Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 28:12:1344089.
doi: 10.3389/fpubh.2024.1344089. eCollection 2024.

Spatial variation and predictors of incomplete pneumococcal conjugate vaccine (PCV) uptake among children aged 12-35 months in Ethiopia: spatial and multilevel analyses

Aklilu Habte Hailegebireal  1 , Samuel Hailegebreal  2   3 , Lire Lemma Tirore  4 , Biruk Bogale Wolde  5
Affiliations

Spatial variation and predictors of incomplete pneumococcal conjugate vaccine (PCV) uptake among children aged 12-35 months in Ethiopia: spatial and multilevel analyses

Aklilu Habte Hailegebireal et al. Front Public Health. .

Abstract

Background: Despite the Ethiopian government included the Pneumococcal Conjugate Vaccine (PCV) in the national expanded program for immunization in 2011, only 56% of children aged 12-23 months received the full dose of PCV. Despite some studies on PCV uptake in Ethiopia, there was a dearth of information on the geographical distribution and multilevel factors of incomplete PCV uptake. Hence, this study aimed to identify the spatial variations and predictors of incomplete PCV uptake among children aged 12-35 months in Ethiopia.

Methods: The study was based on an in-depth analysis of 2016 Ethiopia Demographic Health Survey data, using a weighted sample of 3,340 women having children aged 12-35 months. Arc-GIS version 10.7 and SaTScan version 9.6 statistical software were used for the spatial analysis. To explore spatial variation and locate spatial clusters of incomplete PCV, the Global Moran's I statistic and Bernoulli-based spatial scan (SaTScan) analysis were carried out, respectively. A multilevel mixed-effect multivariable logistic regression was done by STATA version 16. Adjusted odds ratio (AOR) with its corresponding 95% CI was used as a measure of association, and variables with a p < 0.05 were deemed as significant determinants of incomplete PCV.

Results: The overall prevalence of incomplete PCV in Ethiopia was found to be 54.0% (95% CI: 52.31, 55.69), with significant spatial variation across regions (Moran's I = 0.509, p < 0.001) and nine most likely significant SaTScan clusters. The vast majority of Somali, southeast Afar, and eastern Gambela regions were statistically significant hot spots for incomplete PCV. Lacking ANC visits (AOR = 2.76, 95% CI: 1.91, 4.00), not getting pre-birth Tetanus injections (AOR = 1.84, 95% CI: 1.29, 2.74), home birth (AOR = 1.72, 95% CI: 1.23, 2.34), not having a mobile phone (AOR = 1.64, 95% CI: 1.38, 1.93), and residing in a peripheral region (AOR = 4.63; 95% CI: 2.34, 9.15) were identified as statistically significant predictors of incomplete PCV.

Conclusion: The level of incomplete PCV uptake was found to be high in Ethiopia with a significant spatial variation across regions. Hence, the federal and regional governments should collaborate with NGOs to improve vaccination coverage and design strategies to trace those children with incomplete PCV in peripheral regions. Policymakers and maternal and child health program planners should work together to boost access to maternal health services like antenatal care and skilled delivery services to increase immunization coverage.

Keywords: Ethiopia; PCV; children; incomplete immunization; predictors; spatial.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Disparities in the level of incomplete PCV across regions of Ethiopia, EDHS 2016.
Figure 2
Figure 2
Spatial distribution of incomplete PCV uptake among children aged 12–35 months in Ethiopia, EDHS 2016.
Figure 3
Figure 3
The global spatial autocorrelation of incomplete PCV uptake among children aged 12–35 months in Ethiopia, EDHS 2016.
Figure 4
Figure 4
The incremental autocorrelation of incomplete PCV uptake among children aged 12–35 months in Ethiopia, EDHS 2016.
Figure 5
Figure 5
Hot spot and Cold spot analysis of incomplete PCV uptake among children aged 12–35 months in Ethiopia, EDHS 2016.
Figure 6
Figure 6
Ordinary Kriging interpolation of the spatial distribution of incomplete PCV uptake among children aged 12–35 months in Ethiopia, EDHS 2016.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Centre for Disease Control . (2022). Pneumococcal Disease. (2022). Available online at: https://www.cdc.gov/pneumococcal/index.html (accessed September 10, 2023).
    1. Wahl B, O'Brien KL, Greenbaum A, Majumder A, Liu L, Chu Y, et al. . Burden of Streptococcus pneumoniae and Haemophilus influenzae. type b disease in children in the era of conjugate vaccines: global, regional, and national estimates for 2000–15. Lancet Global Health. (2018) 6:e744-e757. 10.1016/S2214-109X(18)30247-X - DOI - PMC - PubMed
    1. mondiale de la Santé O World Health Organization . Pneumococcal conjugate vaccines in infants and children under 5 years of age: WHO position paper–February 2019– Vaccins antipneumococciques conjugués chez les nourrissons et les enfants de moins de 5 ans: note de synthèse de l'OMS–février 2019. Weekly Epidemiological Record= Relevé épidémiologique hebdomadaire. (2019) 94:85–103. Available online at: https://iris.who.int/bitstream/handle/10665/310968/WER9408.pdf?sequence=1
    1. Johnston C, Campo N, Bergé MJ, Polard P, Claverys J-P. Streptococcus pneumoniae, le transformiste. Trends Microbiol. (2014) 22:113–9. 10.1016/j.tim.2014.01.002 - DOI - PubMed
    1. WHO . Pneumonia in Children. (2022). Available online at: https://www.who.int/news-room/fact-sheets/detail/pneumonia (accessed November 11, 2022).

LinkOut - more resources