 |
The 130th Annual Meeting of APHA |
|
The 130th Annual Meeting of APHA |
Timothy H. Holtz, MD, MPH1, Diane J. Terlouw2, Penny A. Phillips-Howard2, Amos Odacha3, Margarette Kolczak2, S. Patrick Kachur4, Allen Hightower2, William A. Hawley2, Arthur Kwena5, J. Vulule5, Rita Helfand2, and Feiko O. ter Kuile2. (1) Epidemiology Program Office, Centers for Disease Control and Prevention, 1600 Clifton Road MS D-18, Atlanta, GA 30333, 212-788-9639, tkh3@cdc.gov, (2) Centers for Disease Control, 4770 Buford Highway, Atlanta, GA 30341, (3) Ministry of Health, Kenya, PO Box 1578, Nairobi, Kenya, (4) Division of Parasitic Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-22, Atlanta, GA 30341, (5) Center for Vector Biology Control, Kenya Medical Research Institute, PO Box 1578, Kisumu, Kenya
Background: Vaccine-preventable illnesses account for significant mortality in children in western Kenya. Identifying missed opportunities for vaccination is an important component of efforts to increase vaccination coverage. Methods: We performed three independent cross-sectional surveys in 60 villages in western Kenya’s Bondo District between February 1998 and June 1999. Households with children under 5 were selected by simple random sampling. Using vaccine cards and history, data were collected on vaccination coverage, recent medical visits, and recent illnesses. Households and health facilities were mapped to establish geographic contours of probability of vaccination. Results: Among 784 children ages 12 to 23 months, full routine polio (4 doses), DPT (3 doses), and measles coverage was 68.5%, 68.5%, and 53.4% respectively. A Poisson regression model showed low caretaker education (PR 1.39, 95% CI 1.20-1.59) and residence greater than 2 kilometers from a health facility with facilities for childhood vaccinations (PR 1.14, 95% CI 0.99-1.31) to be predictive of incomplete vaccination. The Global Positioning System (GPS) was helpful in identifying geographic areas of missed vaccination. Thirty percent of children with incomplete vaccinations had seen a health care provider 2 weeks before the interview. In this setting, measles vaccine coverage could increase by 26.7% to 77.0% if the vaccine can be administered routinely during a health center visit in children with incomplete coverage. Conclusions: Vaccine coverage rates for measles and polio in Bondo District lag behind goals set by the Kenyan government. Emphasis should be placed on ensuring vaccination coverage for all children presenting to health providers and facilities. Ameliorating missed opportunities through GPS tracking could greatly increase vaccine coverage.
Learning Objectives:
Keywords: Immunizations, Developing Countries
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.