Factors associated with incomplete vaccination among children 12-23 months at Alupe Sub-County Hospital, Busia County, Kenya

Abstract

Immunization is a proven and cost effective intervention for the reduction of vaccine preventable diseases. Significant progress was made to increase global immunization coverage between 1980 and 1990 however since then global DPT 3 has stagnated at about 85%. The number of deaths caused by traditional vaccine-preventable diseases (diphtheria, measles, neonatal tetanus, pertussis and poliomyelitis) has fallen from an estimated 0.9 million in 2000 to 0.4 million in 2010. Despite this progress, many regional, national and sub-national coverage discrepancies persist and overall about 20 % of children remain inadequately immunized. This study sought to determine factors associated with incomplete vaccination among children 12-23 months who had received at least one childhood vaccine at Alupe Sub-District Hospital. The study site was chosen due to its low immunization coverage in a county with generally high immunization coverage rates. Facility and National Health Information System immunization coverage data were compared. A case control study was then conducted to determine significant contextual risk factors for the incomplete vaccination among children 12-23 months. Data was collected through an interviewer administered structured questionnaire. Data was analyzed by Epi Info 3.5.4. Ethical clearance was obtained from the Kenyatta National Hospital Ethics and Scientific Review Board. Independent risk factors for incomplete vaccination were age of the child [aOR 4.2(1.8-9.6)], age of the mother [aOR 2.5(1.1-5.0)], timely receipt of BCG [aOR 3.2(1.4-7.3)] and receipt of at least 2 doses of tetanus toxoid by the mother during the antenatal period [aOR 2.5(1.2-5.4)]. Strategies to improve completion rates should target younger mothers during the antenatal period to increase contact with the health system so as to encourage hospital delivery and subsequently early initiation of the immunization schedule.