Spatial distribution and associated factors of measles vaccination among children aged 12–23 months in Ethiopia. A spatial and multilevel analysis

ABSTRACT

Introduction

In Ethiopia, measles continues to be the cause of a significant number of vaccine-preventable infant morbidity and mortality due to the low vaccination rate. However, understanding the geographical distribution of the measles-containing vaccine first dose (MCV1) and identifying associated factors is crucial to setting up appropriate interventions. This study aimed to explore the spatial distribution and associated factors of MCV1 coverage among children aged 12–23 months in Ethiopia using national representative data.

Methods

A cross-sectional study design using a two-stage stratified sampling technique was used. The analysis was performed using STATA 14.2, ArcGIS 10.8, and SaTScan version 9.6 software. To find significant related factors with measles vaccination, researchers used multilevel logistic regression.

Results

The prevalence of MCV1 in Ethiopia was 58.5%. A spatial variation of MCV1 coverage was observed across the study area. The most likely significant primary clusters with low MCV1 coverage were observed in Liben, Afder, Shebelle, Korahe, and Nogob zones of the Somali region; Bale and Guji zones of the Oromia region, and Gedeo and Sidama zones of the SNNPR. Rural areas, maternal primary education, secondary and above school education, Orthodox religion, Muslim religion, health facility delivery, and Afar region were significantly associated with MCV1 vaccination.

Conclusion

The overall MCV1 coverage in Ethiopia was low. Aside from the inadequate coverage, there was a geographical variation across the country. Low MCV1 coverage areas should be prioritized to improve vaccination efforts to control measles across the country.

KEYWORDS:

• Children
• measles vaccine
• spatial analysis
• multilevel analysis
• Ethiopia

Abbreviations

Table

Acknowledgments

The authors would like to thank the MEASURE DHS program for providing the data for further analysis.

Authors’ contribution

All authors made a substantial contribution to the study’s conception, design, methodology, and data analysis. GAT write-up the draft manuscript. All authors read, revised it critically for important intellectual content, and gave the final approval of the manuscript.

Disclosure statement

The authors declared that there was no conflict of interest in this work.

Data availability statement

The dataset used for this study is publicly available at the MEASURE DHS program website https://www.dhsprogram.com/data.

Ethical consideration

This study was done based on secondary data analysis, and permission was obtained from the MEASURE DHS program to download and use the data for our study purpose. So, ethical approval and participants’ consent are not applicable for this particular study. The dataset is publicly available in the official database of the MEASURE DHS program with no personal identity.

Additional information

Funding

This particular study did not receive funds from any funding agencies.