A COMPARATIVE STUDY OF IMMUNIZATION AND NUTRITIONAL STATUS OF CHILDREN AGED BELOW TWO YEARS IN RURAL AND URBAN COMMUNITIES IN BAYELSA STATE

Abstract

Worldwide interest in the assessment of outcomes of health programmes is growing. And vaccine preventable childhood diseases have continued to kill a significant percentage of children worldwide especially in developing countries. This comparative study involves assessing the immunization and nutritional statuses of children aged below two years in rural and urban communities of Bayelsa state with a view to determining factors affecting vaccine utilization, dropout, nutritional status; and association between nutritional status and prevalence of vaccine preventable diseases. Subjects were recruited from Ondewari (a rural settlement) via simple random sampling using house numberings of the National Population commission; while the 30 cluster sampling method, a two-stage cluster sampling scheme was used for Yenagoa (an urban community). Of the 288 subjects recruited from each community, immunization coverage was 136
(47.2%) unimmunized and 33(11.5%) fully immunized for Yenagoa; while 33 (11.5%)
were not immunized and 17(5.9%) fully immunized for Ondewari community. DPT3
vaccine dropout rate was 4.5% and 68.8% respectively for Yenagoa and Ondewari
communities. Reasons given for drop-out included: long waiting time, vaccine
unavailable, vaccinator absent, immunization place too far, unaware of immunization
need, etc. which were also statistically significant (P-value≤ 0.05).
Sociodemographic characteristics such as male sex of study subject, subjects’ fathers
who had primary or higher education, parents/caregivers who were working, and subjects
from families whose religion was Christianity, had a higher ra te of vaccine utilization than
others; with a statistically significant relationship (P-value<0.05). The relationship
between sociodemographic characteristics and nutritional status of subjects from
Yenagoa was significant statistically for sex and parental/caregiver’s marital status (P
value<0.05); whereas parents’/caregivers’ marital status, father’s educational status and
that of mother’s occupation were significant for those from Ondewari community, (P
value<0.05). The likelihood of a child from Yenagoa being normally nourished was higher
if the sex was male and parents were married; whereas it was so for those from Ondewari
community when the father’s educational status was primary and above, mother was
working and parents/caregivers were married.
Finally, the proportion of severely malnourished differed in the two communities with
Ondewari presenting 17 and only 1 from Yenagoa. However, there was no
correspondingly higher morbidity rate of immunizable diseases in Ondewari community.
In conclusion, uptake of vaccines during routine immunization is still low and much
lower in rural areas with several factors responsible for drop-out and non vaccination. It
is recommended that routine immunization be monitored by intermittent coverage
survey to determine vaccine utilization in order to reduce/eradicate vaccine preventable
diseases.

A COMPARATIVE STUDY OF IMMUNIZATION AND NUTRITIONAL STATUS OF CHILDREN AGED BELOW TWO YEARS IN RURAL AND URBAN COMMUNITIES IN BAYELSA STATE