Effects of low birth weight on time to BCG vaccination in an urban poor settlement in Nairobi, Kenya: an observational cohort study

BMC Pediatrics

Peter Mwaniki¹  Elizabeth Echoka⁴  Henrik Ravn⁵  Remare Ettarh²  Rhoune Ochako³  Martin Kavao Mutua¹ 

[1] Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya;Faculty of Medicine, University of British Columbia, Vancouver, Canada;Population Services Kenya, Jumuia Place, Lenana road, Nairobi, Kenya;Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya;OPEN, University of Southern Denmark/Odense University Hospital, Odense, Denmark

关键词: Immunization;    Low birth weight;    Bacillus Calmette-Guérin;   

Others  :  1181766
DOI  :  10.1186/s12887-015-0360-5

 received in 2014-10-21, accepted in 2015-04-01,  发布年份 2015

【 摘 要 】

Background

The World Health Organization recommends Bacillus Calmette-Guérin (BCG) vaccination against tuberculosis be given at birth. However, in many developing countries, pre-term and low birth weight infants get vaccinated only after they gain the desired weight. In Kenya, the ministry of health recommends pre-term and low birth weight infants to be immunized at the time of discharge from hospital irrespective of their weight. This paper seeks to understand the effects of birth weight on timing of BCG vaccine.

Methods

The study was conducted in two Nairobi urban informal settlements, Korogocho and Viwandani which hosts the Nairobi Urban Health and Demographic Surveillance system. All infants born in the study area since September 2006 were included in the study. Data on immunization history and birth weight of the infant were recorded from child’s clinic card. Follow up visits were done every four months to update immunization status of the child. A total of 3,602 infants were included in this analysis. Log normal accelerated failure time parametric model was used to assess the association between low birth weight infants and time to BCG immunization.

Results

In total, 229 (6.4%) infants were low birth weight. About 16.6% of the low birth weight infants weighed less than 2000 grams and 83.4% weighed between 2000 and 2490 grams. Results showed that, 60% of the low birth weight infants received BCG vaccine after more than five weeks of life. Private health facilities were less likely to administer a BCG vaccine on time compared to public health facilities. The effects of low birth weight on females was 0.60 and 0.97-times that of males for infants weighing 2000–2499 grams and for infants weighing <2000 grams respectively. The effect of low birth weight among infants born in public health facilities was 1.52 and 3.94-times that of infants delivered in private health facilities for infants weighing 2000–2499 grams and those weighing < 2000 grams respectively.

Conclusion

Low birth weight infants received BCG immunization late compared to normal birth weight infants. Low birth weight infants delivered in public health facilities were more likely to be immunized much later compared to private health facilities.

【 授权许可】

   
2015 Mutua et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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