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Factors influencing basic vaccination coverage in Myanmar: secondary analysis of 2015 Myanmar demographic and health survey data

机译：影响缅甸基本疫苗接种覆盖的因素：2015年缅甸人口统计和健康调查数据的二次分析

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Abstract Background Immunization is one of the most effective measures for preventing disease when vaccination coverage is sufficient. Although vaccination coverage is known to be influenced by social and cultural barriers, the determinants of childhood immunization in Myanmar remain poorly understood. This study analyzed factors that influenced complete vaccination status (one dose each for Bacillus Calmette-Guérin and measles and three doses each for diphtheria-pertussis and polio) using 2015 data from the Myanmar Demographic Health and Survey. Methods Data from 12 to 23-month-old children and their mothers were extracted from the nationally representative survey results. Bivariate and multivariate analyses with survey-weighted logistic regression were performed to examine the relationships between vaccination status and various sociodemographic and medical factors. The independent variables for the analyses included area of residence, economic status, maternal age, marital status, education, literacy, employment status, antenatal care attendance, tetanus vaccination, place of delivery, postnatal evaluations, child’s sex, number of children, previous child death, decision maker(s) regarding child’s health, frequency of healthcare visits, paternal education, and paternal occupation. Results A representative sample of 904 cases were extracted for the analysis. The overall complete vaccination rate was 55.4%. In the multivariate analysis with backward step-wise selection, complete vaccination was independently associated with middle or high economic status (adjusted odds ratio [AOR]: 2.64, 95% confidence interval [CI]: 1.85–3.78), older maternal age (AOR: 2.87, 95% CI: 1.62–5.10), ≥4 antenatal care visits (AOR: 1.87, 95% CI: 1.28–2.73), and maternal tetanus vaccination before delivery (AOR: 3.26, 95% CI: 1.82–5.85). Conclusion The first Demographic and Health Survey in Myanmar revealed that only approximately one-half of 12–23-year-old children had received complete vaccination, which was lower than the estimated rate from routine administrative coverage. Our results indicate that incomplete immunization status was associated with low economic status, younger maternal age, fewer antenatal care visits, and no maternal tetanus vaccination. These findings may help improve the targeting and strategic implementation of the Expanded Programme on Immunization.
机译：摘要背景免疫是当疫苗接种覆盖率就足够时预防疾病的最有效措施之一。虽然已知疫苗接种覆盖受社会和文化障碍的影响，但缅甸儿童免疫的决定因素仍然明白很差。本研究分析了影响完全疫苗接种状态的因素（每剂量为Bacillus Calmette-guérin和麻疹，每次用于白喉 - 百日咳和脊髓灰质炎），使用来自缅甸人口健康和调查的2015年数据。方法从12至23个月的儿童和母亲的数据从国家代表性调查结果中提取。进行了与调查加权逻辑回归的双变量和多变量分析，以检查疫苗接种状态和各种社会造影和医学因素之间的关系。分析的独立变量包括居住地区，经济状况，产妇年龄，婚姻状况，教育，识字，就业状况，产前应出席，破伤​​风疫苗接种，发货地点，产后评估，儿童的性别，儿童的性别，儿童人数，以前的孩子死亡，关于儿童健康，医疗保健频率，父亲教育和父亲职业的决策者。结果提取了904例的代表性样品进行分析。整体完全疫苗接种率为55.4％。在倒退迈出的选择的多变量分析中，完全疫苗接种与中间或高经济状况有独立相关（调整的赔率比[AOR]：2.64,95％置信区间[CI]：1.85-3.78），孕妇年龄（AOR ：2.87,95％CI：1.62-5.10），≥4八型护理访问（AOR：1.87,95％CI：1.28-2.73）和递送前的母体破伤风疫苗（AOR：3.26,95％CI：1.82-5.85） 。结论缅甸的第一个人口和健康调查显示，只有12-23岁儿童的大约一半收到完整的疫苗接种，低于常规行政覆盖率的估计率。我们的结果表明，不完全的免疫状况与低经济状况，年轻的产妇年龄，较少的产前护理，而且没有母体破伤风疫苗接种有关。这些调查结果可能有助于改善扩大拟免疫计划的目标和战略实施。

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