Determinants of zero-dose children in Kamina, DR Congo
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Introduction : Vaccination is recognized as one of the most effective and cost-effective public health interventions. This work presents a summary of the factors that may explain the presence of zero-dose children in Congolese communities. Methods: This is a cross-sectional analytical study conducted between March 2024 and January 2025. The statistical units were children aged 12 to 23 months and the responding units were the mothers/guardians of these children selected through three (3) stage probability sampling. The data were collected using the SurveyCTO tool and analyzed using IBM SPSS 26 and Jamovi version 2.5.5 software. Cronbach's alpha coefficient allowed us to measure the internal consistency of the data. The associations were tested using the Pearson chi-square or Fischer exact test. The analysis of factors associated with zero-dose children was done using a multivariate logistic regression model of the "Wald Ascending" type. The Archer-Lemeshow test was used to assess the goodness of fit of the model and the ROC curve allowed us to evaluate the performance of the model. Results : The study indicated that the determinants of zero dose children in our environment are the mother's age less than or equal to 19 years (ORa= 10.996 [ 3.035 - 39.840 ]), the mother's low education level (ORa= 16.763 [ 2.230 - 125.991 ]), the mother's "unmarried" status (ORa= 16.436 [ 1.311 - 206.053 ]), the mother's occupation "worker" (ORa= 86.163 [ 12.839 - 578.252 ]), the child's home birth (ORa= 4.950 [ 1.127 - 21.748 ]), the perception that vaccination does not protect the child against diseases (ORa= 8,441 [ 2,385 - 29,872 ]) as well as the non-consideration of the recommendation of health personnel on the vaccination of the child (OR = 4,388 [ 1,254 - 15,354 ]). Conclusion : In order to reduce the incidence of zero-dose children, the study highlights the need to promote female education, deliveries in health facilities, communication activities and community engagement in favor of vaccination.
