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BMC Public Health
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Spatial clustering of measles vaccination coverage among children in sub-Saharan Africa

Authors: Tenley K. Brownwright, Zan M. Dodson, Willem G. van Panhuis

Published in: BMC Public Health | Issue 1/2017

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Abstract

Background

During the past two decades, vaccination programs have greatly reduced global morbidity and mortality due to measles, but recently this progress has stalled. Even in countries that report high vaccination coverage rates, transmission has continued, particularly in spatially clustered subpopulations with low vaccination coverage.

Methods

We examined the spatial heterogeneity of measles vaccination coverage among children aged 12–23 months in ten Sub-Saharan African countries. We used the Anselin Local Moran’s I to estimate clustering of vaccination coverage based on data from Demographic and Health Surveys conducted between 2008 and 2013. We also examined the role of sociodemographic factors to explain clustering of low vaccination.

Results

We detected 477 spatial clusters with low vaccination coverage, many of which were located in countries with relatively high nationwide vaccination coverage rates such as Zambia and Malawi. We also found clusters in border areas with transient populations. Clustering of low vaccination coverage was related to low health education and limited access to healthcare.

Conclusions

Systematically monitoring clustered populations with low vaccination coverage can inform supplemental immunization activities and strengthen elimination programs. Metrics of spatial heterogeneity should be used routinely to determine the success of immunization programs and the risk of disease persistence.
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Metadata
Title
Spatial clustering of measles vaccination coverage among children in sub-Saharan Africa
Authors
Tenley K. Brownwright
Zan M. Dodson
Willem G. van Panhuis
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4961-9

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