%0 Journal Article
%T Timeliness of Childhood Vaccinations in Kampala Uganda: A Community-Based Cross-Sectional Study
%A Juliet N. Babirye
%A Ingunn M. S. Engebretsen
%A Frederick Makumbi
%A Lars T. Fadnes
%A Henry Wamani
%A Thorkild Tylleskar
%A Fred Nuwaha
%J PLOS ONE
%D 2012
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0035432
%X Background Child survival is dependent on several factors including high vaccination coverage. Timely receipt of vaccines ensures optimal immune response to the vaccines. Yet timeliness is not usually emphasized in estimating population immunity. In addition to examining timeliness of the recommended Expanded Programme for Immunisation (EPI) vaccines, this paper identifies predictors of untimely vaccination among children aged 10 to 23 months in Kampala. Methods In addition to the household survey interview questions, additional data sources for variables included data collection of child's weight and length. Vaccination dates were obtained from child health cards. Timeliness of vaccinations were assessed with Kaplan每Meier time-to-event analysis for each vaccine based on the following time ranges (lowest每highest target age): BCG (birth每8 weeks), polio 0 (birth每4 weeks), three polio and three pentavalent vaccines (4 weeks每2 months; 8 weeks每4 months; 12 weeks每6 months) and measles vaccine (38 weeks每12 months). Cox regression analysis was used to identify factors associated with vaccination timeliness. Results About half of 821 children received all vaccines within the recommended time ranges (45.6%; 95% CI 39.8每51.2). Timely receipt of vaccinations was lowest for measles (67.5%; 95% CI 60.5每73.8) and highest for BCG vaccine (92.7%: 95% CI 88.1每95.6). For measles, 10.7% (95% CI 6.8每16.4) of the vaccinations were administered earlier than the recommended time. Vaccinations that were not received within the recommended age ranges were associated with increasing number of children per woman (adjusted hazard ratio (AHR); 1.84, 95% CI 1.29每2.64), non-delivery at health facilities (AHR 1.58, 95% CI 1.02每2.46), being unmarried (AHR 1.49, 95% CI 1.15每1.94) or being in the lowest wealth quintile (AHR 1.38, 95% CI 1.11每1.72). Conclusions Strategies to improve vaccination practices among the poorest, single, multiparous women and among mothers who do not deliver at health facilities are necessary to improve timeliness of vaccinations.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0035432