Pneumococcal Immunisation Uptake and Associated Factors among Caregivers of Infants Between 4-12 Months in Nyamira County, Kenya
Karicha, Jane W.
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Pneumonia is the leading killer among all infectious diseases worldwide. Though treatable, it often results in high mortality and morbidity therefore putting pressure on available health resources. A child dies of pneumonia every 39 seconds bringing the total deaths to more than 2000 per day globally. In Kenya, pneumonia deaths accounted for 15% of child deaths translating to six deaths per 1000 live births in 2018, far from the GAPPD target of three per 1000. The best intervention for pneumonia is prevention through vaccination and Kenya introduced one of the vaccines, PCV 10 in January 2011.The uptake has however remained low thus leaving out a good proportion of children without prevention. The country coverage for PCV 10 has been declining between 2011 and 2017 with 85% and 71% respectively against a recommended target of ≥90%. This low coverage is reflected in the counties and one such county is Nyamira where in fact pneumonia was reported as the leading cause of death for the county in 2014. Within the County, Borabu Sub County is most affected where the PCV 10 coverage in 2017 was 61% while the County‟s was 64% respectively versus a national coverage of 71%. This study looked at the uptake of the Pneumococcal conjugate vaccine, ten- valent (PCV 10) immunization by Caregivers in Nyamira County, Borabu sub-county. A cross sectional approach was applied within Caregivers of children aged 4-12 months. While the County and Sub County to be studied were purposively sampled, the wards and community health units were randomly sampled. Caregivers within sampled households were then sampled to a total sample size of 349.Using questionnaires Caregivers were interviewed and a checklist was used to review the vaccination records. Data was analysed using descriptive statistics and inferential statistics including determining relationship between variables. The results obtained from this study indicated coverage of 82.7%for PCV 10. Caregivers were predominantly female, 97% and in informal employment. Among the demographic factors of the cohort, level of education and the number of children below 5 years were found to be statistically significant with p values of 0.029 and 0.019 as calculated using Fischer‟s Exact and Chi Square respectively. While 63% of the caregivers reported as having ever heard of PCV 10, a sizeable proportion, of 37% had never heard of the vaccine. Only 28% were aware of who is eligible for the vaccine. The likelihood of immunization increased with awareness of Caregivers on the vaccine. Indeed, results showed that knowledge of caregivers had a significant relationship with vaccine uptake with the p values of the knowledge factors resulting to <0.0001 as calculated with chi square. Furthermore, multiple logistic regression findings showed that all factors of knowledge were significant and strong influencers of PCV 10 uptake with resulting adjusted odds ratio with p values <0.005. The findings of this study therefore indicate that the uptake of PCV 10 in Borabu Sub County and in Nyamira County can be enhanced by increasing knowledge of Caregivers on PCV 10 and by enhancing compliance to the vaccination schedule.