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Mejora de la equidad en la vacunación contra el sarampión integrando mosquiteras impregnadas con insecticida en la campaña de vacunación, Madagascar
Author(s) -
Goodson James L.,
Kulkarni Manisha A.,
Vanden Eng Jodi L.,
Wannemuehler Kathleen A.,
Cotte Annett H.,
Desrochers Rachelle E.,
Randriamanalina Bakolalao,
Luman Elizabeth T.
Publication year - 2012
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2011.02953.x
Subject(s) - measles , vaccination , environmental health , medicine , equity (law) , propensity score matching , demography , immunology , political science , sociology , law
Abstract Objective To evaluate the effect of integrating ITN distribution on measles vaccination campaign coverage in Madagascar. Methods Nationwide cross‐sectional survey to estimate measles vaccination coverage, nationally, and in districts with and without ITN integration. To evaluate the effect of ITN integration, propensity score matching was used to create comparable samples in ITN and non‐ITN districts. Relative risks (RR) and 95% confidence intervals (CI) were estimated via log‐binomial models. Equity ratios, defined as the coverage ratio between the lowest and highest household wealth quintile ( Q ), were used to assess equity in measles vaccination coverage. Results National measles vaccination coverage during the campaign was 66.9% (95% CI 63.0–70.7). Among the propensity score subset, vaccination campaign coverage was higher in ITN districts (70.8%) than non‐ITN districts (59.1%) (RR = 1.3, 95% CI 1.1–1.6). Among children in the poorest wealth quintile, vaccination coverage was higher in ITN than in non‐ITN districts (Q1; RR = 2.4, 95% CI 1.2–4.8) and equity for measles vaccination was greater in ITN districts (equity ratio = 1.0, 95% CI 0.8–1.3) than in non‐ITN districts (equity ratio = 0.4, 95% CI 0.2–0.8). Conclusion Integration of ITN distribution with a vaccination campaign might improve measles vaccination coverage among the poor, thus providing protection for the most vulnerable and difficult to reach children.