尼日利亚孕妇的乙肝疫苗接种覆盖率：一项全国性试点横断面研究。
Pregnant women's hepatitis B vaccination coverage in Nigeria: a national pilot cross-sectional study.
作者信息
Eleje George Uchenna, Akaba Godwin Otuodichinma, Mbachu Ikechukwu Innocent, Rabiu Ayyuba, Loto Olabisi Morebise, Usman Hadiza Abdullahi, Fiebai Preye Owen, Chukwuanukwu Rebecca Chinyelu, Joe-Ikechebelu Ngozi Nneka, Nwankwo Chike Henry, Kalu Stephen Okoroafor, Onubogu Chinyere Ukamaka, Ogbuagu Chukwuanugo Nkemakonam, Chukwurah Shirley Nneka, Uzochukwu Chinwe Elizabeth, Inuyomi Samuel Oluwagbenga, Adesoji Bukola Abimbola, Ogwaluonye Uchenna Chukwunonso, Nweje Sussan Ifeyinwa, Egeonu Richard Obinwanne, Igue Odion Emmanuel, Jibuaku Chiamaka Henrietta, Aja Prince Ogbonnia, Chidozie Chiamaka Perpetua, Ibrahim Hadiza Sani, Aliyu Fatima Ele, Numan Aisha Ismaila, Okoro Ogbonna Dennis, Omoruyi Solace Amechi, Oppah Ijeoma Chioma, Anyang Ubong Inyang, Ahmed Aishat, Umeononihu Osita Samuel, Umeh Eric Okechukwu, Emeka Ekene Agatha, Onwuegbuna Arinze Anthony, Igbodike Emeka Philip, Ajuba Ifeoma Clara, Yakasai Ibrahim Adamu, Ezechi Oliver Chukwujekwu, Ikechebelu Joseph Ifeanyichukwu
机构信息
Effective Care Research Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.
Department of Obstetrics and Gynecology, University of Abuja, Abuja, Nigeria.
出版信息
Ther Adv Vaccines Immunother. 2021 Jul 29;9:25151355211032595. doi: 10.1177/25151355211032595. eCollection 2021.
OBJECTIVE
To determine the hepatitis B vaccination coverage, full-dose (⩾3) coverage and the associated factors affecting uptake among pregnant women.
METHODS
This was a cross-sectional study among pregnant women attending antenatal care in six tertiary hospitals across all the geopolitical zones of Nigeria. Pregnant women who consented to the study completed screening questions about their hepatitis B vaccination status and coverage. The main outcome measures were hepatitis B vaccination coverage rate, dose, and factors affecting uptake. Bivariate analysis was performed by the chi-square test and conditional logistic regression analysis was used to determine variables associated with uptake of the vaccination. Odds ratios (ORs) and adjusted odds ratios (aORs) were calculated and statistical significance was accepted when -value was < 0.05.
RESULTS
Of 159 pregnant women who completed the interview questions, 21 [13.2%, 95% confidence interval (CI) 7.9-18.5%] were vaccinated for hepatitis B for one to three doses. The numbers of doses received were: three doses (8/159, 5.0%), two doses (5/159, 3.1%), and one dose (8/159, 5.0%). The reasons for non-uptake of vaccination included: lack of awareness of the vaccine 83/138 (60.1%), inadequate access to vaccine 11/138 (8.0%), and positivity to hepatitis B virus 10/138 (7.2%). The uptake of hepatitis B vaccination was significantly affected by the level of education (OR 0.284, 95% CI 0.08-1.01, = 0.041), but in multivariable logistic regression, adjusted for confounders, the association between hepatitis B vaccination and participants' level of education (aOR 3.09; 95% CI 0.95-10.16; = 0.061) did not remain significant.
CONCLUSIONS
In Nigeria, the national hepatitis B vaccination coverage among pregnant women appears poor, with the full-dose coverage even poorer. The level of education was not positively associated with uptake of hepatitis B vaccination, while lack of awareness of the vaccine was the commonest reason for non-uptake.
FUNDING
TETFund National Research Fund 2019 (grant number TETFund/DR&D/CE/NRF/STI/33).
目的
确定孕妇的乙肝疫苗接种率、全程（≥3剂）接种率以及影响接种的相关因素。
方法
这是一项对尼日利亚所有地缘政治区域的6家三级医院中接受产前护理的孕妇进行的横断面研究。同意参与研究的孕妇完成了关于其乙肝疫苗接种状况和接种率的筛查问题。主要结局指标为乙肝疫苗接种率、接种剂数以及影响接种的因素。采用卡方检验进行双变量分析，并使用条件逻辑回归分析来确定与疫苗接种相关的变量。计算比值比（OR）和调整后的比值比（aOR），当P值<0.05时接受统计学显著性。
结果
在159名完成访谈问题的孕妇中，21名（13.2%，95%置信区间[CI] 7.9 - 18.5%）接种了1至3剂乙肝疫苗。接种的剂数分别为：3剂（8/159，5.0%）、2剂（5/159，3.1%）和1剂（8/159，5.0%）。未接种疫苗的原因包括：对疫苗缺乏认识83/138（60.1%）、难以获得疫苗11/138（8.0%）以及乙肝病毒检测呈阳性10/138（7.2%）。乙肝疫苗接种情况受教育程度显著影响（OR 0.284，95% CI 0.08 - 1.01，P = 0.041），但在多变量逻辑回归中，经混杂因素调整后，乙肝疫苗接种与参与者教育程度之间的关联（aOR 3.09；95% CI 0.95 - 10.16；P = 0.061）不再显著。
结论
在尼日利亚，孕妇的全国乙肝疫苗接种率似乎较低，全程接种率更低。教育程度与乙肝疫苗接种情况无正相关，而对疫苗缺乏认识是未接种的最常见原因。
资助
2019年TETFund国家研究基金（资助编号TETFund/DR&D/CE/NRF/STI/33）
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