Factors influencing childhood vaccination in Nigeria.

摘要

Despite Nigeria's adoption of the World Health Organization's Expanded Programme on Immunization, many children remain unvaccinated. Data from the 2008 Nigeria Demographic and Health Survey revealed DPT3 and OPV3 coverage below 40%. The purpose of this quantitative study was to determine the vaccination status of Nigerian children with acute flaccid paralysis (AFP), and to explore sociodemographic factors associated with un- or under-vaccination. Utilizing the social ecology model (SEM) theory, this retrospective cross-sectional study of 5,501 AFP cases in Nigeria in 2009 and analysis of the 384 cases determined to be polio was conducted to address 6 primary research questions. Findings indicated that vaccination status of AFP cases varied by region of residence. There was a difference in reported number of OPV doses received by WPV cases, with 3 doses of OPV reported at paralysis onset, versus 1 OPV dose reported after laboratory diagnosis of polio for the same child. Children living in proximity to a health facility with routine immunization services were more likely to be vaccinated. A child's gender, or a parent's religious affiliation did not affect vaccination status of AFP cases. Individual, community, and societal factors as held by SEM theory were associated with vaccination status. In multivariate analyses, a child's age and region of residence were predictors of vaccination status. This study contributes to social change by identifying areas of Nigeria where vaccination efforts need to be expanded. In the broader social context, reducing the proportion of unvaccinated children in Nigeria will reduce vaccine preventable diseases in this population, and move Nigeria and the world closer to the goal of poliomyelitis eradication.