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BCG coverage and barriers to BCG vaccination in Guinea-Bissau: an observational study

Sanne Marie Thysen1, Stine Byberg, Marie Pedersen

  • 1Bandim Health Project, INDEPTH network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau. smthysen@gmail.com.

BMC Public Health
|October 6, 2014
PubMed

Insights

Low Bacillus Calmette-Guérin (BCG) vaccination coverage in early infancy is a concern in Guinea-Bissau. Offering BCG at monthly visits significantly improves early vaccination rates and removes socioeconomic barriers to timely immunization.

Area of Science:

  • Global Health
  • Vaccinology
  • Pediatric Infectious Diseases

Background:

  • Bacillus Calmette-Guérin (BCG) vaccination is crucial at birth in low-income nations, yet often delayed due to restricted vial-opening policies.
  • Delayed BCG vaccination can impact neonatal mortality, underscoring the need to assess coverage and identify barriers.
  • Existing reporting of BCG coverage at 12 months masks significant delays in early infancy.

Purpose of the Study:

  • To assess BCG vaccination coverage at various infant ages in rural Guinea-Bissau.
  • To explore the factors contributing to delayed BCG vaccination.
  • To evaluate the impact of providing BCG at monthly visits on vaccination timeliness and equity.

Main Methods:

  • A health and demographic surveillance system (Bandim Health Project) monitored BCG coverage in rural Guinea-Bissau.
  • BCG coverage was assessed for cohorts born in 2010 (restricted vial policy) and 2012-2013 (monthly visits intervention).
  • Logistic regression and log-binomial regression models were used to analyze factors associated with delayed vaccination and compare coverage between regions.

Main Results:

  • In 2010, only 11% of infants received BCG within 1 week and 38% within 1 month.
  • Introducing monthly vaccination visits increased 1-month BCG coverage from 51% (control) to 88% (intervention regions).
  • Socioeconomic factors associated with delayed vaccination in 2010 were no longer significant when BCG was offered monthly, highlighting improved equity.

Conclusions:

  • BCG vaccination coverage in the initial months of life remains low in Guinea-Bissau.
  • Implementing monthly vaccination visits effectively eliminates risk factors associated with delayed BCG immunization.
  • This strategy enhances early childhood protection against tuberculosis and potentially reduces neonatal mortality.
Abstract

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