ObjectivesNational immunisation coverage rate masks subnational immunisation coverage gaps at the state and local district levels. The objective of the current study was to determine the sociodemographic factors associated with incomplete immunisation in children at a sub-national level.DesignCross-sectional study using the WHO sampling method (2018 Reference Manual).SettingFifty randomly selected clusters (wards) in four districts (two urban and two rural) in Enugu state, Nigeria.Participants1254 mothers of children aged 12–23 months in July 2020.Primary and secondary outcome measuresFully immunised children and not fully immunised children.ResultsFull immunisation coverage (FIC) rate in Enugu state was 78.9% (95% CI 76.5% to 81.1%). However, stark difference exists in FIC rate in urban versus rural districts. Only 55.5% of children in rural communities are fully immunised compared with 94.5% in urban communities. Significant factors associated with incomplete immunisation are: children of single mothers (aOR=5.74, 95% CI 1.45 to 22.76), children delivered without skilled birth attendant present (aOR=1.93, 95% CI 1.24 to 2.99), children of mothers who did not receive postnatal care (aOR=6.53, 95% CI 4.17 to 10.22), children of mothers with poor knowledge of routine immunisation (aOR=1.76, 95% CI 1.09 to 2.87), dwelling in rural district (aOR=7.49, 95% CI 4.84 to 11.59), low-income families (aOR=1.56, 95% CI 1.17 to 2.81) and living further than 30 min from the nearest vaccination facility (aOR=2.15, 95% CI 1.31 to 3.52).ConclusionsAlthough the proportion of fully immunised children in Enugu state is low, it is significantly lower in rural districts. Study findings suggest the need for innovative solutions to improve geographical accessibility and reinforce the importance of reporting vaccination coverage at local district level to identify districts for more targeted interventions.

Background Over 20 million preschool-age children (PSAC) in Nigeria require periodic chemotherapy (PC) for soil-transmitted helminth (STH) infections. Persistently low coverage for this age group threatens the World Health Organization (WHO) 2030 target for eliminating STH infections. Current strategies for targeting PSAC have been largely ineffective. Hence, PSAC are mostly dewormed by their parents/caregivers. However, little is known of the perception and attitude of parents/caregivers of PSAC to deworming in this setting. Methods A mixed methods design, combining a community-based interviewer-administered questionnaire-survey (n = 433) and focus group discussions (FGD) (n = 43) was used to assess the perceptions and attitudes of mothers to periodic deworming of preschool children aged 2–5 years in Abakpa-Nike, Enugu, Nigeria. Results Coverage of periodic deworming in PSAC is 42% (95% CI: 37.3–46.8%). There is significant difference in the specific knowledge of transmission of STH (AOR = 0.62, 95% CI: 0.48–0.81, p = 0.000), complication of STH infections (AOR = 0.77, 95% CI: 0.61–0.98, p = 0.034), accurate knowledge of deworming frequency (AOR = 0.41, 95% CI: 0.18–0.90, p = 0.026), and knowledge of PC drug, mebendazole (AOR = 0.28, 95% CI: 0.09–0.90, p = 0.031), and pyrantel (AOR = 8.03, 95% CI: 2.22–29.03, p = 0.001) between mothers who periodically deworm their PSAC and those who do not. There is no significant difference in specific knowledge of the symptoms of STH infections (AOR = 0.76, 95% CI: 0.57–1.02, p = 0.069) and PC drug, Albendazole (AOR = 1.00, 95% CI: 0.46–2.11, p = 0.972). FGD revealed misconceptions that are rooted in stark ignorance of the disease. Overall attitude to deworming is positive and favourable. Conclusions Poor coverage of periodic deworming for STH infections in PSAC in this setting are primarily driven by poor specific knowledge of the risks and burden of the infection. Focused health education on the burden and transmission of STH infections could complement existing strategies to improve periodic deworming of PSAC in this setting.

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Background: Blood donation is crucial in saving lives, as blood cannot be manufactured artificially and can thus be obtained only from human blood sources. Voluntary blood donation is the cornerstone of a safe and adequate supply of blood and blood components. We aim to understand the level of knowledge, attitude, and practice of blood donation and associated factors among undergraduate students in Nigeria. Method: We conducted a cross-sectional descriptive study among 300 undergraduate students at Enugu State University College of Medicine Parklane, Enugu, Nigeria in June 2022 to access their knowledge, attitude, and practice of blood donation. Data were analyzed using multivariable logistics regression to identify factors associated with blood donation practice. Results: Most of the students had good knowledge of blood donation, and it was revealed that the initial source of information was mostly from school (37.7%), 89.0% of participants knew their blood group, and 98.3% were aware of infections through blood donation. Also, the attitude of our respondents towards blood donation revealed that the majority (95.0%) agreed blood donation saves lives, that blood donation is good (91.0%), and that voluntary blood donation (84.7%) is the best source of donor blood; most were indifferent to paid donation. Regression analysis suggests that knowing own blood group, having a positive attitude towards blood donation, and being willing to donate in the future were significantly associated with blood donation practice.  Conclusion: Hence, there is a need for adequate enlightenment campaigns and health education on the need for voluntary blood donation to improve knowledge of, change attitudes towards voluntary blood donation, and ultimately encourage undergraduate students in developing countries to donate blood.