Demographic, socio-economic and geographic determinants of seasonal influenza vaccine uptake in rural western Kenya, 2011.
Influenza-associated acute lower respiratory infections cause a considerable burden of disease in rural and urban sub-Saharan Africa communities with the greatest burden among children. Currently, vaccination is the best way to prevent influenza infection and accompanying morbidities. We examined geographic, socio-economic and demographic factors that contributed to acceptance of childhood seasonal influenza vaccination among children living in a population-based morbidity surveillance system in rural western Kenya, where influenza vaccine was offered free-of-charge to children 6 months-10 years old from April to June, 2011. We evaluated associations between maternal and household demographic variables, socio-economic status, and distance from home to vaccination clinics with family vaccination status. 7249 children from 3735 households were eligible for vaccination. Of these, 2675 (36.9%) were fully vaccinated, 506 (7.0%) were partially vaccinated and 4068 (56.1%) were not vaccinated. Children living in households located >5km radius from the vaccination facilities were significantly less likely to be vaccinated (aOR=0.70; 95% CI 0.54-0.91; p=0.007). Children with mothers aged 25-34 and 35-44 years were more likely to be vaccinated than children with mothers less than 25 years of age (aOR=1.36; 95% CI 1.15-1.62; p<0.001; and aOR=1.35; 95% CI 1.10-1.64; p=0.003, respectively). Finally, children aged 2-5 years and >5 years of age (aOR=1.38; 95% CI 1.20-1.59; p<0.001; and aOR=1.41; 95% CI 1.23-1.63; p<0.001, respectively) and who had a sibling hospitalized within the past year (aOR=1.73; 95% CI 1.40-2.14; p<0.001) were more likely to be vaccinated. Shorter distance from the vaccination center, older maternal and child age, household administrator's occupation that did not require them to be away from the home, and having a sibling hospitalized during the past year were associated with increased likelihood of vaccination against influenza in western Kenya. These findings should inform the design of future childhood seasonal influenza vaccination campaigns in rural Kenya, and perhaps elsewhere in Africa.
Kenya Medical Research Institute/Centers for Disease Control and Prevention - Kenya (KEMRI/CDC), Kenya. Electronic address: Notieno@kemricdc.org.
Nancy A
NA
Otieno
Kenya Medical Research Institute/Centers for Disease Control and Prevention - Kenya (KEMRI/CDC), Kenya.
Bryan O
BO
Nyawanda
Kenya Medical Research Institute/Centers for Disease Control and Prevention - Kenya (KEMRI/CDC), Kenya.
Allan
A
Audi
Kenya Medical Research Institute/Centers for Disease Control and Prevention - Kenya (KEMRI/CDC), Kenya.
Gideon
G
Emukule
Kenya Medical Research Institute/Centers for Disease Control and Prevention - Kenya (KEMRI/CDC), Kenya.
Emmaculate
E
Lebo
Kenya Medical Research Institute/Centers for Disease Control and Prevention - Kenya (KEMRI/CDC), Kenya.
Godfrey
G
Bigogo
Kenya Medical Research Institute/Centers for Disease Control and Prevention - Kenya (KEMRI/CDC), Kenya.
Rachel
R
Ochola
Ministry of Public Health and Sanitation, Division of Disease Surveillance and Response (MoPHS, DDSR), Nairobi, Kenya.
Phillip
P
Muthoka
Centers for Disease Control and Prevention, Influenza Division, Atlanta, GA, United States.
Marc-Alain
MA
Widdowson
Centers for Disease Control and Prevention, Influenza Division, Atlanta, GA, United States.
David K
DK
Shay
Centers for Disease Control and Prevention, Global Disease Detection Division, Atlanta, GA, United States.
Deron C
DC
Burton
Centers for Disease Control and Prevention, Global Disease Detection Division, Atlanta, GA, United States.
Robert F
RF
Breiman
Centers for Disease Control and Prevention, Influenza Division, Atlanta, GA, United States.
Mark A
MA
Katz
Centers for Disease Control and Prevention, Influenza Division, Atlanta, GA, United States.
Joshua A
JA
Mott
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003710:Demography; D005260:Female; D005843:Geography; D006801:Humans; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D007630:Kenya; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D012959:Socioeconomic Factors; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
D007252:Influenza Vaccines
Children; Determinants; Seasonal influenza; Vaccine uptake