Risk factors for delay in age-appropriate vaccinations among Gambian children

Wednesday, 4th of November 2015

BMC Health Serv Res. 2015 Aug 2815346. doi 10.1186/s12913-015-1015-9.

Risk factors for delay in age-appropriate vaccinations among Gambian children.

Odutola A¹ Afolabi MO² Ogundare EO³ Lowe-Jallow YN⁴ Worwui A⁵ Okebe J⁶ Ota MO⁷⁸.

Abstract

BACKGROUND

Vaccination has been shown to reduce mortality and morbidity due to vaccine-preventable diseases. However these diseases are still responsible for majority of childhood deaths worldwide especially in the developing countries. This may be due to low vaccine coverage or delay in receipt of age-appropriate vaccines. We studied the timeliness of routine vaccinations among children aged 12-59 months attending infant welfare clinics in semi-urban areas of The Gambia a country with high vaccine coverage.

METHODS

A cross-sectional survey was conducted in four health centres in the Western Region of the Gambia. Vaccination dates were obtained from health cards and timeliness assessed based on the recommended age ranges for BCG (birth-8 weeks) Diphtheria-Pertussis-Tetanus (6 weeks-4 months 10 weeks-5 months 14 weeks-6 months) and measles vaccines (38 weeks-12 months). Risk factors for delay in age-appropriate vaccinations were determined using logistic regression. Analysis was limited to BCG third dose of Diphtheria-Pertussis -Tetanus (DPT3) and measles vaccines.

RESULTS

Vaccination records of 1154 children were studied. Overall 63.3% (95 % CI 60.6-66.1%) of thechildren had a delay in the recommended time to receiving at least one of the studied vaccines. The proportion of children with delayed vaccinations increased from BCG [5.8% (95 % CI 4.5-7.0%)] to DPT3 [60.4% (95 % CI 57.9%-63.0%)] but was comparatively low for the measles vaccine [10.8% (95 % CI 9.1%-12.5%)]. Mothers of affected children gave reasons for the delay and their profile correlated with type of occupation place of birth and mode of transportation to the health facilities.

CONCLUSION

Despite high vaccination coverage reported in The Gambia a significant proportion of thechildrens vaccines were delayed for reasons related to health services as well as profile of mothers. These findings are likely to obtain in several countries and should be addressed by programme managers in order to improve and optimize the impact of the immunization coverage rates.