ArticleBMC public health2025
Determinants of incomplete age-appropriate immunization among hill tribe children under six years of age in Chiang Rai Province, Thailand: a community-based case-control study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe poor access rate of the expanded program on immunization (EPI) service among hill tribe children under six years of age has clearly been observed, resulting in several episodes of outbreaks of measles, diphtheria, and pertussis reported among the children in the hill tribe villages in Chiang Rai Province. This study aimed to investigate the determinants of incomplete immunization among hill tribe children under six years of age in Chiang Rai Province, Thailand.
methodsA community-based case-control study was conducted to collect data from caregivers of hill tribe children under six years of age residing in Chiang Rai Province using a structured questionnaire. Data were collected through face-to-face interviews. Logistic regression was used to identify factors associated with incomplete age-appropriate immunization, with a significance level of α = 0.05.
resultsA total of 600 participants were analyzed. 204 (34.0%) children were incomplete immunization: 53.9% were female, 49.5% were aged over 4 years, 91.7% were members of Lahu and Akha, and 63.7% of caregivers were aged over 30 years. Three factors were significantly associated with incomplete immunization among young hill tribe children in the multivariable analysis. Children without Thai nationality had a 2.50-fold greater chance of incomplete immunization than did children with Thai nationality (95% CI: 1.01-6.18). Children whose mothers had never attended antenatal clinics during their pregnancy had a 5.61-fold greater chance of incomplete immunization than did children with mothers who had attended antenatal clinics during their pregnancy (95% CI: 1.67-18.84). Finally, children whose caregivers were over 30 years of age had a 1.67 times greater chance of incomplete immunization than those whose caregivers were under 30 years old (95% CI: 1.02-2.72).
conclusionsHill tribe children under six years of age who are non-Thai citizens, whose caregivers are over 30 years of age, and whose mothers have never been cared for during pregnancy are likely to be incompletely immunized. Public health interventions focused on caregivers aged over 30 years or mothers who have never been cared for properly during pregnancy should be carefully designed and implemented, particularly to increase community engagement.
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