Date of Award

12-2020

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr. Rehana Siddiqui

Second Advisor

Mr. Syed Iqbal Azam

Third Advisor

Dr.Muslima Ejaz

Department

Community Health Sciences

Abstract

Title: Factors associated with adequate oral polio vaccine coverage during SIAs among children less than 5 years of age in District Pishin, Baluchistan: A cross-sectional study.
Introduction: Polio is an infectious disease mainly affecting children less than 5 Years of age. Poliovirus replicates in intestines and spreads through oro-fecal route. Pakistan and Afghanistan are the only remaining countries, which are yet to be declared polio free. Inadequate oral polio vaccine coverage, of < 95%, that increases risk of polio outbreaks is a significant health problem in some districts of Pakistan. Some parts of the country like Districts of Quetta, Pishin and Killa Abdullah in Baluchistan are referred to as Tier 1 districts due to continuous presence of virus both in Acute Flaccid Paralysis cases and in their sewerage sites. Oral Polio vaccine coverage is suboptimal in these districts and is considered a significant challenge due to different reasons. This study was conducted in Pishin district of Baluchistan to identify the factors responsible for suboptimal oral polio vaccine coverage among children less than 5 years of age during supplementary immunization activities (SIAs).
Objective: To assess the factors associated with adequate oral polio vaccine coverage during SIAs among children less than 5 years of age in District Pishin, Baluchistan.
Methods: A cross sectional study was conducted from Dec 18, 2019 to June 05, 2020 on a sample of four hundred and twenty (420) children less than five years of age in 60 villages of District Pishin, Baluchistan. We used two-stage cluster sampling design, using villages as cluster. An interviewer-administered questionnaire adapted from Rapid response unit, WHO tool was used to assess OPV coverage during previous round of SIA and to ascertain determinants of OPV coverage. The questionnaire comprised of different questions aimed at identifying the potential determinants like child sex, age and travel history, communication strategies in place of residence, caregiver education status, ethnicity, knowledge and socioeconomic status. Cox regressions were used to identify the factors associated with adequate OPV coverage.
Result: We approached households in 60 villages and selected 420 children < 5 years of age, one from each household randomly to assess determinants of OPV coverage. The mean age of children was 34.41 months (SD-17.97) and 214 (50.95%) male children. Most of the caregivers had primary level education 198 (47.03%) while 12 (2.85%) of them were not literate. More than half of the sampled population belonged to Kakar and Syed tribe, 323 (76.90%). The coverage of OPV during the last SIA was 379 (90.23%).%). Increasing age, educational status of caregiver and routine immunization were significantly associated with adequate OPV coverage at univariate level. In the final model the adjusted prevalence ratio (APR) of adequate OPV coverage was 3 times greater in children who had received 3 doses of routine immunization (APR: 3.08, CI: (2.04-13.71)); 2 times greater in children who had received two doses of routine immunization (APR: 2.21, CI: (1.65-13.18)), and similar in children who had received one dose of RI (APR:0. 98, CI: (0.34-13.82)) to than in non-immunized children for routine doses adjusting for all other variables in the model.
Conclusion: A higher coverage of OPV in children was associated with those receiving routine immunization doses. Public health managers and partner organizations should consider the results of this study when planning campaigns for SIAs and RI.

First Page

1

Last Page

41

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