completeness of immunization among children under five years old in Indonesia. The study used a cross-sectional design with a quantitative approach, utilizing secondary data from the Indonesian Family Life Study (IFLS) V big data in 2014. The sample consisted of children aged 12-59 months from 13 provinces in Indonesia, representing 83% of the total population. Data were analyzed using SPSS and STATA programs. Statistical analysis was performed to determine the association between immunization status and stunting. The results showed a significant statistical relationship (p-value <0.05) between immunization status and stunting occurrence among children aged 12-59 months in Indonesia, with a p-value of 0.001 and a PR value of 1.2 (95% CI: 1.14-1.6). Children who receive incomplete immunization have a 1.2 times greater risk of stunting compared to those who receive complete immunization. The study concluded that completeness of immunization is associated with stunting among children under five years old in Indonesia. Therefore, it is essential to ensure complete immunization coverage to prevent stunting in this population.

Low Vaccine Coverage and Factors Associated with Incomplete Childhood Immunization in Racial/Ethnic Minorities and Rural Groups, Central Brazil.

Discrimination and limited access to healthcare services in remote areas can affect vaccination coverage. Therefore, this study aimed to estimate vaccination coverage for children living in quilombola communities and rural settlements in the central region of Brazil during their first year of life and to analyze the factors associated with incomplete vaccination. An analytical cross-sectional study was conducted on children born between 2015 and 2017. The percentage of children who received all vaccines recommended by the National Immunization Program in Brazil by 11 months and 29 days was used to calculate immunization coverage. Children who received the following vaccines were considered as having a complete basic vaccination schedule: one dose of BCG; three doses of Hepatitis B, of Diphtheria-Tetanus-Pertussis (DPT), of Haemophilus influenzae type b (Hib), and of Poliovirus (Polio); two doses of Rotavirus, of 10-valent pneumococcal (PCV10), and of Serogroup C meningococcal conjugate (MenC); and one dose of Yellow Fever (YF). Measles-mumps-rubella (MMR) and other doses recommended at or after 12 months were not included. Consolidated logistic regression was used to identify factors associated with incomplete vaccination coverage. Overall vaccination coverage was 52.8% (95% CI: 45.5-59.9%) and ranged from 70.4% for the Yellow Fever vaccine to 78.3% for the Rotavirus vaccine, with no significant differences between the quilombola and settler groups. Notably, the likelihood of incomplete general vaccination coverage was higher among children who did not receive a visit from a healthcare professional. Urgent strategies are required to achieve and ensure health equity for this unique and traditionally distinct group with low vaccination coverage.

Association of developmental milestones with vitamin B12 and folate status among hospitalized severe acute malnutrition children at a tertiary care center in North India

Abstract Introduction: Severe acute malnutrition (SAM) is a severe form of malnutrition affecting nearly 20 million children worldwide. Besides increasing the risk of death and disease, malnutrition also leads to growth retardation and impaired psychosocial and cognitive development. Vitamin B12 and folate are water-soluble essential micronutrients critical in average growth and development, particularly during infancy and childhood. A deficiency of folate and vitamin B12 can result in anemia, poor growth, and increased infections, and vitamin B12 deficiency can cause irreversible neurologic damage to the developing brain. We conducted this study to assess serum folate and vitamin B12 levels in children with SAM at admission and determine its relation with their developmental milestones. Materials and Methods: One hundred admitted SAM children between ages 6 and 59 months were taken to assess serum folate and vitamin B12 levels status in a tertiary care hospital and determine its relation with their developmental milestones. Results: The majority of the participants were in the age group 6–12 months (64%), rural (95%), the lower class of socioeconomic status (76%), and incomplete immunization (63%). Serum vitamin B12 and folate levels were found to be significantly associated with different domains of childhood development. Conclusion: This analysis revealed a high prevalence of vitamin B12 deficiency among malnourished children aged 6–59 months. We found that serum vitamin B12 level and folic acid were significantly associated with developmental delay in all domains (gross motor, fine motor, language, and social) of milestones.

Socio-Cultural Determinants of Parental Refusal for Childhood Vaccination: A Semantic and Latent Thematic Analysis

Incomplete vaccination coverage is hazardous for the upcoming generations of a country. Child immunization against various vaccine-preventable diseases is a focus all over the world. The vaccination schedule information is a vital component of vaccination coverage, and its failure leads to incomplete immunization among newborns. Education, employment, and urban facilities are also essential for the complete immunization of a child. There is a significant difference in vaccination coverage due to all these factors. The main objective of this study was to explore the reasons for incomplete vaccination coverage due to the factors mentioned earlier, like why the information gap is there and what makes uneducated parents vulnerable to incomplete immunization, and why the urban-rural disparity exists regarding complete vaccination coverage in Punjab, Pakistan. The researchers conducted in-depth interviews of the mothers having at least one child from 1-2 years of age to explore factors responsible for incomplete vaccination coverage. Insufficient vaccination coverage was related to perceived adverse effects, cultural settings, information gap, lifestyle, parental employment and occupation, the risk to the immune system, risk perception about the disease, perception of efficacy, and misconception about vaccination. In-depth interviews proved vital for exploring underlying reasons for incomplete vaccination coverage. The current study explicates the profound views of respondents on why they refuse vaccination for their children. There should be a rigorous focus on increasing awareness of vaccination.

SOCIODEMOGRAPHIC AND HEALTHCARE FACTORS AS DETERMINANTS OF CHILDHOOD BASIC IMMUNIZATION INCOMPLETION IN PAPUA

Background: The morbidity and mortality rate for children under five in Indonesia is high in eastern Indonesia. Incomplete coverage of basic immunization for children under five can increase the risk of Vaccine-Preventable Diseases (VPD). As a province in eastern Indonesia, the coverage of complete basic immunization in Papua is low. Purpose: This study aimed to identify sociodemographic and healthcare factors among children who default to complete basic immunizations in Papua. Methods: This study utilized data from the 2018 Indonesian National Basic Health Research (Riskesdas). The sample was children aged 12-35 months who live in the Census Blocks (BS) of Riskesdas 2018 in Papua Province and selected to be the sample of Riskesdas 2018. Totally 453 children were included. Bivariate analysis of the data was using Chi-Square test and multivariate with logistic regression. Results: The result showed that the prevalence rate for defaulting basic immunization was 71.74%. Sociodemographic factors that increased incomplete basic immunization were poor economic families (OR=1.97; 95% CI=1.10-3.56) and low maternal education (OR=2.00; 95%CI=1.09-3.65). Meanwhile, healthcare factors like no immunization card (OR=6.82; 95%CI=2.65-17.56) and not being born in a healthcare facility (OR=6.05; 95%CI=3.14-11.66) become the strongest factors that increase the risk of incomplete basic immunization. Conclusion: This study indicates that sociodemographic and healthcare factors could increase the risk of incomplete basic immunization in Papua. It is important to actively improve healthcare services and educate people about the importance of immunization to reduce the risk of incomplete basic immunization for children in Papua.