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Modelling the spatial variability and uncertainty for under-vaccination and zero-dose children in fragile settings

Victor A Alegana1, Johnson M Ticha2, Jason M Mwenda2

  • 1WHO Regional Office for Africa, Brazzaville, Congo. aleganav@gmail.com.

Scientific Reports
|October 17, 2024
PubMed

Insights

This study mapped under-immunized and zero-dose children in Chad, revealing significant spatial variations in vaccination coverage. Identifying these vulnerable populations is crucial for improving childhood immunization programs and child health outcomes.

Area of Science:

  • * Global Health
  • * Epidemiology
  • * Demography

Background:

  • * Universal childhood vaccination is vital for child health and achieving sustainable development goals.
  • * Identifying under-immunized and zero-dose children at a granular level is essential for targeted interventions.

Purpose of the Study:

  • * To identify under-immunized and zero-dose children in Chad using fine-scale spatial modeling.
  • * To estimate age-disaggregated populations and vaccination coverage at a 1km x 1km resolution.

Main Methods:

  • * Utilized the most recent nationally representative household survey data from Chad.
  • * Employed a Bayesian geostatistical framework to model population and vaccination coverage.
  • * Adjusted models using parsimonious covariates for fine spatial resolution.

Main Results:

  • * Estimated 312,723 zero-dose children (based on DTP1) in Chad.
  • * Revealed significant spatial variation in the 12-23 month population, with a national mean of 18.6%.
  • * Reported modelled birth coverage for BCG (49.0%), DTP1 (44.8%), DTP3 (24.7%), and MCV1 (47.0%).

Conclusions:

  • * Fine-scale mapping identified substantial numbers of zero-dose children, highlighting inequities in vaccination access.
  • * Improving routine immunization requires strengthening primary healthcare systems.
  • * Acknowledged uncertainties in estimates, emphasizing the need for higher quality data and further investigation.

Keywords:
Bayesian geostatistical modellingExceedance probabilityUnder-immunizationZero-dose

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