Vaccination timeliness among newborns and infants in Ethiopia

BACKGROUND: We characterize the risk factors for delayed polio dose 1, diphtheria-tetanus-pertussis (DTP) dose 1, pentavalent dose 1, and measles dose 1 in Ethiopian infants. We also examine the interaction between institutional delivery and demographic factors on the birth doses of the BCG and poli...

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Autores principales: Boulton, Matthew L., Carlson, Bradley F., Wagner, Abram L., Porth, Julia M., Gebremeskel, Berhanu, Abeje, Yemesrach
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380539/
https://www.ncbi.nlm.nih.gov/pubmed/30779781
http://dx.doi.org/10.1371/journal.pone.0212408
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author Boulton, Matthew L.
Carlson, Bradley F.
Wagner, Abram L.
Porth, Julia M.
Gebremeskel, Berhanu
Abeje, Yemesrach
author_facet Boulton, Matthew L.
Carlson, Bradley F.
Wagner, Abram L.
Porth, Julia M.
Gebremeskel, Berhanu
Abeje, Yemesrach
author_sort Boulton, Matthew L.
collection PubMed
description BACKGROUND: We characterize the risk factors for delayed polio dose 1, diphtheria-tetanus-pertussis (DTP) dose 1, pentavalent dose 1, and measles dose 1 in Ethiopian infants. We also examine the interaction between institutional delivery and demographic factors on the birth doses of the BCG and polio vaccines to better understand factors influencing vaccination. METHODS: Using the 2011 Ethiopia Demographic and Health Survey, we calculated the distribution of the study population across different demographic and vaccination characteristics. We computed acceleration factors using a multivariable accelerated failure time model with a Weibull distribution to account for left and right censoring. For the birth doses, we further specified an interaction term between institutional delivery and every other a priori specified independent variable to test whether institutional delivery modifies sociodemographic disparities in vaccination timeliness. RESULTS: Low wealth status, home delivery, and ethnicity are risk factors for delayed vaccination of polio 1, DPT 1, pentavalent 1, and measles 1. Religion is a risk factor for measles 1 vaccination delay and rural residence are risk factors for delayed DPT1 and polio 1 doses. For birth doses of polio and BCG, institutional delivery attenuated many sociodemographic disparities in vaccination delay, except for urbanicity, which showed rural dwellers with more delay than urban dwellers with an institutional vs home birth. CONCLUSIONS: Less delayed vaccination among children with institutional deliveries highlights the importance of perinatal care and the potential for promoting healthy behaviors to parents. Persistent disparities between urban and rural residents, even among those with institutional births, can be targeted for future interventions. Timely vaccination is key to prevention of unnecessary childhood mortality.
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spelling pubmed-63805392019-03-01 Vaccination timeliness among newborns and infants in Ethiopia Boulton, Matthew L. Carlson, Bradley F. Wagner, Abram L. Porth, Julia M. Gebremeskel, Berhanu Abeje, Yemesrach PLoS One Research Article BACKGROUND: We characterize the risk factors for delayed polio dose 1, diphtheria-tetanus-pertussis (DTP) dose 1, pentavalent dose 1, and measles dose 1 in Ethiopian infants. We also examine the interaction between institutional delivery and demographic factors on the birth doses of the BCG and polio vaccines to better understand factors influencing vaccination. METHODS: Using the 2011 Ethiopia Demographic and Health Survey, we calculated the distribution of the study population across different demographic and vaccination characteristics. We computed acceleration factors using a multivariable accelerated failure time model with a Weibull distribution to account for left and right censoring. For the birth doses, we further specified an interaction term between institutional delivery and every other a priori specified independent variable to test whether institutional delivery modifies sociodemographic disparities in vaccination timeliness. RESULTS: Low wealth status, home delivery, and ethnicity are risk factors for delayed vaccination of polio 1, DPT 1, pentavalent 1, and measles 1. Religion is a risk factor for measles 1 vaccination delay and rural residence are risk factors for delayed DPT1 and polio 1 doses. For birth doses of polio and BCG, institutional delivery attenuated many sociodemographic disparities in vaccination delay, except for urbanicity, which showed rural dwellers with more delay than urban dwellers with an institutional vs home birth. CONCLUSIONS: Less delayed vaccination among children with institutional deliveries highlights the importance of perinatal care and the potential for promoting healthy behaviors to parents. Persistent disparities between urban and rural residents, even among those with institutional births, can be targeted for future interventions. Timely vaccination is key to prevention of unnecessary childhood mortality. Public Library of Science 2019-02-19 /pmc/articles/PMC6380539/ /pubmed/30779781 http://dx.doi.org/10.1371/journal.pone.0212408 Text en © 2019 Boulton et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Boulton, Matthew L.
Carlson, Bradley F.
Wagner, Abram L.
Porth, Julia M.
Gebremeskel, Berhanu
Abeje, Yemesrach
Vaccination timeliness among newborns and infants in Ethiopia
title Vaccination timeliness among newborns and infants in Ethiopia
title_full Vaccination timeliness among newborns and infants in Ethiopia
title_fullStr Vaccination timeliness among newborns and infants in Ethiopia
title_full_unstemmed Vaccination timeliness among newborns and infants in Ethiopia
title_short Vaccination timeliness among newborns and infants in Ethiopia
title_sort vaccination timeliness among newborns and infants in ethiopia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380539/
https://www.ncbi.nlm.nih.gov/pubmed/30779781
http://dx.doi.org/10.1371/journal.pone.0212408
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