Childhood vaccination uptake and associated factors among children 12-23 months in rural settings of the Gambia: a community-based cross-sectional study.

BACKGROUND: Globally, immunization prevents 2-3 million deaths annually from vaccine-preventable diseases such as diphtheria, tetanus, pertussis, influenza, and measles. In developing countries, several immunization programs have made progress, but the coverage remains a standstill in some areas. In order to inform policies and practices, the present study aimed at assessing vaccination uptake and contextual-associated factors among children aged 12-23 months in rural Gambia. METHODS: A community-based triangulated cross-sectional design was conducted in January 2020, with 200 caregivers with children aged 12-23 months in selected households in rural communities across Upper River Region of the Gambia using multistage sampling technique were recruited. A structured interview questionnaire was developed and Infant Welfare Cards were assessed to elicit information regarding contextual household characteristics towards childhood immunization uptake. Percentages, chi-square/fisher exact test for variables with p-value ≤0.15 were considered for inclusion into logistic regression model. The significance level was set at p < 0.05. The adjusted Odds Ratio (aOR) with 95% Confidence Interval (CI) were reported to declare significance. RESULTS: The proportion of children who received all the required vaccines was 66%. At the level of antigen-specific coverage, about 88.5% received BCG, 71% received OPV 3, 82.5% received Penta 3, while 72 and 71% received Measles-Rubella and yellow fever, respectively. Caregivers who had primary education level 88.8% (aOR = 0.112; 95% CI = 0.029-0.434), secondary & above 87.2% (aOR = 0.128; 95% CI = 0.029, 0. 561) and arabic/madrassa 95.7% (aOR = 0.043; 95% CI = 0.008-1.227) were less likely to be fully vaccinated when compared to those who have never been to school. Farmers are less likely by 88.9% (aOR = 0.111; 95% CI 0.020, 0.635) while children from family size of more than 20 members had reduced odds (aOR = 0.420; 95% CI = 0.197, 0.894) for their children to complete their vaccination schedule as compared to those with at most 20 household members. CONCLUSION: There is moderately a burden of incomplete vaccination in rural Gambia. Vaccination programs should be constantly monitored and evaluated by the Ministry of Health, especially in rural areas. To increase societal awareness and vaccine acceptance, a robust community-based health education efforts are desperately needed as part of initiatives to increase vaccine service utilization for these high-risk classes.

Knowledge, Attitude, and Practice of Provincial Dwellers on Prevention and Control of Schistosomiasis: Evidence from a Community-Based Cross-Sectional Study in the Gambia.

BACKGROUND: Socioeconomically disadvantaged and neglected communities were found to be the most affected groups for schistosomiasis as a result of inadequate safe water and sanitation facilities. In order to inform policies and practices, the present study examined the influence of sociodemographic factors and attitudes on the knowledge and practice in the prevention and control of schistosomiasis in eighteen endemic rural communities in the Gambia. METHODS: In January 2019, a community-based cross-sectional study was conducted in which 383 household heads in rural communities across Kuntaur and Janjanbureh Local Government Areas (LGAs) in Central River Region were recruited. A structured interview questionnaire was developed to elicit information regarding residents' knowledge, attitude, and practice on schistosomiasis prevention and control measures. Percentages, chi-square test, and binary and multiple logistic regression models were used to identify sociodemographic factors associated with the KAP variables. The significance level was set at p < 0.05. RESULTS: Among the 383 participants, only 14.9% had good knowledge, while 54.3% had poor knowledge, 96.9% had positive attitude, and 57.7% had good practice towards prevention and control of schistosomiasis. Older age (≥40 years), compared with residents aged 30-39 years (AOR = 0.331; 95% CI: 0.133, 0.825); ever heard of bilharziasis (AOR = 11.911; 95% CI: 3.452, 41.099); and risks of contact with the polluted river (AOR = 0.101; 95% CI: 0.042, 0.242) were more likely to have good knowledge on schistosomiasis prevention and control in the rural Gambia. Conversely, young people (≤30 years), compared with residents aged ≥40 years (AOR = 2.503; 95% CI = 1.539, 4.071); residents aged 30-39 years (AOR = 2.880; 95% CI = 1.559, 5.320); and male residents (AOR = 2.631; 95% CI = 1.703, 4.067) were more likely to have good practice towards schistosomiasis prevention and control in the rural Gambia. CONCLUSION: Despite the low knowledge, rural dwellers' attitudes were found to be positive with slightly good practice towards schistosomiasis prevention and control measures. Thus, while maintaining health system improvement strategies, disease control efforts should focus on these factors as they may influence the knowledge and practices of rural dwellers in a given setting. The findings could prompt appropriate policy responses towards improving the knowledge and practices on schistosomiasis prevention and control in the Gambia.