Related Experiment Videos
A general practice case-control study of delayed immunisation in under two year old children
1Department of General Practice, Wellington School of Medicine.
Insights
Children with delayed immunisation often live in households with more children, younger parents, and fewer siblings who are up-to-date with their vaccinations. These social factors can help target preventive care for better child health outcomes.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Delayed immunisation poses a significant public health challenge, impacting child health outcomes.
- Identifying social determinants of health is crucial for effective public health interventions.
Purpose of the Study:
- To identify social factors characterizing households with children experiencing delayed immunisation.
- To inform targeted preventive care strategies within general practice settings.
Main Methods:
- A case-control study was conducted in 15 general practices in the Wellington region.
- Preschool children with delayed immunisation (cases) were compared with age-matched children up-to-date with immunisations (controls).
Main Results:
- Children with delayed immunisation were more likely to belong to Maori and Pacific Island ethnic groups.
- Their households had more children, single female adults, younger mothers and fathers, and parents with community service cards.
- Fewer siblings in these households were immunised, and mothers had lower cervical smear update rates.
Conclusions:
- A distinct group of children with delayed immunisation can be identified through specific social factors.
- These factors, obtainable from general practice records, allow for targeted preventive care.
- General practices can leverage this information for efficient and effective child health interventions.
Aim:
To identify social factors which characterise the household of children with delayed immunisation.
Method:
The study was done in 15 general practices in the Wellington city region with a case-control design where preschool children who were not up to date (cases) for their immunisations were compared with children who were up to date (controls).
Results:
There were 215 cases where immunisation was delayed among 3723 children at the time of audit in June 1996. Ethnic status was available from general practice records in 33% of cases and 40% of controls. There were more Maori and Pacific Island children among the cases compared to controls (39% versus 21%, odds ratio (OR) = 2.39, 95% confidence interval (CI) 1.12-5.10, p = 0.022. CASE SAMPLE HOUSEHOLDS COMPARED WITH CONTROLS HAD: (1) more children in the households (mean 2.27 versus 1.98, p = 0.01); (2) more households with a female as the only adult (35% versus 24%, OR = 1.61, 95% CI 1.04-2.51, p = 0.034). There was no difference in the proportions of male only adults (0.02% versus 0.01%, p = 0.70); (3) more mothers who were under 30 years of age (38% versus 25%, OR = 1.61, 95% CI 1.04-2.51, p = 0.034); and more fathers under 30 years of age (20% versus 10%, OR = 2.16, 95% CI 0.97-4.84, p = 0.06); (4) fewer mothers who were up to date with their recorded cervical smear status (66% versus 83%, OR = 0.69, 95% CI 0.23-0.63, p < 0.001); (5) more parents with an active community services card (38% versus 25%, OR 1.82, 95% CI 1.17-2.82, p = 0.007); (6) fewer siblings being immunised (70% versus 94%, OR = 0.14, 95% CI 0.07-0.28, p < 0.001).
Conclusion:
There is a distinct group of New Zealand children for whom immunisation is delayed. Such children live in households which can be characterised by various social factors easily obtainable from general practice records. The identified households could be targeted for efficient preventive care by general practices.