Fernando de la Hoz1, Ligia Pérez2, Jeremy G. Wheeler3, Marlen de Neira1, Andrew J. McBain4
1Instituto Nacional de Salud de Colombia, Universidad Nacional de Colombia, Bogotá, Colombia
2Secretaria de Salud del Amazonas, Leticia, Amazonas, Colombia
3Institute of Public Health and Primary Care, University of Cambridge, Cambridge, UK
4London School of Hygiene and Tropical Medicine, London, UK
Tóm tắt
SummaryObjectives We conducted a vaccination coverage survey in the Colombian Amazon, an area highly endemic for hepatitis B (HB), where HB vaccine was introduced in 1992. The aim was to measure vaccine coverage and factors influencing it, especially those related to health services.Methods A total of 3573 children younger than 11 years were randomly selected from four populations. Vaccination status was ascertained through the vaccination card and a questionnaire on socio‐demographic factors was applied to children's caretakers. Health workers (HW) in charge of vaccination in rural and urban areas were interviewed regarding knowledge and practices in vaccination. Individual and HW characteristics were related to individual vaccination using logistic regression.Results Overall cumulated vaccination coverage was high for polio (96%, 95% CI: 94–98), measles (94%, 95% CI: 92.8–95.2), BCG (91%, 95% CI: 90–93), DPT (90%, 95% CI: 88–92) and HB (88%, 95% CI: 86–90). However, <50% of children completed the primary course of vaccination in the first year of life. Individual factors improving the likelihood of being either fully or HB vaccinated were: age > 1 year, living in Leticia, being affiliated to the social security, and living in a house with a roof made of tiles rather than palm tree leaf. Among the variables related to HWs, poor knowledge of vaccine contraindications predicted a lower chance of being fully or HB vaccinated in the population served by them, even after controlling for individual variables.Conclusions The HB control program in Colombia has achieved good coverage in one of the most endemic areas of the country. However, barriers to vaccination arise from inequities in the distribution of health insurance and inadequate HW knowledge.
