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Compliance with diphtheria, tetanus, and pertussis immunisation in Bangladesh: factors identifying high risk groups
S Zeitlyn1, A K Rahman, B H Nielsen
1International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Insights
Mothers
Area of Science:
- Public Health
- Pediatrics
- Epidemiology
Background:
- Vaccination is crucial for child health.
- Ensuring complete immunization is a global health priority.
- Socioeconomic factors can impact healthcare access and adherence.
Purpose of the Study:
- To identify factors influencing non-compliance with the second diphtheria, tetanus, and pertussis vaccine dose.
- To determine at-risk populations for incomplete childhood immunizations in Dhaka.
- To inform targeted public health interventions.
Main Methods:
- A cohort study was conducted at a Dhaka treatment center.
- 136 unvaccinated children aged 6 weeks to 23 months were followed.
- Compliance with the second vaccine dose was assessed, with non-compliance factors analyzed.
Main Results:
- Only 41% of children received the second vaccine dose.
- Maternal education level and household income were significantly associated with non-compliance.
- Higher maternal knowledge about immunization correlated with increased compliance.
Conclusions:
- Socioeconomic status and maternal education significantly affect immunization compliance.
- Preventive healthcare services, like vaccinations, require tailored approaches.
- Enhancing health education effectiveness for uneducated parents is critical for improving immunization rates.
Objective:
To evaluate factors associated with non-compliance with having second vaccination against diphtheria, tetanus, and pertussis in a treatment centre in Dhaka to determine which children were most at risk of not completing immunisation.
Design:
Cohort study of infants given first dose of the vaccine and followed up six weeks later to ascertain compliance with having second dose. Factors associated with non-compliance were evaluated.
Setting:
Dhaka treatment centre of the International Centre for Diarrhoeal Disease Research, Bangladesh.
Subjects:
136 unimmunised children aged 6 weeks to 23 months who lived within reach of the treatment centre. At time of the six week follow up 16 of the children could not be traced and seven had died.
Interventions:
All children received their first dose of the vaccine. In each case health education workers had informed the mother about the value of immunisation, and she was given clear instructions to bring the child back after four weeks for the second dose.
Main Outcome Measure:
Rate of non-compliance with advice to return child for second vaccination.
Results:
46 of 113 children (41%) received the second dose of the vaccine. Factors most closely associated with mothers' failure to comply with the second dose were lack of education and low income. Children whose mothers knew most about immunisation at first interview were more likely to have their second dose.
Conclusions:
Preventive health care services such as immunisation are appropriately offered in treatment centres, but compliance among children varies with socioeconomic status and mother's education. Further research should be aimed at ways to make health education more effective among uneducated parents.