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Updated: May 22, 2025
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Determinants of immunisation in children with sickle cell disease in Libreville
Edgard B Ngoungou1,2, Ulrick J Bisvigou1,2, Jean Engohang-Ndong2,3
1Department of Community and Social Medicine, Faculty of Medicine, University of Health Sciences, Owendo, Gabon.
Insights
Immunisation coverage for children with sickle cell disease (SCD) in Gabon is higher than national rates, but knowledge gaps and access barriers persist. Improving public health facilities is crucial for better vaccine uptake in these vulnerable children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Sickle cell disease (SCD) patients face high risks of severe infectious diseases.
- Preventive immunisation is critical for SCD children, yet Gabon lacks a specific schedule.
- This study addresses immunisation determinants in Gabonese children with SCD.
Purpose of the Study:
- To investigate factors influencing immunisation status in children with SCD in Libreville, Gabon.
- To identify barriers and facilitators for vaccine uptake in this high-risk pediatric population.
- To inform the development of targeted immunisation strategies for SCD patients.
Main Methods:
- A cross-sectional study was conducted in five Libreville healthcare facilities.
- Data were collected from 172 parents of children under 18 with SCD.
- Knowledge, attitudes, and practices regarding immunisation and SCD were assessed.
Main Results:
- 87.9% of children with SCD had complete immunisation according to the Expanded Programme of Immunisation (EPI) schedule.
- Parental understanding of SCD complications (28.5%) and prevention (22.7%) was low.
- Factors like proximity to health centers, parental marital status, and access to private pediatric care influenced coverage.
Conclusions:
- Immunisation coverage in Gabonese children with SCD exceeds national averages.
- Significant gaps in parental knowledge about SCD and its prevention were observed.
- Enhancing public healthcare facilities and addressing cost barriers are vital for optimizing immunisation programs.
Background:
Infectious diseases are frequent and sometimes deadly in sickle cell disease (SCD) patients. Some of these infectious diseases could be avoided through immunisation, but an immunisation schedule for children with SCD is not available in Gabon.
Aim:
This study looked into the determinants of immunisation in children with SCD in Libreville.
Setting:
This work was performed in five healthcare facilities in Libreville.
Methods:
A cross-sectional study on knowledge, attitudes, and practices was conducted from February 2019 to September 2019 in Libreville healthcare facilities, targeting children under 18 years with SCD.
Results:
A total of 172 parents of children with SCD participated. The average age of children was 7.1 ± 4.2 years, with a sex ratio of 1:36. Immunisation status was considered complete for 87.9% (95% CI = 79.8-93.1) according to the Expanded Programme of Immunisation (EPI) schedule. Only 49 (28.5%) parents understood SCD complications, and 39 (22.7%) knew how to prevent them. Immunisation coverage was better for children near public health centres (p = 0.008). For non-EPI vaccines, coverage improved for children of married parents (p = 0.041) and those seen by paediatricians in private facilities (p = 0.046). Multivariate analysis indicated that marital status, a lack of knowledge, facility access, and high vaccine costs predicted immunisation coverage.
Conclusion:
Immunisation coverage of children with SCD was better than the national immunisation coverage in Gabon.
Contribution:
This study unravels the need for Gabon to improve its immunisation programmes in public healthcare facilities.
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