Spatial distribution of rotavirus immunization coverage in Ethiopia: a geospatial analysis using the Bayesian...

Area of Science:

• Public Health
• Epidemiology
• Geospatial Analysis

Background:

• Rotavirus infection poses a significant global health burden, particularly for children under five.
• Inadequate rotavirus vaccination coverage persists in many African nations, including Ethiopia, hindering disease prevention efforts.
• Understanding sub-national immunization coverage is crucial for developing effective, targeted vaccination campaigns.

Purpose of the Study:

• To investigate the spatial distribution of rotavirus immunization coverage across Ethiopia.
• To identify geographic and socioeconomic factors associated with variations in rotavirus vaccination rates.

Main Methods:

• Utilized data from the Ethiopian Demographic and Health Survey (EDHS 2019) for rotavirus immunization coverage.
• Employed a Bayesian geostatistics model to estimate coverage at a pixel level.
• Integrated covariate data from various public sources to analyze spatial clustering factors.

Main Results:

• National rotavirus immunization coverage in Ethiopia was found to be 52.3%.
• Significant sub-national variations were observed, with low coverage clustering in Eastern, Southeastern, and Northeastern Ethiopia.
• Low coverage areas were associated with higher altitudes, longer travel times to cities, and greater distances to health facilities.

Conclusions:

• Rotavirus immunization coverage in Ethiopia exhibits substantial sub-national and local-level variability.
• Geographic factors like altitude and healthcare access (distance to facilities, travel time) significantly influence spatial clustering of coverage.
• Strengthening immunization programs, particularly in identified low-coverage eastern regions, and implementing outreach services are recommended.