Factors associated with DPT 1-3 vaccine dropout in Kabarole district

Abstract

Background: Among the top ten causes of poor health in the district are complications due to vaccine preventable diseases notably diphtheria, pertussis and tetanus (DPT). In 2008, the DPT dropout rate in Kabarole was high (18%). This study assessed the service, community and individual factors associated with DPT1-3 dropout in Kabarole District. Methods: A cross sectional study using cluster sampling was employed. Two clusters at parish level (rural and urban) each from a county in the district were selected by sim ple random sampling and all villages therein were studied. A total of 230 children (115 from either cluster) were recruited and their parent or guardian interviewed. Cross-tabulations and chi-square tests were used to determine the strength of associations between independent variables and the outcome. Binary logistic regression was done to adjust for potential confounders and identify independent predic tors. Key informant interviews were held with in-charges of health units. Qualitative data was analysed manually using thematic approach and results presented in the form of text. Results: Factors found to be associated with DPT1-3 dropout were; lack of caretaker knowledge about DPT dosage, (adj. OR = 8.2; 95% CI: 3.12, 21.53); Child’s Birth Order, 6th and above (adj. OR = 3.0; 95% CI: 0.80, 11.05); Child Birth Order 2-3 (adj. OR = 2.2; 95% CI: 0.70, 6.71); Child age group 31-36 compared to 12-18 (adj. OR = 2.5; 95% CI: 0.81, 7.84). However, Rural residence (OR = 1.2; 95% CI: 0.56, 2.57); and Child without immunisation card (OR = 4.4; 95% CI: 0.35, 39.86) were not significantly associated with DPT dropout. Conclusion: The current DPT1-3 dropout prevalence in Kabarole is still high but dropping (13.7%). DPT 1-3 dropout is associated with caretaker lack of knowledge of number of dosages a child should receive and involvement of religious leaders, long travel distance to point of accessing transport means, and convenient time for immunisation. Findings from this study can be used to improve DPT immunisation services. Specific campaigns on DPT immunisation through home visits, involving community leaders and full day immunisation can help further reduce the dropout rate