Predictors of measles vaccination coverage among children 6-59 months of age in the Democratic Republic of the Congo.

Tuesday, 9th of January 2018

Vaccine. 2017 Dec 13. pii: S0264-410X(17)31613-4. doi: 10.1016/j.vaccine.2017.11.049. [Epub ahead of print]

Predictors of measles vaccination coverage among children 6-59 months of age in the Democratic Republic of the Congo.

Ashbaugh HR¹ Hoff NA² Doshi RH² Alfonso VH² Gadoth A² Mukadi P³ Okitolonda-Wemakoy E⁴ Muyembe-Tamfum JJ⁵ Gerber SK⁶ Cherry JD⁷ Rimoin AW⁸.

Author information

1

Fielding School of Public Health University of California Los Angeles Department of Epidemiology Los Angeles CA 90095 United States. Electronic address: hashbaugh@ucla.edu.

2

Fielding School of Public Health University of California Los Angeles Department of Epidemiology Los Angeles CA 90095 United States.

3

Kinshasa University School of Medicine Kinshasa The Democratic Republic of the Congo.

4

Kinshasa School of Public Health Kinshasa The Democratic Republic of the Congo.

5

National Institute for Biomedical Research Kinshasa The Democratic Republic of the Congo.

6

Bill and Melinda Gates Foundation Seattle WA 98109 United States.

7

David Geffen School of Medicine at UCLA Los Angeles CA 90095 United States.

8

Fielding School of Public Health University of California Los Angeles Department of Epidemiology Los Angeles CA 90095 United States. Electronic address: arimoin@ucla.edu.

Abstract

BACKGROUND:

Measles is a significant contributor to child mortality in the Democratic Republic of the Congo (DRC) despite routine immunization programs and supplementary immunization activities (SIA). Further national immunization coverage levels may hide disparities among certain groups of children making effective measles control even more challenging. This study describes measles vaccination coverage and reporting methods and identifies predictors of vaccination among children participating in the 2013-2014 DRC Demographic and Health Survey (DHS).

METHODS:

We examined vaccination coverage of 6947 children aged 6-59 months. A multivariate logistic regression model was used to identify predictors of vaccination among children reporting vaccination via dated card in order to identify least reached children. We also assessed spatial distribution of vaccination report type by rural versus urban residence.

RESULTS:

Urban children with educated mothers were more likely to be vaccinated (OR = 4.1 95% CI: 1.6 10.7) versus children of mothers with no education as were children in wealthier rural families (OR = 2.9 95% CI: 1.9 4.4). At the provincial level urban areas more frequently reported vaccination via dated card than rural areas.

CONCLUSIONS:

Results indicate that while the overall coverage level of 70% is too low socioeconomic and geographic disparities also exist which could make some children even less likely to be vaccinated. Dated records of measles vaccination must be increased and groups of children with the greatest need should be targeted. As access to routine vaccination services is limited in DRC identifying and targeting under-reached children should be a strategic means of increasing country-wide effective measles control.

Copyright © 2017. Published by Elsevier Ltd.

KEYWORDS:

Democratic Republic of the Congo; Measles; Routine immunization; Vaccination coverage

 

DOI:

10.1016/j.vaccine.2017.11.049