背景:肺炎球菌疾病是一个严重的全球公共卫生问题。肺炎等严重疾病的主要病原体,脑膜炎,急性中耳炎,菌血症是肺炎球菌。肺炎球菌结合疫苗是降低肺炎球菌疾病负担的关键策略。了解完整的儿童肺炎球菌结合疫苗利用的空间分布及其相关因素对于设计策略以改善疫苗接种实施至关重要。因此,本研究旨在确定埃塞俄比亚儿童肺炎球菌结合疫苗接种覆盖率的空间分布,并确定其决定因素.
方法:使用2019年埃塞俄比亚迷你人口与健康调查的数据进行了空间和多水平分析。该分析包括总共2055名加权儿童。结果变量和解释变量之间的关联是通过在95%置信区间计算调整后的比值比确定的。如果p值小于0.05,解释变量被认为与结果显着相关。
结果:埃塞俄比亚儿童完全肺炎球菌结合疫苗的患病率为53.94%(95%CI:51.77,56.08)。在亚的斯亚贝巴观察到更高的儿童肺炎球菌疫苗接种覆盖率,提格雷,阿姆哈拉,Benishangul-Gumuz,和奥罗米亚地区,虽然在阿法尔的覆盖率较低,索马里,和埃塞俄比亚的SNNPR地区。与完整的儿童肺炎球菌结合疫苗接种显着相关的因素包括母亲年龄,产前护理访问,交货地点,区域,社区妇女的文化水平,社区贫困水平,和社区产前保健的利用。
结论:完整的儿童肺炎球菌结合疫苗的分布在埃塞俄比亚呈现空间变异性。在该国,大约一半的12至35个月的儿童接受了全剂量的儿童肺炎球菌结合疫苗。几个因素被确定为完全儿童肺炎球菌结合疫苗接种的统计学显著决定因素,包括产妇年龄,产前护理访问,交货地点,区域,社区妇女的文化水平,社区贫困水平,和社区ANC利用率。因此,旨在防治肺炎球菌疾病的政策和战略应考虑这些决定因素,并针对疫苗接种覆盖率低的地区.
BACKGROUND: Pneumococcal disease is a serious global public health concern. The primary causative agent of severe illnesses such as pneumonia, meningitis, acute otitis media, and bacteremia is the pneumococcus bacterium. The pneumococcal conjugate vaccine is a key strategy to reduce the burden of pneumococcal disease. Understanding the spatial distribution of complete childhood pneumococcal conjugate vaccine utilization and its associated factors is crucial for designing strategies to improve vaccination implementation. Therefore, this study aimed to determine the spatial distribution of complete childhood pneumococcal conjugate vaccination coverage and identify its determinants in Ethiopia.
METHODS: A spatial and multilevel analysis was conducted using data from the 2019 Ethiopian Mini Demographic and Health Survey. The analysis included a total of 2,055 weighted children. The association between the outcome variable and the explanatory variables was determined by calculating adjusted odds ratios at a 95% confidence interval. Explanatory variables were considered significantly associated with the outcome if the p-value was less than 0.05.
RESULTS: The prevalence of complete childhood pneumococcal conjugate vaccination in Ethiopia was 53.94% (95% CI: 51.77, 56.08). Higher complete childhood pneumococcal vaccination coverage was observed in the Addis Ababa, Tigray, Amhara, Benishangul-Gumuz, and Oromia regions, while lower coverage was seen in the Afar, Somali, and SNNPR regions of Ethiopia. Factors significantly associated with complete childhood pneumococcal conjugate vaccination included maternal age, antenatal care visits, place of delivery, region, community women\'s literacy level, community poverty level, and community antenatal care utilization.
CONCLUSIONS: The distribution of complete childhood pneumococcal conjugate vaccination exhibited spatial variability across Ethiopia. Approximately half of children aged twelve to thirty-five months received the full dose of the childhood pneumococcal conjugate vaccine in the country. Several factors were identified as statistically significant determinants of complete childhood pneumococcal conjugate vaccination, including maternal age, antenatal care visits, place of delivery, region, community women\'s literacy level, community poverty level, and community ANC utilization. Therefore, policies and strategies aimed at combating pneumococcal disease should consider these determinants and address areas with low vaccination coverage.