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Vaccine. 2022 Sep 2;40(37):5483-5493. doi: 10.1016/j.vaccine.2022.07.020 Q23.52024

Beyond coverage: Rural-urban disparities in the timeliness of childhood vaccinations in Tanzania

超越覆盖率：坦桑尼亚儿童疫苗接种及时性的城乡差异 翻译改进

Valerie Yelverton  1, Nicole L Hair  1, Suvomita Happy Ghosh  2, Sayoki Godfrey Mfinanga  3, Esther Ngadaya  4, Joy Noel Baumgartner  5, Jan Ostermann  6, Lavanya Vasudevan  7

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作者单位

  • 1 Department of Health Services Policy & Management, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
  • 2 Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC 27710, USA.
  • 3 Muhimbili Research Centre, National Institute for Medical Research, P.O. Box 65001, Dar-es-Salaam, Tanzania; Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania; The Nelson Mandela African Institution of Science and Technology (NM-AIST), Nelson Mandela Rd, Arusha, Tanzania; Alliance for Africa Research and Innovation (A4A), Dar es Salaam, Tanzania.
  • 4 Muhimbili Research Centre, National Institute for Medical Research, P.O. Box 65001, Dar-es-Salaam, Tanzania.
  • 5 Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC 27710, USA; School of Social Work, University of North Carolina at Chapel Hill, Tate-Turner-Kuralt Building, 325 Pittsboro St, CB #3550, Chapel Hill, NC 27599, USA.
  • 6 Department of Health Services Policy & Management, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC 27710, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
  • 7 Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC 27710, USA; Department of Family Medicine and Community Health, 2200 W. Main Street, Suite 600, School of Medicine, Duke University, Durham, NC 27710, USA. Electronic address: lavanya.vasudevan@duke.edu.

    • DOI: 10.1016/j.vaccine.2022.07.020 PMID: 35961796

    摘要 Ai翻译

    Background: Timely vaccination maximizes efficacy for preventing infectious diseases. In the absence of national vaccination registries, representative sample survey data hold vital information on vaccination coverage and timeliness. This study characterizes vaccination coverage and timeliness in Tanzania and provides an analytic template to inform contextually relevant interventions and evaluate immunization programs.

    Methods: Cross-sectional data on 6,092 children under age 3 from the 2015-16 Tanzania Demographic and Health Survey were used to examine coverage and timeliness for 14 vaccine doses recommended in the first year of life. The Kaplan-Meier method was used to model time to vaccination. Cox proportional hazard models were used to examine factors associated with timely vaccination.

    Results: Substantial rural-urban disparities in vaccination coverage and timeliness were observed for all vaccines. Across 14 recommended doses, documented coverage ranged from 52 % to 79 %. Median vaccination delays lasted up to 35 days; gaps were larger among rural than urban children and for later doses in vaccine series. Among rural children, median delays exceeded 35 days for the 3rd doses of the polio, pentavalent, and pneumococcal vaccines. Median delays among urban children were < 21 days for all doses. Among rural and urban children, lower maternal education and delivery at home were associated with increased risk of delayed vaccination. In rural settings, less household wealth and greater distance to a health facility were also associated with increased risk of delayed vaccination.

    Discussion: This study highlights persistent gaps in uptake and timeliness of childhood vaccinations in Tanzania and substantial rural-urban disparities. While the results provide an informative situation assessment and outline strategies for identifying unvaccinated children, a national electronic registry is critical for comprehensive assessments of the performance of vaccination programs. The timeliness measure employed in this study-the amount of time children are un- or undervaccinated-may serve as a sensitive performance metric for these programs.

    Keywords: Childhood vaccination; Demographic and Health Survey; Rural-urban disparities; Tanzania; Vaccination coverage; Vaccination timeliness.

    Keywords：rural-urban disparities; tanzania

    关键词：城乡差异; 儿童疫苗接种及时性; 坦桑尼亚

    Copyright © Vaccine. 中文内容为AI机器翻译，仅供参考！

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    期刊名：Vaccine

    缩写：VACCINE

    ISSN：0264-410X

    e-ISSN：1873-2518

    IF/分区：3.5/Q2

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    Beyond coverage: Rural-urban disparities in the timeliness of childhood vaccinations in Tanzania