Background Despite global efforts to reduce preventable childhood illness by distributing infant vaccines,immunization coverage in sub-Saharan African settings remains low.Further,timely administration of vaccines at ...Background Despite global efforts to reduce preventable childhood illness by distributing infant vaccines,immunization coverage in sub-Saharan African settings remains low.Further,timely administration of vaccines at birth—tuberculosis(Bacille Calmette-Guerin[BCG])and polio(OPV0)—remains inconsistent.As countries such as Democratic Republic of the Congo(DRC)prepare to add yet another birth-dose vaccine to their immunization schedule,this study aims to improve current and future birth-dose immunization coverage by understanding the determinants of infants receiving vaccinations within the national timeframe.Methods The study used two ordered regression models to assess barriers to timely BCG and first round of the hepatitis B(HepB3)immunization series across multiple time points using the Andersen Behavioral Model to conceptualize determinants at various levels.The assessment leveraged survey data collected during a continuous quality improvement study(NCT03048669)conducted in 105 maternity centers throughout Kinshasa Province,DRC.The final sample included 2398(BCG analysis)and 2268(HepB3 analysis)women-infant dyads living with HIV.Results Between 2016 and 2020,1981 infants(82.6%)received the BCG vaccine,and 1551(68.4%)received the first dose of HepB3 vaccine.Of those who received the BCG vaccine,26.3%,43.5%,and 12.8%received BCG within 24 h,between one and seven days,and between one and 14 weeks,respectively.Of infants who received the HepB3 vaccine,22.4%received it within six weeks,and 46%between six and 14 weeks of life.Many factors were positively associated with BCG uptake,including higher maternal education,household wealth,higher facility general readiness score,and religious-affiliated facility ownership.The factors influencing HepB3 uptake included older maternal age,higher education level,household wealth,transport by taxi to a facility,higher facility general and immunization readiness scores,and religious-affiliated facility ownership.Conclusions This study demonstrated that the study participants’uptake of vaccines was consistent with the country average,but not in a timely manner.Various factors were associated with timely uptake of BCG and HepB3 vaccines.These findings suggest that investment to strengthen the vaccine delivery system might improve timely vaccine uptake and equity in vaccine coverage.展开更多
基金supported by the President’s Emergency Plan for AIDS Relief(PEPFAR)the National Institute of Health and Child Development(NIHCD 1R01H087993)+1 种基金supported by the National Institutes of Health(NIAID U01AI096299,NICHD R01HD105526)The funders had no role in study design,data collection,data analysis and interpretation,preparation of the manuscript,or decision to submit.PT is funded by a grant from the NIH(NIAID K08AI148607).
文摘Background Despite global efforts to reduce preventable childhood illness by distributing infant vaccines,immunization coverage in sub-Saharan African settings remains low.Further,timely administration of vaccines at birth—tuberculosis(Bacille Calmette-Guerin[BCG])and polio(OPV0)—remains inconsistent.As countries such as Democratic Republic of the Congo(DRC)prepare to add yet another birth-dose vaccine to their immunization schedule,this study aims to improve current and future birth-dose immunization coverage by understanding the determinants of infants receiving vaccinations within the national timeframe.Methods The study used two ordered regression models to assess barriers to timely BCG and first round of the hepatitis B(HepB3)immunization series across multiple time points using the Andersen Behavioral Model to conceptualize determinants at various levels.The assessment leveraged survey data collected during a continuous quality improvement study(NCT03048669)conducted in 105 maternity centers throughout Kinshasa Province,DRC.The final sample included 2398(BCG analysis)and 2268(HepB3 analysis)women-infant dyads living with HIV.Results Between 2016 and 2020,1981 infants(82.6%)received the BCG vaccine,and 1551(68.4%)received the first dose of HepB3 vaccine.Of those who received the BCG vaccine,26.3%,43.5%,and 12.8%received BCG within 24 h,between one and seven days,and between one and 14 weeks,respectively.Of infants who received the HepB3 vaccine,22.4%received it within six weeks,and 46%between six and 14 weeks of life.Many factors were positively associated with BCG uptake,including higher maternal education,household wealth,higher facility general readiness score,and religious-affiliated facility ownership.The factors influencing HepB3 uptake included older maternal age,higher education level,household wealth,transport by taxi to a facility,higher facility general and immunization readiness scores,and religious-affiliated facility ownership.Conclusions This study demonstrated that the study participants’uptake of vaccines was consistent with the country average,but not in a timely manner.Various factors were associated with timely uptake of BCG and HepB3 vaccines.These findings suggest that investment to strengthen the vaccine delivery system might improve timely vaccine uptake and equity in vaccine coverage.
