High-Resolution Geospatial Mapping of Zero-Dose and Underimmunized Children Following Nigeria's 2021 Multiple
Anne Eudes Jean Baptiste1, John Wagai1, Susan Hahné2
1Country Office, World Health Organization, Abuja, Nigeria.
Insights
Nigeria has over 2.3 million unvaccinated children, the highest globally. Geospatial modeling identified high-risk areas for zero-dose children, aiding targeted vaccination strategies to improve coverage.
Area of Science:
- Public Health
- Epidemiology
- Geospatial Analysis
Background:
- Nigeria has the world's largest population of "zero-dose" children, defined as those lacking any routine vaccinations or the initial diphtheria, tetanus, and pertussis vaccine.
- Over 2.3 million unvaccinated children were estimated in Nigeria as of 2022, highlighting a critical public health challenge.
Purpose of the Study:
- To identify and map "zero-dose" and underimmunized children in Nigeria.
- To pinpoint high-risk geographical areas for targeted immunization interventions.
Main Methods:
- Utilized data from the 2021 Nigeria Multiple Indicator Cluster Survey/National Immunization Coverage Survey.
- Employed high-resolution (1 × 1 km) geospatial modeling to predict the prevalence and distribution of unvaccinated children.
Main Results:
- "Zero-dose" and underimmunized children are disproportionately found in socially deprived populations.
- Positive correlations were observed between unvaccinated children and factors including stunting, contraceptive prevalence, and literacy.
- Significant regional and ethnic variations in prevalence were noted, with higher rates in northern Nigeria, indicating substantial heterogeneity.
Conclusions:
- Enhancing Nigeria's immunization system is crucial for improving vaccine coverage.
- Geospatial modeling offers an effective strategy for delivering vaccines to underserved communities.
- Equitable vaccine access is essential for achieving global vaccination goals.
Background:
"Zero-dose" children are those who are without any routine vaccination or are lacking the first dose of the diphtheria, tetanus, and pertussis-containing vaccine. Based on global estimates from the World Health Organization/United Nations Children's Fund in 2022, Nigeria has the highest number of zero-dose children, with >2.3 million unvaccinated.
Methods:
We used data from the 2021 Nigeria Multiple Indicator Cluster Survey/National Immunization Coverage Survey to identify zero-dose and underimmunized children. Geospatial modeling techniques were employed to determine the prevalence of zero-dose children and predict risk areas with underimmunized children at a high resolution (1 × 1 km).
Results:
Zero-dose and underimmunized children are more prevalent in socially deprived groups. Univariate and multivariate bayesian analyses showed positive correlations between the prevalence of zero-dose and underimmunized children and factors such as stunting, contraceptive prevalence, and literacy. The prevalence of zero-dose and underimmunized children varies significantly by region and ethnicity, with higher rates observed in the country's northern parts. Significant heterogeneity in the distribution of undervaccinated children was observed.
Conclusions:
Nigeria needs to enhance its immunization system and coverage. Geospatial modeling can help deliver vaccines effectively to underserved communities. By adopting this approach, countries can ensure equitable vaccine access and contribute to global vaccination objectives.
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