Factors associated with vaccination coverage in children < 5 years in Angola

OBJECTIVE To analyze vaccination coverage and factors associated with a complete immunization scheme in children < 5 years old. METHODS This cross-sectional household census survey evaluated 1,209 children < 5 years old living in Bom Jesus, Angola, in 2010. Data were obtained from interviews, questionnaires, child immunization histories, and maternal health histories. The statistical analysis used generalized linear models, in which the dependent variable followed a binary distribution (vaccinated, unvaccinated) and the association function was logarithmic and had the children’s individual, familial, and socioeconomic factors as independent variables. RESULTS Vaccination coverage was 37.0%, higher in children < 1 year (55.0%) and heterogeneous across neighborhoods; 52.0% of children of both sexes had no immunization records. The prevalence rate of vaccination significantly varied according to child age, mother’s level of education, family size, ownership of household appliances, and destination of domestic waste. CONCLUSIONS Vulnerable groups with vaccination coverage below recommended levels continue to be present. Some factors indicate inequalities that represent barriers to full immunization, indicating the need to implement more equitable policies. The knowledge of these factors contributes to planning immunization promotion measures that focus on the most vulnerable groups.

研究目的：分析5岁以下儿童的疫苗接种覆盖率及完成全程免疫规划的相关影响因素。方法：本研究为横断面家庭普查调查，于2010年对安哥拉邦热苏斯（Bom Jesus）地区的1209名5岁以下儿童开展评估。数据通过访谈、问卷、儿童免疫接种史及产妇健康史采集获得。统计分析采用广义线性模型，以二分类分布（完成接种/未完成接种）作为因变量，以对数作为关联函数，将儿童个体、家庭及社会经济因素设为自变量。结果：整体疫苗接种覆盖率为37.0%，其中1岁以下儿童接种率达55.0%，且不同社区间接种率存在异质性；52.0%的男女儿童无免疫接种记录。疫苗接种率随儿童年龄、母亲受教育程度、家庭规模、家庭电器拥有量及生活垃圾处理方式存在显著差异。结论：疫苗接种覆盖率未达推荐标准的弱势人群依然存在。部分因素反映了免疫接种公平性障碍，提示需推行更具公平性的公共卫生政策。明确此类影响因素有助于针对弱势人群制定免疫接种推广计划。