Determinants of vaccination coverage among children aged 12-23 months in rural KwaZulu-Natal
Date
2009-05-18T12:24:00Z
Authors
Ndirangu, James Ng'Ang'a
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Abstract
To evaluate the impact of maternal HIV-infection on routine childhood immunization
coverage, comparison was made on the immunization status of children born to HIV-infected
and HIV-uninfected women in rural KwaZulu Natal. The study population was all children
enrolled in the routine demographic surveillance system as at 31st December 2005 (n=18,171)
in Africa Centre Demographic Surveillance Area. Sampling of subjects was done based on
the dates of birth that were between the period 1st Jan 2004 and 31st December 2005
(n=2,020). This was further divided based on maternal HIV status namely; 236 HIV (+), 777
HIV (-) and 1,007 HIV (unknown). The main outcome measure was the percent of complete
routine childhood immunizations recommended by the WHO as assessed from the Road-to-
Health cards or maternal recall during household interviews. For all vaccines, children born to
HIV-infected mothers had lower immunization coverage than children born to HIV-negative
mothers (78.21% vs. 86.52%). The children of mothers who were HIV-infected were 31-55%
(P-value <0.020) less likely to be immunized compared to children of mothers who were HIVuninfected.
We conclude that maternal HIV-infection is associated with childhood under immunisation.
VCT health workers should encourage HIV-infected mothers to complete childhood
immunization. Improving access to immunization services could benefit vulnerable
populations such as children born to HIV-infected mothers.
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Keywords
vaccination, children, KwaZulu Natal, South Africa