ArticleBMJ public health2026
Infant vaccination coverage trajectories and immunisation system archetypes in the WHO African region, 2019-2024: a longitudinal analysis of 47 countries.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: COVID-19 disrupted childhood vaccination, but country-specific heterogeneity in diphtheria-tetanus-pertussis-containing vaccines (DTP3) coverage across the WHO African region remains poorly understood. This study addressed this gap by quantifying temporal trajectories and identifying latent structural patterns in DTP3 coverage across all 47 countries in the WHO African region from 2019 to 2024, spanning the onset and recovery phases of the COVID-19 pandemic. Methods: Country-level DTP3 coverage data from 2019 to 2024 were extracted from the WHO/United Nations Children's Fund Estimates of National Immunisation Coverage, published in July 2025. Country-specific ordinary least squares regression models estimated annual rates of change (slopes) in DTP3 coverage, while linear mixed-effects modelling decomposed within-country and between-country variance components. Principal component (PC) analysis (PCA) was then applied to the 6-year coverage matrix to derive two dominant, uncorrelated components capturing coverage level (PC1) and temporal trajectory (PC2). K-means clustering of PC scores grouped countries into empirically distinct immunisation system archetypes. Results: Between 2019 and 2024, the estimated annual rate of change in DTP3 coverage was positive in 21 countries and negative in 24; Eritrea and Burkina Faso showed no evidence of a linear trend. The fixed-effect slope was 0.07 percentage points per year (95% CI -0.34 to 0.47; p=0.75), indicating no statistically significant net regional change, while between-country heterogeneity was substantial (random-intercept variance, 188.18; random-slope variance, 1.18). PCA showed that PC1 dominated, explaining 93% of variance (capturing sustained coverage level), with PC2 contributing an additional 3% (capturing temporal trajectory). K-means clustering of PC scores yielded four archetypes: cluster 1 (high coverage, consolidating; n=15), cluster 2 (chronically low coverage, divergent trajectories; n=9), cluster 3 (mid-low coverage, predominantly improving; n=11) and cluster 4 (mid-high coverage, erosion risk; n=12). Conclusion: This study generated an empirically derived, model-driven typology of immunisation system performance across the WHO African region, characterised by four distinct DTP3 coverage archetypes. The typology provides decision-makers with a granular basis for differentiating programmatic strategies, prioritising resource deployment and designing cluster-specific implementation research rather than applying uniform regional solutions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.