Immunisation coverage among children born to HIV-infected women in Rakai district, Uganda: effect of voluntary testing and counselling (VCT)

Mast, T. Christopher; Kigozi, Godfrey; Wabwire-Mangen, Frederick; Sewankambo, Nelson; Serwadda, David; Gray, Ronald H.; Wawer, Maria J.; Black, Robert E.

doi:10.1080/09540120500521053

Cited by 23 publications

(21 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Mothers who perceived that irrespective of the absolute values, distance to the immunisation centre can be overcome are more than four times more likely to get their children immunised (OR 4.52, CI 2.14–9.55). This is consistent with Mast et al ‘s conclusion in Uganda 24 that immunisation coverage in venues difficult to reach had odds of immunisation more than four times those venues easy to reach. Jamil et al cited in Chowdhury 25 maintained that children living far from immunisation venues were 30% less likely to be fully immunized compared with children living nearby.…”

Section: Discussionsupporting

confidence: 91%

Socio cultural and geographical determinants of child immunisation in Borno State, Nigeria

Monguno

2013

J Public Health Africa

View full text Add to dashboard Cite

Immunisation has been an important strategy for disease prevention globally. Despite proven successes in other settings, child immunisation has continued to be problematic in developing countries including Nigeria. In addressing the problems, policy in Nigeria is largely directed at overcoming socio cultural issues surrounding parents’ rejection of vaccines. However, determinants of immunisation have geographical implications as well. A cross sectional survey was used to select 484 mothers/caregivers through a multi stage cluster sampling technique from the three senatorial districts of Borno State, Nigeria. Mothers or caregivers of children 12–23 months were interviewed using a structured questionnaire adapted from the Nigeria Demographic and Health Survey (2008). Socio cultural factors measured include mother’s education, religion, husband’s permission and sex of child while spatial variables include location i.e. whether rural or urban, and distance measured in terms of physical distance, cost and perception of physical distance. Descriptive statistics, univariate and multivariate logistic regressions were used to analyse the results. Data indicate that only 10.5% of children were fully immunised. Though immunisation uptake differed between the senatorial districts, this was not significant (P=0.1). In the bivariate analysis, mothers living in urban areas, <1 km to immunisation centre, their perception of travel distance and travel cost were the spatial predictors of immunisation while literacy and husband’s permission were the socio-cultural factors of significance. However, in the multivariate regression only two geographical factors i.e. living in an urban area [odds ratio (OR) 3.42, confidence interval (CI) 1.40–8.33] and mothers’ perception of distance (OR 4.52, CI 2.14–9.55) were protective against under immunisation while mother’s education was the only socio cultural variable of significance (OR 0.10, CI 0.03–0.41). It was concluded that while it is important to address socio cultural issues, policies directed at overcoming the friction of distance especially mobile clinics in rural areas are required to significantly improve immunisation uptake in the state.

show abstract

Section: Discussionsupporting

confidence: 91%

Socio cultural and geographical determinants of child immunisation in Borno State, Nigeria

Monguno

2013

J Public Health Africa

View full text Add to dashboard Cite

show abstract

“…One reason for this increased mortality may be that children born to HIV-positive mothers are less likely to receive routine childhood vaccinations. HIV-positive mothers may be too weak or too poor to bring their children to vaccination clinics (Mast et al 2006; Eley 2008) or they may be reluctant to access primary health care clinics for fear of stigma (Aggleton & Parker 2002). HIV infection may also be an indicator of relatively high tolerance of health risks in general, and mothers who are more tolerant of risks to their own health may be less motivated to ensure that their children receive risk-reducing interventions, such as vaccinations (Mast et al 2004).…”

Section: Introductionmentioning

confidence: 99%

Levels of childhood vaccination coverage and the impact of maternal HIV status on child vaccination status in rural KwaZulu‐Natal, South Africa*

Ndirangu

Bärnighausen

Tanser

et al. 2009

Tropical Med Int Health

View full text Add to dashboard Cite

ObjectivesTo analyse coverage of childhood vaccinations in a rural South African population and investigate whether maternal HIV status is associated with children’s vaccination status.Methods2 431 children with complete information, 12–23 months of age at some point during the period January 2005 through December 2006 and resident in the Africa Centre Demographic Surveillance Area at the time of their birth were investigated. We examined the relationship between maternal HIV status and child vaccination status for five vaccinations [Bacillus Calmette-Guérin (BCG), diphtheria-tetanus-pertussis (DTP3), poliomyelitis (polio3), hepatitis B (HepB3), and measles] in multiple logistic regressions, controlling for household wealth, maternal age, maternal education and distances to roads, fixed and mobile clinics.ResultsCoverage of the five vaccinations ranged from 89.3% (95% CI 81.7–93.9) for BCG to 77.3% (67.1–83.6) for measles. Multivariably, maternal HIV-positive status was significantly associated with lower adjusted odds ratios (AOR) of child vaccination for all vaccines [(AOR) 0.60–0.74, all P≤ 0.036] except measles (0.75, P= 0.073), distance to mobile clinic was negatively associated with vaccination status (all P≤ 0.029), household wealth was positively (all P≤ 0.013) and distance to nearest road negatively (all P≤ 0.004) associated with vaccination status.ConclusionPositive maternal HIV status independently reduces children’s probability to receive child vaccinations, which likely contributes to the morbidity and mortality differential between children of HIV-positive and HIV-negative mothers. As a means of increasing vaccination coverage, policy makers should consider increasing the number of mobile clinics in this and similar communities in rural Africa.

show abstract

“…However, health care staff responsible for immunization delivery may miss opportunities for immunizing HIV-infected children because they are unaware of those recommendations, they are concerned about greater risk with use of vaccines in this population, or other reasons. African [4, 5] and European studies [6,7, 8] found lower immunization coverage of HIV-infected children compared to uninfected peers, while a North American study found equally low vaccine coverage, for both HIV-infected and the HIV-exposed uninfected populations for some vaccines [9]. In a rural South African population, maternal HIV-positive status was independently associated with lower vaccination rates for four vaccines in children 12–23 month of age (BCG, DTP3, poliomyelitis, and hepatitis B) [10].…”

mentioning

confidence: 99%

Undervaccination of Perinatally HIV-infected and HIV-exposed Uninfected Children in Latin America and the Caribbean

Succi

Krauss

Harris

et al. 2013

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

Background Perinatally HIV-infected children (PHIV) may be at risk of undervaccination. Vaccination coverage rates among PHIV and HIV-exposed uninfected children (HEU) in Latin America and the Caribbean were compared. Methods All PHIV and HEU children born from 2002–2007 that were enrolled in a multi-site observational study conducted in Latin America and the Caribbean were included in this analysis. Children were classified as up to date (UTD) if they had received the recommended number of doses of each vaccine at the appropriate intervals by 12 and 24 months of age. Fisher’s exact test was used to analyze the data. Covariates potentially associated with a child’s HIV status were considered in multivariable logistic regression modeling. Results Of 1156 eligible children, 768 (66.4%) were HEU and 388 (33.6%) were PHIV. HEU children were significantly (p<0.01) more likely to be UTD by 12 and 24 months of age for all vaccines examined. Statistically significant differences persisted when the analyses were limited to children enrolled prior to 12 months of age. Controlling for birth weight, sex, primary caregiver education and any use of tobacco, alcohol or illegal drugs during pregnancy did not contribute significantly to the logistic regression models. Conclusions PHIV children were significantly less likely than HEU children to be UTD for their childhood vaccinations at 12 and 24 months of age, even when limited to children enrolled before 12 months of age. Strategies to increase vaccination rates in PHIV are needed.

show abstract

Immunisation coverage among children born to HIV-infected women in Rakai district, Uganda: effect of voluntary testing and counselling (VCT)

Cited by 23 publications

References 34 publications

Socio cultural and geographical determinants of child immunisation in Borno State, Nigeria

Socio cultural and geographical determinants of child immunisation in Borno State, Nigeria

Levels of childhood vaccination coverage and the impact of maternal HIV status on child vaccination status in rural KwaZulu‐Natal, South Africa*

Undervaccination of Perinatally HIV-infected and HIV-exposed Uninfected Children in Latin America and the Caribbean

Contact Info

Product

Resources

About