Abstract
Objectives The Democratic Republic of Congo (DR Congo) is one of the ten countries, which accounts for 60% of unvaccinated children worldwide. The aim of this study was to assess predictors of incomplete and untimely immunization among a cohort of infants recruited at birth and followed up through 24 weeks in Kinshasa. Methods Complete immunization for each vaccine was defined as receiving all the recommended doses. Untimely immunization was defined as receiving the given dose before (early) or after (delayed) the recommended time window. Infants not immunized by the end of the follow-up time were considered missing. Multivariate hierarchical model and generalized logistic model were used to assess the independent contribution of each socio-economic and demographic factors considered to complete immunization and timeliness, respectively. Results Overall, of 975 infants from six selected clinics included in the analysis 84.7% were fully immunized the three doses of DTP or four doses of Polio by 24 weeks of age. Independently of the vaccine considered, the strongest predictor of incomplete and untimely immunization was the clinic in which the infant was enrolled. This association was strengthened after adjustment for socio-economic and demographic characteristics. Education and the socio-economic status also were predictive of completion and timeliness of immunization in our cohort. Discussion In conclusion, the strongest predictor for incomplete and untimely immunization among infants in Kinshasa was the clinics in which they were enrolled. The association was likely due to the user fee for well-baby clinic visits and its varying structure by clinic.
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Acknowledgements
This study was supported by a grant from the Bill & Melinda Gates Foundation to FHI 360, through the Alive & Thrive Small Grants Program managed by UC Davis via a sub-award to the University of North Carolina at Chapel Hill, Sub-agreement #: 09-000076-AT11-123-UNC-DRC. The sponsors of the study had no role in study design, data collection, data analysis, data interpretation, writing of the report, or the decision to submit the paper for publication. We are grateful for the participation and time of the study mothers and infants; the time and efforts of the personnel of the participating clinics; the technical support of Drs. Aimee Lulebo, Bienvenu Kawende, Dinah Kayembe, Jean Lambert S. Chalachala, Mrs. Kathryn Salisbury, and Deidre Thompson; the data collection and data entry contributions of Clever Akili, Dyna Anambatu, Valerie B. Chalachala, Marie Dauly, Dydy Kayembe, Mamie Lulebo, Fanny Matadi, Myriam Mbonze, Espérance Mindia, Sarah Mushiya, Gisèle Mvumbi, Dodo Mwela, Jolly Ntirume, Ros Samba; and the administrative support of the UNC’s, KSPH’s, and Alive & Thrive administrative teams.
Funding
Grant from the Bill & Melinda Gates Foundation to FHI 360, through the Alive & Thrive Small Grants Program managed by UC Davis via a sub-award to the University of North Carolina at Chapel Hill. MY is partially supported by the NIAID U01AI096299-01 and the NICHD R01HD087993. The sponsors of the study had no role in study design, data collection, data analysis, data interpretation, writing of the report, or the decision to submit the paper for publication.
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Zivich, P.N., Kiketa, L., Kawende, B. et al. Vaccination Coverage and Timelines Among Children 0–6 Months in Kinshasa, the Democratic Republic of Congo: A Prospective Cohort Study. Matern Child Health J 21, 1055–1064 (2017). https://doi.org/10.1007/s10995-016-2201-z
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DOI: https://doi.org/10.1007/s10995-016-2201-z