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. 2023 Sep 29;23(1):493.
doi: 10.1186/s12887-023-04300-x.

Spatio-temporal analysis of childhood vaccine uptake in Nigeria: a hierarchical Bayesian Zero-inflated Poisson approach

Temitayo Victor Lawal  1   2 , Kehinde Adebola Atoloye  3   4   5 , Ayo Stephen Adebowale  3   6 , Adeniyi Francis Fagbamigbe  3   7   8   9
Affiliations

Spatio-temporal analysis of childhood vaccine uptake in Nigeria: a hierarchical Bayesian Zero-inflated Poisson approach

Temitayo Victor Lawal et al. BMC Pediatr. .

Abstract

Background: Globally, child mortality and morbidity remain a serious health challenge and infectious diseases are the leading causes. The use of count models together with spatial analysis of the number of doses of childhood vaccines taken is limited in the literature. We used a Bayesian zero-inflated Poisson regression model with spatio-temporal components to assess the number of doses of childhood vaccines taken among children aged 12-23 months and their associated factors.

Methods: Data of 19,564 children from 2003, 2008, 2013 and 2018 population-based cross-sectional Nigeria Demographic and Health Survey were used. The childhood vaccines include one dose of Bacillus-Calmette-Guérin; three doses of Diphtheria-Pertussis-Tetanus; three doses of Polio and one dose of Measles. Uptake of all nine vaccines was regarded as full vaccination. We examined the multilevel factors associated with the number of doses of childhood vaccines taken using descriptive, bivariable and multivariable Bayesian models. Analysis was conducted in Stata version 16 and R statistical packages, and visualization in ArcGIS.

Results: The prevalence of full vaccination was 6.5% in 2003, 14.8% in 2008, 21.8% in 2013 and 23.3% in 2018. Full vaccination coverage ranged from 1.7% in Sokoto to 51.9% in Anambra. Factors associated with the number of doses of childhood vaccines taken include maternal age (adjusted Incidence "risk" Ratio (aIRR) = 1.05; 95% Credible Interval (CrI) = 1.03-1.07) for 25-34 years and (aIRR = 1.07; 95% CrI = 1.05-1.10) for 35-49 years and education: (aIRR = 1.11, 95% CrI = 1.09-1.14) for primary and (aIRR = 1.16; 95% CrI = 1.13-1.19) for secondary/tertiary education. Other significant factors are wealth status, antenatal care attendance, working status, use of skilled birth attendants, religion, mother's desire for the child, community poverty rate, community illiteracy, and community unemployment.

Conclusion: Although full vaccination has remained low, there have been improvements over the years with wide disparities across the states. Improving the uptake of vaccines by educating women on the benefits of hospital delivery and vaccines through radio jingles and posters should be embraced, and state-specific efforts should be made to address inequality in access to routine vaccination in Nigeria.

Keywords: Bayesian; Child vaccination; Immunization; MCMC; Multilevel; Nigeria; Zero-inflated Poisson.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Trend of number of doses of the vaccines among children between 2003 and 2018
Fig. 2
Fig. 2
Percentage distribution of number of doses of the vaccines taken between 2003 and 2018
Fig. 3
Fig. 3
Spatial distribution of the prevalence of full vaccination across the survey years
Fig. 4
Fig. 4
Posterior estimates of the smoothed posterior estimates showing the non-linear effects (log-odds) and 95% credible interval of mother’s age on the likelihood of vaccine uptake from the adjusted model for year and spatial effect
Fig. 5
Fig. 5
Adjusted Total Spatial Effects (A) with the 2.5% (B) and 97.5% (C) posterior estimates significance map for vaccine uptake among children aged 12–23 months in Nigeria
See this image and copyright information in PMC

References

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    1. National Population Commission (NPC) [Nigeria] and ICF. Nigeria Demographic and Health Survey, 2018. Abuja, Nigeria, and Rockville, Maryland, USA; 2019.
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    1. UN Inter-agency Group for Child Mortality Estimation. Child Mortality Estimates [Internet]. 2021 [cited 2023 Feb 26]. Available from: https://childmortality.org/.

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