Pneumococcal Immunisation Uptake and Associated Factors among Caregivers of Infants Between 4-12 Months in Nyamira County, Kenya
Date
2021
Authors
Karicha, Jane W.
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
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.
Description
A Research Thesis Submitted in Partial Fulfillment of the Requirements for the Award of The Degree of Master of Public Health (Epidemiology & Disease Control) in the School of Public Health and Applied Human Sciences of Kenyatta University, November 2021
Keywords
Pneumococcal Immunisation, Caregivers, Infants, 4-12 Months, Nyamira County, Kenya