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Bayesian spatial analysis of incomplete vaccination among children aged 12-23 months in Nigeria
Lanre Quadri Ahmed1, Ayo S Adebowale2,3, Martin E Palamuleni3
1Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria. quadriahmed2016@gmail.com.
Insights
In Nigeria, incomplete childhood vaccination remains high, particularly in northern regions. Maternal age, education, health facility delivery, and media exposure significantly influence vaccination status.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Nigeria faces significant challenges with high childhood disease prevalence and under-five mortality rates.
- Vaccination is a critical, cost-effective intervention for preventing childhood diseases.
Purpose of the Study:
- To identify the key determinants of incomplete vaccination (IV) among children aged 12-23 months in Nigeria.
- To analyze the influence of maternal and community-level factors on childhood vaccination status.
Main Methods:
- Utilized the 2018 Nigeria Demographic and Health Survey (NDHS) dataset with a cross-sectional design.
- Employed Integrated Nested Laplace Approximation and Bayesian binary regression models for data analysis.
- Visualized incomplete vaccination patterns using ArcGIS software.
Main Results:
- The study found a high prevalence of incomplete vaccination (IV) in Nigeria, with northern regions showing higher rates.
- Maternal age (older mothers less likely to have IV), higher education, delivery at a health facility, and media exposure were associated with reduced odds of IV.
- Maternal characteristics were the primary drivers of IV variability, outweighing community and state-level factors.
Conclusions:
- Significant regional and socioeconomic disparities in childhood vaccination exist in Nigeria.
- Targeted interventions focusing on maternal education and access to healthcare facilities are crucial.
- Enhanced vaccination sensitization programs and campaigns are necessary to improve coverage and reduce childhood disease burden.
Abstract:
High childhood disease prevalence and under-five mortality rates have been consistently reported in Nigeria. Vaccination is a cost-effective preventive strategy against childhood diseases. Therefore, this study aimed to identify the determinants of Incomplete Vaccination (IV) among children aged 12-23 months in Nigeria. This cross-sectional design study utilized the 2018 Nigeria Demographic and Health Survey (NDHS) dataset. A two-stage cluster sampling technique was used to select women of reproductive age who have children (n = 5475) aged 12-23 months. The outcome variable was IV of children against childhood diseases. Data were analyzed using Integrated Nested Laplace Approximation and Bayesian binary regression models (α0.05). Visualization of incomplete vaccination was produced using the ArcGIS software. Children's mean age was 15.1 ± 3.2 months and the median number of vaccines received was four. Northern regions contributed largely to the IV. The likelihood of IV was lower among women aged 25-34 years (aOR = 0.67, 95% CI = 0.54-0.82, p < 0.05) and 35-49 years (aOR = 0.59, 95%CI = 0.46-0.77, p < 0.05) compared to younger women in the age group 15-24 years. An increasing level of education reduces the risk of odds of IV. Other predictors of IV were delivery at the health facility (aOR = 0.64, 95% CI = 053-0.76, p < 0.05), and media exposure (aOR = 0.63, 95%CI = 0.54-0.79, p < 0.05). Mothers' characteristics explained most of the variability in the IV, relatively to smaller overall contributions from the community and state-level factors (p < 0.05). The level of IV against childhood diseases was high in Nigeria. However, disparities exist across the regions and other socioeconomic segments of the population. More efforts are required to improve vaccination sensitization programs and campaigns in Nigeria.
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