Compliance with diphtheria, tetanus, and pertussis immunisation in Bangladesh: factors identifying high risk groups.
OBJECTIVE
To evaluate factors associated with non-compliance with having second vaccination against diphtheria, tetanus, and pertussis in a treatment centre in Dhaka to determine which children were most at risk of not completing immunisation.


METHODS
Cohort study of infants given first dose of the vaccine and followed up six weeks later to ascertain compliance with having second dose. Factors associated with non-compliance were evaluated.


METHODS
Dhaka treatment centre of the International Centre for Diarrhoeal Disease Research, Bangladesh.


METHODS
136 unimmunised children aged 6 weeks to 23 months who lived within reach of the treatment centre. At time of the six week follow up 16 of the children could not be traced and seven had died.


METHODS
All children received their first dose of the vaccine. In each case health education workers had informed the mother about the value of immunisation, and she was given clear instructions to bring the child back after four weeks for the second dose.


METHODS
Rate of non-compliance with advice to return child for second vaccination.


RESULTS
46 of 113 children (41%) received the second dose of the vaccine. Factors most closely associated with mothers' failure to comply with the second dose were lack of education and low income. Children whose mothers knew most about immunisation at first interview were more likely to have their second dose.


CONCLUSIONS
Preventive health care services such as immunisation are appropriately offered in treatment centres, but compliance among children varies with socioeconomic status and mother's education. Further research should be aimed at ways to make health education more effective among uneducated parents.
Zeitlyn
S
S
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Rahman
A K
AK
Nielsen
B H
BH
Gomes
M
M
Kofoed
P E
PE
Mahalanabis
D
D
D001459:Bangladesh; D003906:Developing Countries; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D004522:Educational Status; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D010290:Parents / Q000523:psychology; D010349:Patient Compliance; D012959:Socioeconomic Factors; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data
D015721:Diphtheria-Tetanus-Pertussis Vaccine