Timeliness and completeness of measles vaccination among children in rural areas of Guangxi, China: A stratified three-stage cluster survey

Tang, Xin-Yuan; Geater, Alan; McNeil, Edward; Zhou, Hongxia; Deng, Qi; Dong, Aihu

doi:10.1016/j.je.2016.08.006

Cited by 13 publications

(11 citation statements)

References 39 publications

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“…Migrant mothers were found as a positive factor of recall bias for DTP and MCV. Generally, migrant status had been considered as a risk factor of low coverage, poor completeness and timeliness of childhood vaccination in several previous surveys in Zhejiang Province and other areas of China [28,29,30]. Commonly, migrant people have poor social adaptation ability, which is reflected in challenges such as adapting to a new socio-cultural environment or living in poor economic conditions.…”

Section: Discussionmentioning

confidence: 99%

Validity of Maternal Recall to Assess Vaccination Coverage: Evidence from Six Districts in Zhejiang Province, China

Chen

Wang

et al. 2019

IJERPH

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Background: Although recall-based data are collected by survey when the vaccination records are not available, the preferred estimates remain the record-based ones due to the limited validity of recall-based data. However, the evidence on validity of maternal recalls is limited and varied across vaccine types. To close the gaps, we validated the maternal recall on vaccination against record-based data in six districts in Zhejiang Province, China. Methods: We used a cross-sectional survey of about 648 households with mothers who delivered in the last 12 months prior to the survey in October 2017, from six districts in Zhejiang Province. Vaccination status on five vaccine types scheduled before 12 months of age were collected through maternal recall and vaccination records. The level of agreement and recall bias between the two resources, the sensitivity and specificity of maternal recall were evaluated. Risk factors for maternal recall bias were also identified through logistic regression model for each type of vaccine. Results: The level of agreement between recall and record was above 90% across vaccine types, with the recall bias ranged from 2.2% to 9.7%. Recall bias due to over-reporting was slightly higher than that due to under-reporting. Recall bias was positively associated with high parity, home delivery, younger mothers, mothers with low education, and migrant mothers. Conclusions: This study indicated most of the vaccination status across vaccine types was accurately identified through maternal recall and supported the use of maternal recall to estimate the vaccination coverage as an alternative in the absence of record-based data.

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Section: Discussionmentioning

confidence: 99%

Validity of Maternal Recall to Assess Vaccination Coverage: Evidence from Six Districts in Zhejiang Province, China

Chen

Wang

et al. 2019

IJERPH

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“…In contrast to our findings, a study conducted in Sri Lanka found higher timeliness in rural areas compared to urban settings [ 5 ]. The education of the mother has also been shown in other studies [ 2 , 4 , 44 ] to be an important driver on timely immunization or timely completion of specific vaccinations. These results indicate that there is a need to further improve access to health services, especially in remote rural areas.…”

Section: Discussionmentioning

confidence: 80%

“…The timely administration of vaccines is considered to be important for both individual and community immunity. Studies in the UK [ 1 ], China [ 2 ], the USA [ 3 ] and lower-income countries such as Senegal [ 4 ], Sri Lanka [ 5 ], Malawi [ 6 ] and India [ 7 , 8 ] have investigated the impact of timeliness on vaccination. Delayed vaccinations of children may increase the risk of infection before vaccination, compromising the success of the intervention as well as herd immunity.…”

Section: Introductionmentioning

confidence: 99%

Timeliness of immunisation with the pentavalent vaccine at different levels of the health care system in the Lao People’s Democratic Republic: A cross-sectional study

Hefele¹,

Syphan

Xayavong

et al. 2020

PLoS ONE

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Background The timely administration of vaccines is considered to be important for both individual and herd immunity. In this study, we investigated the timeliness of the diphtheria-tetanus-whole cell pertussis-hepatitis B-Haemophilus influenzae type b (pentavalent) vaccine, scheduled at 6, 10 and 14 weeks of age in the Lao People’s Democratic Republic. We also investigated factors associated with delayed immunization. Methods 1162 children aged 8–28 months who had received the full course of the pentavalent vaccine at different levels of the health care system were enrolled. Vaccination dates documented in hospital records and/or immunisation cards were recorded. Age at vaccination and time intervals between doses were calculated. Predictors for timely completion with the pentavalent vaccine at 24 weeks were assessed by bivariate and multivariable analyses. Results Several discrepancies in dates between vaccination documents were observed. In general, vaccination with the pentavalent vaccine was found to be delayed, especially in health care settings below the provincial hospital level. Compared to the central hospital level, less participants who were vaccinated at the district/health center level received the third dose by 16 (48% at the central hospital level vs. 7.1% at the district and 12.4% at the health center level) and 24 weeks of age (94.4% at the central hospital level vs 64.6% at the district-outreach and 57.4% at the health center level) respectively. In logistic regression analyses, lower education level of the mother as well as vaccination by outreach service, were independently associated with delayed completion of vaccination. Conclusion We observed a general delay of vaccination, especially at lower ranked facilities, which correlated with indicators of poor access to health services. This highlights the need for further improving health equity in rural areas. Age-appropriate vaccination should become a quality indicator for the national immunization programme. In addition, we recommend further training of the health care staff regarding the importance of reliable documentation of dates.

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“…[31] Thus, the regional differences in proportions of parental migration may impact the heterogeneity of vaccination timeliness in this area, which can further cause the variation in measles incidence. [1] In general, it seems that the measles immunization program was unevenly carried out in Ludian county, there were vulnerable populations in the mountainous areas. These findings highlight the necessity to further optimize vaccination policies and measures in rural China so as to reduce inequities in timely vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…Measles is a highly contagious disease and one of the major causes of death among children worldwide. [1] The average incubation period of measles is 10 days. [2] The main clinical symptoms are fever, cough, coryza (running nose), red maculopapular rash, Koplik spots, anorexia, diarrhea (especially in infants), and generalized lymphadenopathy.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional study on serum measles antibody levels of a healthy population in southwest China

Chen

Xiao

Yang³

et al. 2019

Medicine

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This study aimed to investigate measles antibody level and its associated factors in a healthy Chinese population, so as to provide evidence to measles prevention and control measures in the future.We conducted a cross-sectional survey by using probability proportionate to size sampling (PPS) among a healthy population aged 8 months to 45 years. Information on measles vaccination status was obtained from the vaccination certificates. Serum measles IgG antibody was detected by enzyme-linked immunosorbent assay. Multivariate logistic and linear regression models were used to analysis the associated factors of measles antibody.Of the 663 study subjects, the positive rate, protective rate, and geometric mean concentration (GMC) of measles antibodies were 92.76%, 77.53%, 1612.55 mIU/ml, respectively. The antibody concentration was higher in Han ethnical majority than in Hui minority. The positive rate, protective rate and concentration of antibodies in different age groups and regions were clearly disparate. Age, area, and measles-containing vaccine (MCV) immunization history were the prominent influencing factors of antibody positive rate and protective rate. Ethnicity, age, area, and MVC immunization history were the influencing factors of antibody concentration.Our major findings suggest that, children in rural China, especially in impoverished mountainous regions, were more likely to suffer from delays in measles vaccination. Various measures in optimizing vaccination practices should be implemented in order to prevent possible measles epidemic, even outbreak in these regions.

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Timeliness and completeness of measles vaccination among children in rural areas of Guangxi, China: A stratified three-stage cluster survey

Cited by 13 publications

References 39 publications

Validity of Maternal Recall to Assess Vaccination Coverage: Evidence from Six Districts in Zhejiang Province, China

Validity of Maternal Recall to Assess Vaccination Coverage: Evidence from Six Districts in Zhejiang Province, China

Timeliness of immunisation with the pentavalent vaccine at different levels of the health care system in the Lao People’s Democratic Republic: A cross-sectional study

A cross-sectional study on serum measles antibody levels of a healthy population in southwest China

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