Cargando…

Finding Children with High Risk of Non-Vaccination in 92 Low- and Middle-Income Countries: A Decision Tree Approach

Reducing vaccination inequalities is a key goal of the Immunization Agenda 2030. Our main objective was to identify high-risk groups of children who received no vaccines (zero-dose children). A decision tree approach was used for 92 low- and middle-income countries using data from Demographic and He...

Descripción completa

Detalles Bibliográficos
Autores principales: Santos, Thiago M., Cata-Preta, Bianca O., Victora, Cesar G., Barros, Aluisio J. D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8231774/
https://www.ncbi.nlm.nih.gov/pubmed/34199179
http://dx.doi.org/10.3390/vaccines9060646
_version_ 1783713491274694656
author Santos, Thiago M.
Cata-Preta, Bianca O.
Victora, Cesar G.
Barros, Aluisio J. D.
author_facet Santos, Thiago M.
Cata-Preta, Bianca O.
Victora, Cesar G.
Barros, Aluisio J. D.
author_sort Santos, Thiago M.
collection PubMed
description Reducing vaccination inequalities is a key goal of the Immunization Agenda 2030. Our main objective was to identify high-risk groups of children who received no vaccines (zero-dose children). A decision tree approach was used for 92 low- and middle-income countries using data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys, allowing the identification of groups of children aged 12–23 months at high risk of being zero dose (no doses of the four basic vaccines—BCG, polio, DPT and measles). Three high-risk groups were identified in the analysis combining all countries. The group with the highest zero-dose prevalence (42%) included 4% of all children, but almost one in every four zero-dose children in the sample. It included children whose mothers did not receive the tetanus vaccine during and before the pregnancy, who had no antenatal care visits and who did not deliver in a health facility. Separate analyses by country presented similar results. Children who have been missed by vaccination services were also left out by other primary health care interventions, especially those related to antenatal and delivery care. There is an opportunity for better integration among services in order to achieve high and equitable immunization coverage.
format Online
Article
Text
id pubmed-8231774
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-82317742021-06-26 Finding Children with High Risk of Non-Vaccination in 92 Low- and Middle-Income Countries: A Decision Tree Approach Santos, Thiago M. Cata-Preta, Bianca O. Victora, Cesar G. Barros, Aluisio J. D. Vaccines (Basel) Article Reducing vaccination inequalities is a key goal of the Immunization Agenda 2030. Our main objective was to identify high-risk groups of children who received no vaccines (zero-dose children). A decision tree approach was used for 92 low- and middle-income countries using data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys, allowing the identification of groups of children aged 12–23 months at high risk of being zero dose (no doses of the four basic vaccines—BCG, polio, DPT and measles). Three high-risk groups were identified in the analysis combining all countries. The group with the highest zero-dose prevalence (42%) included 4% of all children, but almost one in every four zero-dose children in the sample. It included children whose mothers did not receive the tetanus vaccine during and before the pregnancy, who had no antenatal care visits and who did not deliver in a health facility. Separate analyses by country presented similar results. Children who have been missed by vaccination services were also left out by other primary health care interventions, especially those related to antenatal and delivery care. There is an opportunity for better integration among services in order to achieve high and equitable immunization coverage. MDPI 2021-06-13 /pmc/articles/PMC8231774/ /pubmed/34199179 http://dx.doi.org/10.3390/vaccines9060646 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Santos, Thiago M.
Cata-Preta, Bianca O.
Victora, Cesar G.
Barros, Aluisio J. D.
Finding Children with High Risk of Non-Vaccination in 92 Low- and Middle-Income Countries: A Decision Tree Approach
title Finding Children with High Risk of Non-Vaccination in 92 Low- and Middle-Income Countries: A Decision Tree Approach
title_full Finding Children with High Risk of Non-Vaccination in 92 Low- and Middle-Income Countries: A Decision Tree Approach
title_fullStr Finding Children with High Risk of Non-Vaccination in 92 Low- and Middle-Income Countries: A Decision Tree Approach
title_full_unstemmed Finding Children with High Risk of Non-Vaccination in 92 Low- and Middle-Income Countries: A Decision Tree Approach
title_short Finding Children with High Risk of Non-Vaccination in 92 Low- and Middle-Income Countries: A Decision Tree Approach
title_sort finding children with high risk of non-vaccination in 92 low- and middle-income countries: a decision tree approach
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8231774/
https://www.ncbi.nlm.nih.gov/pubmed/34199179
http://dx.doi.org/10.3390/vaccines9060646
work_keys_str_mv AT santosthiagom findingchildrenwithhighriskofnonvaccinationin92lowandmiddleincomecountriesadecisiontreeapproach
AT catapretabiancao findingchildrenwithhighriskofnonvaccinationin92lowandmiddleincomecountriesadecisiontreeapproach
AT victoracesarg findingchildrenwithhighriskofnonvaccinationin92lowandmiddleincomecountriesadecisiontreeapproach
AT barrosaluisiojd findingchildrenwithhighriskofnonvaccinationin92lowandmiddleincomecountriesadecisiontreeapproach