在埃塞俄比亚的服务不足和特殊环境人群中,零剂量儿童的高患病率使用了概括估计方程和度指数分析
Gashaw Andargie Biks1, Fisseha Shiferie2, Dawit Abraham Tsegaye2
1Project HOPE, Ethiopia Country Office, Addis Ababa, Ethiopia. Gandargie@projecthope.org.
BMC public health
|February 23, 2024
概括
在埃塞俄比亚,超过三分之一的儿童没有接种疫苗,称为零剂量. 关键因素包括贫困,低产妇年龄和有限的获得产前和产后护理服务.
科学领域:
- 公共卫生 公共卫生
- 儿科 儿科 儿科
- 全球健康 全球健康
背景情况:
- 全球范围内,在低收入和中等收入国家,主要在非洲和东南亚,超过1430万名儿童尚未接种疫苗 (零剂量).
- 埃塞俄比亚是零剂量儿童负担较高的前十个国家之一,需要集中干预.
研究的目的:
- 估计埃塞俄比亚服务不足人口中零剂量儿童的患病率.
- 识别导致这些弱势群体中零剂量状态的相关因素.
主要方法:
- 在2022年6月进行了一项横截面疫苗覆盖率调查,涉及12-35个月龄的儿童的母亲.
- 通过CommCare应用程序收集数据,并使用Stata 17进行分析,采用加权分析和通用估计方程模型.
- 使用调整的几率比率 (AOR) 来确定统计显著性,其中 95% 的置信区间 (CI) 和 0.05.05 的 p 值值.
主要成果:
- 零剂量儿童的总体患病率为33.7% (95%CI:34.9%,75.7%),在发展中国家,牧民,国内流离失所者,新成立地区和受冲突影响地区的患病率更高.
- 关键预测因素包括贫困 (最贫穷:AOR=2.78;最贫穷:AOR=1.96),单身婚姻状况 (AOR=2.4),年轻的孕产妇年龄 (15-24岁:AOR=1.2),以及少于四次产前护理 (ANC) 访问 (AOR=1.3).
- 其他重要因素是缺乏产后护理 (PNC) 服务 (AOR=2.1),附近卫生设施的不可用性 (AOR=3.7),由女性领导的家庭 (AOR=1.3),以及较低的性别赋权水平 (低:AOR=1.6;中:AOR=1.7).
结论:
- 埃塞俄比亚零剂量儿童的高患病率凸显了免疫覆盖率的严重差距.
- 贫困,对孕产妇健康服务 (ANC/PNC) 的有限准入,年轻的孕产妇年龄,单身婚姻状况和性别赋权的低水平是重要的预测因素.
- 建议采用量身定制的,特定于环境的服务提供策略,包括延长免疫接种时间,以提高疫苗接种率.
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