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ORIGINAL CONTRIBUTION |
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| Year : 1999 | Volume
: 53
| Issue : 5 | Page : 212-215 |
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Delayed immunisation against vaccine preventable diseases - factors responsible among children under 5 years of age
RR Tiwari, PN Kulkarni
Department of Preventive and Social Medicine, Indira Gandhi Medical College, Nagpur., India
Correspondence Address:
R R Tiwari
C/o. Dr. S. P. Zodpey, 305, Hanuman nagar, Nagpur 440009.
India
PMID: 10695231
How to cite this article:
Tiwari R R, Kulkarni P N. Delayed immunisation against vaccine preventable diseases - factors responsible among children under 5 years of age. Indian J Med Sci 1999;53:212-5 |
How to cite this URL:
Tiwari R R, Kulkarni P N. Delayed immunisation against vaccine preventable diseases - factors responsible among children under 5 years of age. Indian J Med Sci [serial online] 1999 [cited 2013 May 19];53:212-5. Available from: http://www.indianjmedsci.org/text.asp?1999/53/5/212/12245 |
Under the Universal Immunisation Programme, the children udder 5 years of are vaccinated, against six vaccine preventable diseases, namely tuberculosis, poliomyelitis;- diphtheria, pertussis, tetanus and measles. Under Health for All by 2000 AD, a target of 100% coverage of children with vaccine against these vaccine preventable disease is kept [1] , But inspite of implementation of Universal Immunisation Programme, since 1985 and extensive immunisation campaign in last two decades, apporximately 20% of the children are not immunised currently and 10% to 20% receive delayed immunisaion. [2] It is acknowledged that number of risk factors namely family size, number of children <5 years, birth-order, sex, religion, maternal and paternal education, socio-economic status, years of residence, distance from health centre, area of residence are associated with delay in immunisation. [3],[4],[5] Thus, the present study was undertaken to study these risk factors so that childhood immunisation could be timely and effectively delivered.
| ¤ Material and Methods | |  |
A hospital based, pair matched case - control study was carried out during September 1998 at Immunoprophylactic centre of Indira Gandhi Medical College and hospital, Nagpur, which is a tertiary care hospital. 57 cases and 57 controls were included in the study. Cases comprised of children with delay of 45 days for scheduled primary immunisation and controls (matched for a dose) were the children who received timely primarily immunisation.
The study included as many as 11 risk factors, namely family size, number of children < 5 years in the family, birth order, sex, paternal education, maternal education, socio-economic status, religion, area of residence, years of residence at current place and distance from the health centre. A detailed scheme of measurement of risk factors in shown in [Table 1], universal odd's ratio with 95% confidence intervals were estimated to study the strength of association between various risk factors and delayed immunisation.
| ¤ Results | | |
[Table 1] describes the distribution of risk factors in cases and controls. Categorisation of individual risk factor thereby classifying an individual into exposed and unexposed category is also represented in the table. [Table 2] shows the strength of association between various risk factors and delay in immunisation. The estimates of OR, 95% confidence intervals are also shown in this table. The risk factors namely family size, number of children < 5 years, sex, paternal education, maternal education, socio-economic status, distance from health centre were found to be significantly associated with delayed immunisation however, birth order, area of residence, year of residence and religion were not significantly associated with delayed immunisation. [Table 3] shows the reason for delayed immunisation in majority of the cases, i.e. 21 (36.8), negligience on the part of parents was main reason. Unawareness was the reason for delayed immunisation in 17 (29.8%). Thirteen (22.8%) cases received delayed immunisation because of sickness. A total of six (10.6%) parents quoted the reasons like social function, non-availability of vaccines etc. for delayed immunisation.
| ¤ Discussion | | |
In the present study out of the 11 risk factors studied, seven risk factors were identified to be potentially associated with delayed immunisation in children under 5 years. Families with large family size and more number of children under 5 years of age were more likely to have delayed immunisation as reported by other studies also. [3],[4],[5] , Delayed immunisation associated with female sex may be due to sex discrimation which is more common in this society, Education status of both the parents and socio-economic status (SES) of the family were found to be significantly associated with delayed immunisation in this study. These findings are consistent with the fact that immunisation coverage is reported to be low in low literacy and low SES group. [4],[7],[8] Residing at a long distance from the health centre has also increased the risk of delayed immunisation in the study gorup. The non-significant association of area of residence, years of residence at current place, birth order and religion with delayed immunisation may be due to inadequate number of study subjects after categorisation of these risk factors. Negligence on the parts of parents and unawareness were the main reasons for delayed immunisation which can be corrected by health education camp. Hence it can be concluded from the study that incorporation of health education of mothers with emphasis on the above significant risk factors particularly during antenatal visits can help in effective and timely delivery of childhood immunisation.
| ¤ Summary | | |
In the present case - control study, out of the eleven risk factors of delayed immunisation. only seven, namely family size, sex, number of children <5 years, material education, paternal education, distance from health centre and low socio-economic status were found to be significantly associated. The common causes for delayed immunisation were negligience on part of parents, unawareness about the ose of vaccine and sickness of child. Thus, health education of the parents is recommended.
| ¤ References | | |
| 1. | 1.World Health Organisation. Expanded Programme on Immunisation Porgram Report - 1992, 1st edition. Geneva : WHO, 1993:8.4.  |
| 2. | Park K. Textbook of Preventive and Social Medicine, 14th edition. Jabalpur; Banarsidas Bhanot Publishers, 1904:328-30. |
| 3. | Lieu TA, Black SB, Ray P, Chellino M, Shinfield HR, Adler NE. Risk factors for delayed immunisation among children in an Health Maintenance Organisation (HMO). Am J Public Health 1994:84:1621-25. |
| 4. | Marks JS, Halpin TJ, Irvin JJ, Johnson DA, Keller JR. Risk factors associated with failure to receive vaccination - Paediatrics 1979:64:304-9. |
| 5. | Bobo JK, Gale JL, Thapa PB, Wassila l SGP. Risk factors for delayed immunisation in a random sample of 1163 children from Oregon and Washington. Paediatrics 1993:91:308-14. |
| 6. | Gupta M, Agarwal KN. Importance of parental education and socio-economic status in family planning and immunisation status of children. Indian Paediatrics 1972:9:447-49. |
| 7. | Hooja V, Ghosh S, Mittal SK, Verma RK,. Immunisation status in an urban community. Indian Paediatric 1976:13:747-750. |
| 8. | Singh R, Singh H, Mohan V, Joshi VS. Immunisation status of children of parents belonging to various educational group. Indian Paeddiatri 1976;43:118-24. |
[Table 1], [Table 2], [Table 3]
| This article has been cited by | | 1 |
Reasons for non-immunization of children in an urban, low income group in North India |
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| Mathew JL, Babbar H, Yadav S | | TROPICAL DOCTOR. 2002; 32 (3): 135-138 | | [Pubmed] | |
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