title: Risk factors for low vaccination coverage among Roma children in disadvantaged settlements in Belgrade, Serbia.
abstract: BACKGROUND
  Full vaccination coverage for children under 59 months of age in Serbia is over 90%. This study assesses vaccination coverage and examines its association with birth registration among Roma children who resided in disadvantaged settlements in Belgrade, Serbia.
  
  
  METHODS
  The First Roma Health and Nutrition Survey in Belgrade settlements, 2009, was conducted among households of 468 Roma children between the ages of 6-59 months. The 2005 WHO Immunization Coverage Cluster Survey sampling methodology was employed. Vaccinations were recorded using children's vaccination cards and through verification steps carried out in the Primary Health Care Centers. For those who had health records the information on vaccination was recorded.
  
  
  RESULTS
  About 88% of children had vaccination cards. The mean rate of age appropriate full immunization was 16% for OPV and DTP and 14.3% for MMR. Multivariate analyses indicated that children whose births were registered with the civil authorities were more likely to have their vaccination cards [OR=6.1, CI (2.5, 15.0)] and to have their full, age appropriate, series vaccinations for DTP, OPV, MMR and HepB [OR=3.8, CI (1.5, 10.0), OR=3.2, CI (1.5, 6.6), OR=4.8, CI (1.1, 21.0), OR=5.4, CI (1.4, 21.6), respectively].
  
  
  CONCLUSIONS
  The immunization coverage among Roma children in settlements is far below the WHO/UNICEF MDG4 target in achieving prevention and control of vaccine preventable diseases. It demonstrates the need to include "invisible" populations into the health systems in continuous, integrated, comprehensive, accessible and sensitive modes.
authors: World Health Organization Serbia Country Office, Hadzi Melentijeva 30, Belgrade 11000, Serbia. kristefers@gmail.com
authors: Kristefer
authors: K
authors: Stojanovski
authors: Gerry
authors: G
authors: McWeeney
authors: Nedret
authors: N
authors: Emiroglu
authors: Piroska
authors: P
authors: Ostlin
authors: Theadora
authors: T
authors: Koller
authors: Lucianne
authors: L
authors: Licari
authors: Dorit Nitzan
authors: DN
authors: Kaluski
mesh_terms: D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000627:therapeutic use; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000627:therapeutic use; D011055:Poliovirus Vaccine, Oral / Q000627:therapeutic use; D012044:Regression Analysis; D012307:Risk Factors; D055771:Serbia / Q000208:ethnology; D014611:Vaccination / Q000706:statistics & numerical data*; D035862:Vulnerable Populations / Q000208:ethnology / Q000706:statistics & numerical data
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D011055:Poliovirus Vaccine, Oral