Is Colombia reaching the goals on infant immunization coverage? A quantitative survey from 80 municipalities

Narváez, Javier; Osorio, May Bibiana; Castañeda-Orjuela, Carlos; Zakzuk, Nelson Alvis; Cediel, Natalia; Chocontá-Piraquive, Luz Ángela; Hoz-Restrepo, Fernando De la

doi:10.1016/j.vaccine.2017.01.073

Cited by 17 publications

(12 citation statements)

References 19 publications

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“…Chukwuma et al 46 showed that only 66% of mothers who received ANC continued to use SBA in 28 African countries, inclusive of Nigeria 46. The lower effect of SBA on the child being fully immunised could also be due to insufficient MHC/immunisation communication interventions and socio-demographic factors such as the location of health facility, high cost of health services and cultural practices which could be barriers to mother’s use of SBA which may subsequently lead to a child not being fully immunised 36 40 41 45 49…”

Section: Discussionmentioning

confidence: 99%

The impact of maternal health care utilisation on routine immunisation coverage of children in Nigeria: a cross-sectional study

Anichukwu

Asamoah

2019

BMJ Open

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ObjectiveTo examine the impact of maternal healthcare (MHC) utilisation on routine immunisation coverage of children in Nigeria.DesignIndividual level cross-sectional study using bivariate and multivariable logistic regression analyses to examine the association between MHC utilisation and routine immunisation coverage of children.SettingNigeria Demographic and Health Survey 2013.Participants5506 women aged 15–49 years with children aged 12–23 months born in the 5 years preceding the survey.Primary outcome measuresFully immunised children and not fully immunised children.ResultsThe percentage of children fully immunised with basic routine childhood vaccines by the age of 12 months was 25.8%. Antenatal care (ANC) attendance irrespective of the number of visits (adjusted OR (AOR)1–3 visits2.4, 95% CI 1.79 to 3.27; AOR4–7 visits3.2, 95% CI 2.52 to 4.13; AOR≥ 8 visits3.5, 95% CI 2.64 to 4.50), skilled birth attendance (SBA) (AOR 1.9, 95% CI 1.65 to 2.35); and maternal postnatal care (PNC) (AOR 1.7, 95% CI 1.46 to 2.06) had positive effects on the child being fully immunised after adjusting for covariates (except for each other, ie, ANC, SBA and PNC). Further analyses (adjusting stepwise for each MHC service) showed a mediation effect that led to the effect of PNC not being significant.ConclusionsThe percentage of fully immunised children in Nigeria was very low. ANC attendance, SBA and maternal PNC attendance had positive impact on the child being fully immunised. The findings suggest that strategies aimed at maximising MHC utilisation in Nigeria could be effective in achieving the national coverage target of at least 80% for routine immunisation of children.

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Section: Discussionmentioning

confidence: 99%

The impact of maternal health care utilisation on routine immunisation coverage of children in Nigeria: a cross-sectional study

Anichukwu

Asamoah

2019

BMJ Open

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“…Vaccination coverage with DwPT increased gradually since 1980, but was below 80% between 1998-2002, possibly related to the shortage of biologicals and the reorganization of the provision of health services after the reform of the Colombian health system 5,26 , a situation that may be more critical in some municipalities due to disparities in vaccination coverage. 27 Although maternal vaccination coverage increased gradually in 2018, in 2020 it presented a global figure of less than 80%, after the COVID-19 pandemic. 20 This study estimated that pertussis incidence would not have been reduced if there had not been massive vaccination of children and significant maternal vaccination.…”

Section: Discussionmentioning

confidence: 99%

Impact of Childhood and Maternal Vaccination against Diphtheria, Tetanus, and Pertussis in Colombia

Hoyos

Hincapié-Palacio

Ochoa

et al. 2022

Journal of Public Health Research

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Background: In Latin America, there are few studies of the impact of vaccination against diphtheria, tetanus, and pertussis. We estimate the impact of infant and maternal vaccination on the incidence of these diseases in Colombia.Design and methods: an interrupted time series study analyzing the incidence before and after of vaccination with DwPT (1975-2018) and with Tdap in pregnant women (2008-2018). A segmented regression model with negative binomial distribution estimated the change in level and trend of the predicted incidence ratio after vaccination in relation to the incidence if vaccination had not been started (IRR), using a Prais Winsten regression.Results: The pertussis IRR decreased immediately after the start of childhood vaccination (0.91, p=0.51), but this was only significant (1.01, p<0.001) along with the trend per year, after the start of maternal vaccination (0.98, p<0.001). In the absence of vaccination, the incidence would not have been reduced. Neonatal tetanus had the highest rate of change with significant reduction -1.69 - CI 95%: -2.91, -0.48). The trend after vaccination was the highest with an annual reduction of 19% (0.81, p=0.001). The change in incidence of diphtheria was significant, although slow (-0.02 - CI 95%: -0.04, -0.004). The sustained effect in the post-vaccination period was smaller (0.95, p=0.79).Conclusions: Childhood and maternal vaccination markedly reduced the incidence of pertussis and neonatal tetanus. It is necessary to maintain optimal vaccination coverage and surveillance, within an integrated elimination plan, which prevents the resurgence of these diseases.

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“…The authors conducted a population survey of children under six years of age, whose homes were randomly chosen from a two-stage sample of 80 municipalities in the country. They analyzed disparities in immunization, identifying that the mother’s schooling, older age, having more siblings, low socioeconomic status, and not having health insurance were associated with low immunization [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence against Diphtheria in Pregnant Women and Newborns in Colombia: New Arguments to Promote Maternal Immunization

et al. 2022

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The tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine is recommended during pregnancy for neonatal protection against pertussis, although little is known of the protection it provides against diphtheria. The work used a cross-sectional design to estimate seroprevalence against diphtheria in 805 pregnant women with ≥37 gestation weeks and their newborns whose deliveries were attended in eight hospitals randomly chosen from a subregion of Antioquia, Colombia and to explore factors related with maternal protection. Levels of IgG antibodies were determined by using a commercial enzyme-linked immunosorbent assay test. Placental transfer of antibodies and crude and adjusted prevalence ratio (aPR) were analyzed to describe factors related with maternal protection against diphtheria. Protection against diphtheria was observed in 91.7% (95% CI 90.3–93.0) of the pregnant women and 93.1% (95% CI 91.7–94.4) of newborns, whose antibody levels were positively correlated (Spearman’s r = 0.769; p = 0.000). Maternal protection could be influenced by having been vaccinated during the current pregnancy (aPR 0.85, 95% CI: 0.82–0.93). The protective effect of vaccination during pregnancy and the efficiency of maternal antibody transfers were detected. Public health efforts should focus on increasing Tdap vaccination during each pregnancy to protect mothers and newborns against diphtheria.

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Is Colombia reaching the goals on infant immunization coverage? A quantitative survey from 80 municipalities

Cited by 17 publications

References 19 publications

The impact of maternal health care utilisation on routine immunisation coverage of children in Nigeria: a cross-sectional study

The impact of maternal health care utilisation on routine immunisation coverage of children in Nigeria: a cross-sectional study

Impact of Childhood and Maternal Vaccination against Diphtheria, Tetanus, and Pertussis in Colombia

Seroprevalence against Diphtheria in Pregnant Women and Newborns in Colombia: New Arguments to Promote Maternal Immunization

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