背景:刚果民主共和国(DRC)是世界上未接种和未接种疫苗的儿童以及难民和国内流离失所者(IDPs)数量最多的国家之一。这项研究旨在确定和比较刚果民主共和国难民和国内流离失所者中零剂量(ZD)和疫苗接种不足(UV)儿童的比例和特征,以及疫苗接种时间表不完整的原因。
方法:数据来自2022年9月10日至2023年7月3日在刚果民主共和国12个省的难民和国内流离失所者中进行的滚动疫苗接种覆盖率调查。ZD定义为12-23个月的儿童,未接受任何剂量的五价疫苗DTP-Hib-HepB(通过卡或召回)和紫外线,作为未接受第三剂五价疫苗的儿童。使用逻辑回归模型显示了ZD和UV儿童的未接种和接种不足的比例以及相关因素。使用WHO免疫行为和社会驱动因素概念框架描述了这些儿童未接种疫苗的原因,并使用Pearson的Chi2检验进行了比较。
结果:在分析中纳入的692名12至23个月的儿童中,9.3%(95%CI:7.2-11.7%)为ZD,40.9%(95%CI:95%:37.2-44.6%)为UV。Penta1/Penta3的辍学率为34.9%。调整后,ZD儿童有重要的家庭或道路出生史。紫外线儿童与40岁以下、未受过教育的母亲/照顾者显著相关,农民,牧场主,employed,农村居民,以及家庭或公路出生。ZD(50.0%)比紫外线(38.3%)更经常引用与人们的感知和感受有关的原因。ZD(40.6%)比紫外线(35.7%)更经常引用与社会原因有关的那些。与“计划和实际问题”相关的原因在ZD(90.5%)中被引用的次数少于UV(97.1%)。
结论:在刚果民主共和国的难民和国内流离失所者中,ZD和紫外线儿童占很大比例。然而,ZD的比例低于整个国家,虽然紫外线的比例相当,反映在一个非常高的辍学率。类似于刚果民主共和国普通人群的研究,ZD儿童的原因主要与照顾者接种疫苗动机的挑战有关,而对于紫外线儿童,它们通常与卫生系统的语法和实际问题有关。
刚果民主共和国(DRC)是世界上未接种和未接种疫苗的儿童以及难民和国内流离失所者(IDPs)数量最多的国家之一。这项研究旨在确定和比较刚果民主共和国难民和国内流离失所者中零剂量(ZD)和疫苗接种不足(UV)儿童的比例和特征,以及疫苗接种时间表不完整的原因。数据来自2022年9月10日至2023年7月3日在刚果民主共和国12个省的难民和国内流离失所者中进行的滚动疫苗接种覆盖率调查。ZD定义为12-23个月的儿童,未接受任何剂量的五价疫苗DTP-Hib-HepB(通过卡或召回)和紫外线,作为未接受第三剂五价疫苗的儿童。未接种疫苗和疫苗接种不足的比例,介绍了ZD和UV儿童未接种疫苗的相关因素和原因。在分析中包括的692名12至23个月的儿童中,9.3%(95%CI:7.2-11.7%)为ZD,40.9%(95%CI:95%:37.2-44.6%)为UV。Penta1/Penta3的辍学率为34.9%。调整后,ZD儿童有重要的家庭或道路出生史。紫外线儿童与40岁以下、未受过教育的母亲/照顾者显著相关,农民,牧场主,employed,农村居民,以及家庭或公路出生。ZD(50.0%)比紫外线(38.3%)更经常引用与人们的感知和感受有关的原因。ZD(40.6%)比紫外线(35.7%)更经常引用与社会原因有关的那些。与“计划和实际问题”有关的原因在ZD(90.5%)中被引用的次数少于UV(97.1%)。ZD和紫外线儿童在刚果民主共和国的难民和国内流离失所者营地中占很大比例。然而,ZD的比例低于整个国家,虽然紫外线的比例相当,反映在一个非常高的辍学率。类似于刚果民主共和国普通人群的研究,ZD儿童的原因主要与照顾者接种疫苗动机的挑战有关,而对于紫外线儿童,它们通常与卫生系统的语法和实际问题有关。
BACKGROUND: The Democratic Republic of Congo (DRC) has one of the highest numbers of un and under-vaccinated children as well as number of refugees and internally displaced persons (IDPs) in the world. This study aims to determine and compare the proportion and characteristics of zero-dose (ZD) and under-vaccinated (UV) children among refugees and IDPs in the DRC, as well as the
reasons for incomplete vaccination schedules.
METHODS: Data from a rolling vaccination coverage survey conducted from September 10, 2022, to July 03, 2023, among refugees and IDPs in 12 provinces of the DRC. ZD was defined as a child aged 12-23 months who had not received any dose of pentavalent vaccine DTP-Hib-Hep B (by card or recall) and UV as a child who had not received the third dose of pentavalent vaccine. The proportions of non and under-vaccination and the associated factors using a logistic regression model are presented for ZD and UV children. The
reasons for non-vaccination of these children are described using the WHO-Immunization behavioral and social-drivers-conceptual framework and compared using Pearson\'s Chi2 test.
RESULTS: Of 692 children aged 12 to 23 months included in the analysis, 9.3% (95% CI: 7.2-11.7%) were ZD and 40.9% (95% CI: 95%: 37.2-44.6%) UV. The Penta1/Penta3 drop-out rate was 34.9%. After adjustment, ZD children had a significant history of home or road birth. And UV children were significantly associated with mothers/caregivers being under 40, uneducated, farmers, ranchers, employed, rural residents, as well as with home or road births. Reasons linked to people\'s perceptions and feelings were cited much more often for ZD (50.0%) than for UV (38.3%). Those related to social
reasons were cited much more often by ZD (40.6%) than by UV (35.7%).
Reasons related to \"programmatic and practical issues\" were cited less for ZD (90.5%) than for UV (97.1%).
CONCLUSIONS: ZD and UV children represent significant proportions in refugee and IDPs sites in the DRC. However, the proportion of ZD is less than for the entire country, while the proportion of UV is comparable, reflected in a very high drop-out rate. Similarly to studies in the general population in DRC, the reasons for ZD children were mainly linked to challenges in caregiver motivation to vaccinate, while for UV children, they were more often linked to pro-grammatic and practical problems of the health system.
The Democratic Republic of Congo (DRC) has one of the highest numbers of un and under-vaccinated children as well as number of refugees and internally displaced persons (IDPs) in the world. This study aims to determine and compare the proportion and characteristics of zero-dose (ZD) and under-vaccinated (UV) children among refugees and IDPs in the DRC, as well as the
reasons for incomplete vaccination schedules. Data from a rolling vaccination coverage survey conducted from September 10, 2022, to July 03, 2023, among refugees and IDPs in 12 provinces of the DRC. ZD was defined as a child aged 12–23 months who had not received any dose of pentavalent vaccine DTP-Hib-Hep B (by card or recall) and UV as a child who had not received the third dose of pentavalent vaccine. The proportions of non and under-vaccination, the associated factors and reasons for non-vaccination are presented for ZD and UV children. Of 692 children aged 12 to 23 months included in the analysis, 9.3% (95% CI: 7.2–11.7%) were ZD and 40.9% (95% CI: 95%: 37.2–44.6%) UV. The Penta1/Penta3 drop-out rate was 34.9%. After adjustment, ZD children had a significant history of home or road birth. And UV children were significantly associated with mothers/caregivers being under 40, uneducated, farmers, ranchers, employed, rural residents, as well as with home or road births. Reasons linked to people’s perceptions and feelings were cited much more often for ZD (50.0%) than for UV (38.3%). Those related to social
reasons were cited much more often by ZD (40.6%) than by UV (35.7%). Reasons related to “programmatic and practical issues” were cited less for ZD (90.5%) than for UV (97.1%). ZD and UV children represent significant proportions in refugee and IDPs sites in the DRC. However, the proportion of ZD is less than for the entire country, while the proportion of UV is comparable, reflected in a very high drop-out rate. Similarly to studies in the general population in DRC, the reasons for ZD children were mainly linked to challenges in caregiver motivation to vaccinate, while for UV children, they were more often linked to pro-grammatic and practical problems of the health system.