PMID- 36962208
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231101
IS  - 2767-3375 (Electronic)
IS  - 2767-3375 (Linking)
VI  - 2
IP  - 5
DP  - 2022
TI  - Population and sub-national (district) level diversity in missed and dropout of 
      different doses of hepatitis-B vaccine among Indian children aged 12-59 months.
PG  - e0000243
LID - 10.1371/journal.pgph.0000243 [doi]
LID - e0000243
AB  - Initiating with a birth dose and a full immunization against hepatitis-B is 
      crucial during early childhood in a country like India where maternal screening 
      of hepatitis-B surface antigen is almost negligible and there is a considerable 
      risk of vertical transmission among children. It is also evident that coverage of 
      hepatitis-B is lowest among all other vaccine doses included in the universal 
      immunization program. In addition, the major challenge is posed by the missed and 
      drop-out of different doses of hepatitis-B among Indian children. In this 
      context, this study examined the population and sub-national level diversity in 
      missed and dropout of different doses of hepatitis-B vaccine in India. We 
      analysed a large dataset of 196,654 children aged 12-59 months from a nationally 
      representative cross-sectional survey, the National Family Health Survey (NFHS), 
      2015-16. Bivariate cross tabulation was used to estimate the prevalence and the 
      dropout rates. Multivariable-adjusted logistic regression was applied to assess 
      the likelihood of the study events. Within a Bayesian framework, a district-level 
      spatial analysis was conducted employing the Besag-York-Mollie (BYM) Model and 
      the Leroux Model. During 2016, 38% of the children missed the birth dose 
      nationally and 45% of the children did not complete full immunization of 
      hepatitis-B. Findings suggest, presence of socio-economic and demographic 
      gradients in missed and drop-out of different doses of hepatitis-B at national 
      level. The sub-national level spatial analysis identifies more than 280 (out of 
      640) districts with substantially higher risk (Posterior Median Risk>1) in terms 
      of missed and drop-out of different doses. Most of these districts are scattered 
      across the North-Eastern and Northern part of India. The findings hint the 
      existence of a population and sub-national level diversity in India's missed out 
      and dropout of hepatitis-B doses. Identifying high risk population sub-groups and 
      the districts with children at higher risk of missing the birth and consecutive 
      doses informs the existing knowledge base and helps in formulating 
      community-oriented policies and programs.
CI  - Copyright: (c) 2022 Khan et al. This is an open access article distributed under 
      the terms of the Creative Commons Attribution License, which permits unrestricted 
      use, distribution, and reproduction in any medium, provided the original author 
      and source are credited.
FAU - Khan, Junaid
AU  - Khan J
AUID- ORCID: 0000-0003-4662-2318
AD  - LASI, International Institute for Population Sciences, Mumbai, Maharashtra, 
      India.
FAU - Shil, Apurba
AU  - Shil A
AUID- ORCID: 0000-0002-9043-0244
AD  - Dept. of Public Health, Faculty of Health Sciences, Ben-Gurion University of the 
      Negev, Beersheba, Israel.
FAU - Puri, Parul
AU  - Puri P
AUID- ORCID: 0000-0001-6272-837X
AD  - International Institute for Population Sciences, Mumbai, Maharashtra, India.
LA  - eng
PT  - Journal Article
DEP - 20220517
PL  - United States
TA  - PLOS Glob Public Health
JT  - PLOS global public health
JID - 9918283779606676
PMC - PMC10021217
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/03/25 06:00
MHDA- 2023/03/25 06:01
PMCR- 2022/05/17
CRDT- 2023/03/24 17:49
PHST- 2021/11/23 00:00 [received]
PHST- 2022/04/19 00:00 [accepted]
PHST- 2023/03/24 17:49 [entrez]
PHST- 2023/03/25 06:00 [pubmed]
PHST- 2023/03/25 06:01 [medline]
PHST- 2022/05/17 00:00 [pmc-release]
AID - PGPH-D-21-01002 [pii]
AID - 10.1371/journal.pgph.0000243 [doi]
PST - epublish
SO  - PLOS Glob Public Health. 2022 May 17;2(5):e0000243. doi: 
      10.1371/journal.pgph.0000243. eCollection 2022.