Childhood immunization rates in rural Intibucá, Honduras: an analysis of a local database tool and community health center records for assessing and improving vaccine coverage

BMC Public Health

Research Article

Elizabeth P Schlaudecker¹  Joseph B Ranz²  Mary Carroll³  Lori M Singleton³  Paria M Wilson³  Alan Zarychta⁴  Yuan He⁴ 

[1] Division of Infectious Diseases, Global Health Center, Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH, USA;Global Health Center, Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH, USA;Global Health Track, Pediatric Residency Training Program, Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH, USA;Shoulder to Shoulder, Concepción, Intibucá, Honduras;

关键词: Vaccines;    Childhood immunization;    Honduras;    Database;    Community health workers;    Public health;   

DOI  :  10.1186/1471-2458-12-1056

 received in 2012-05-22, accepted in 2012-11-27,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundVaccines are highly effective at preventing infectious diseases in children, and prevention is especially important in resource-limited countries where treatment is difficult to access. In Honduras, the World Health Organization (WHO) reports very high immunization rates in children. To determine whether or not these estimates accurately depict the immunization coverage in non-urban regions of the country, we compared the WHO data to immunization rates obtained from a local database tool and community health center records in rural Intibucá, Honduras.MethodsWe used data from two sources to comprehensively evaluate immunization rates in the area: 1) census data from a local database and 2) immunization data collected at health centers. We compared these rates using logistic regression, and we compared them to publicly available WHO-reported estimates using confidence interval inclusion.ResultsWe found that mean immunization rates for each vaccine were high (range 84.4 to 98.8 percent), but rates recorded at the health centers were significantly higher than those reported from the census data (p≤0.001). Combining the results from both databases, the mean rates of four out of five vaccines were less than WHO-reported rates (p <0.05). Overall immunization rates were significantly different between townships (p=0.03). The rates by individual vaccine were similar across townships (p >0.05), except for diphtheria/tetanus/pertussis vaccine (p=0.02) and oral polio vaccine (p <0.01).ConclusionsImmunization rates in Honduras were high across data sources, though most of the rates recorded in rural Honduras were less than WHO-reported rates. Despite geographical difficulties and barriers to access, the local database and Honduran community health workers have developed a thorough system for ensuring that children receive their immunizations on time. The successful integration of community health workers and a database within the Honduran decentralized health system may serve as a model for other immunization programs in resource-limited countries where health care is less accessible.

【 授权许可】

Unknown   
© He et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.