Despite years of progress, vaccination coverage in many African countries is highly variable

According to a new scientific study, many African countries have made substantial progress in immunizing children against life-threatening diseases. However, large disparities persist within countries.

The proportion of children receiving the full set of three diphtheria, pertussis and tetanus (DPT3) vaccines increased in nearly three-quarters of the districts in Africa between 2000 and 2016. However, in 29 of the 52 countries studied, DPT3 coverage varied more. less than 25% at the district level, highlighting substantial variations within countries.

The study, funded by the Bill & Melinda Gates Foundation and conducted by the Institute for Health Metrics and Evaluation at the University of Washington, was published in the international medical journal. The lancet.

"Despite substantial gains in coverage, progress was far from universal," said Dr. Jonathan Mosser, lead author of the study. "Routine childhood vaccinations are among the most effective and cost-effective public health interventions because they make a substantial contribution to children living beyond their fifth birthday, ensuring that all children have access to vaccines. salvators. "

The study, "Mapping Diphtheria-Pertussis-Tetanus Vaccine Coverage in Africa, 2000-2016: A Spatial and Temporal Modeling Study," maps countries in 5-by-5-km increments, so that officials health at the national and local levels can identify gaps in vaccination coverage and target interventions accurately, tailoring health policy decisions at the local level.

Using data from nearly 900,000 children, this badysis provides the first annual estimates of DTC-3 coverage among children across the African continent. It measures each community against the Global Immunization Action Plan, which is to achieve national coverage of 90% and 80% in each district. These goals were defined in 2012 by WHO member countries, as well as by other organizations, including UNICEF, the Gates Foundation and Gavi, the Vaccine Alliance, a public-private partnership for health committed to increasing access to immunization in poor countries.

Of the 52 countries surveyed, only Morocco and Rwanda have already reached the target of 80% coverage per district. On the other hand, at the local level, DPT3 coverage areas of 25% and below have been found in several countries, including Nigeria, Chad, Ethiopia, Somalia and Angola. In addition, abandonment rates above 25% have been identified in parts of Nigeria, Angola, Mali, Guinea, Liberia, Equatorial Guinea and Central African Republic. Central African Republic, Somalia and Ethiopia.

"National estimates can hide pockets of low coverage at the sub-national level, leaving children at risk for preventable diseases and deaths," said Mosser. "Our study provides health ministers and other country decision makers with clues to better understand local patterns of immunization coverage and to determine where to improve vaccine delivery systems."

A Gates Foundation official emphasized the value of the study and its geospatial mapping techniques.

"We know that many children do not get the vaccines they need, but we do not know exactly where they are," said Violaine Mitchell, Vaccine Delivery Program Director at the Bill & Melinda Gates Foundation. "These maps are a crucial step forward in revealing important details about the situation of unvaccinated children, so that tailor-made strategies can be developed to reach them and actually achieve equitable coverage."