ArticleBMJ open2021
Exploring spatial variation in BCG vaccination among children 0-35 months in Ethiopia: spatial analysis of Ethiopian Demographic and Health Survey 2016.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- Determinants of BCG vaccine coverage among 0-2 months aged Somali children: Promoting equality in vaccination.Human vaccines & immunotherapeutics · 2026Article
- Geospatial disparities in post-pandemic SARS-CoV-2 vaccination: Evidence from Chile beyond the national success.PLOS global public health · 2026Article
- Article
- Spatial distribution of effective coverage of child immunisation in Ethiopia.BMJ public health · 2025Article
- Spatial co-distribution of tuberculosis prevalence and low BCG vaccination coverage in Ethiopia.Scientific reports · 2024Article
- Spatial distribution of zero-dose children in Ethiopia: evidence for a targeted intervention from a large-scale cross-sectional evaluation survey.Frontiers in pediatrics · 2024Article
- Spatial behavior of hepatitis A, MMR, and varicella vaccination coverage in the state of Minas Gerais, 2020.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2023Article
- Mapping BCG vaccination coverage in Ethiopia between 2000 and 2019.BMC infectious diseases · 2022Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTuberculosis is a major public health problem and is the second leading cause of death worldwide. BCG vaccination is a life-saving and important part of standard tuberculosis control measures, particularly in Ethiopia where tuberculosis is endemic. The End Tuberculosis Strategy targets of 2020 have not been achieved. Exploring spatial variations in BCG vaccination among children is vital to designing and monitoring effective intervention programmes. Therefore, this study aimed to explore the spatial variation in BCG vaccination among children in Ethiopia.
designCross-sectional study design.
settingEthiopia.
participantsChildren aged 0-35 months. PRIMARY OUTCOME: BCG vaccination coverage.
methodsData from the 2016 Ethiopian Demographic and Health Survey were used and a total of 4453 children aged 0-35 months were included. Spatial autocorrelation analysis, cluster and outlier analysis, hotspot analysis, spatial interpolation, and spatial scan statistics were carried out to identify geographical risk areas for BCG vaccine utilisation. ArcGIS V.10.6 and SaTScan V.9.6 statistical software were employed to explore spatial pattern and significant hotspot areas for BCG vaccination among children.
resultsBCG vaccination was spatially clustered in Ethiopia at the regional level (Global Moran's I=0.516, p<0.001). A total of 51 most likely clusters of low BCG vaccination were identified in the Somali and Afar regions (log-likelihood ratio=136.58, p<0.001). Significant secondary clusters were also identified in North West Gambela, South Amhara, South West Addis Ababa, North East Southern Nations, Nationalities, and People's Region, and South West Oromia.
conclusionA low probability of receiving BCG vaccination was found among children in the Somali and Afar regions. Therefore, these areas should be given attention when designing effective immunisation strategies to improve BCG vaccination among children in order to reduce the burden of tuberculosis in Ethiopia.
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