{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T01:31:40Z","timestamp":1772155900869,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T00:00:00Z","timestamp":1655078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1020327"],"award-info":[{"award-number":["OPP1020327"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We determined the risk factors associated with unvaccinated children in rural Gambia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted prospective demographic surveillance and recorded immunisations in real time in the Upper River Region, The Gambia. Analysis included residents born from 1 January 2012 to 31 December 2016. Data included age, sex, household members and relationships, migrations, births, deaths, ethnicity, residential location and birth type. Children were defined as unvaccinated at 10, 15 and 24 mo of age if they missed all primary series doses (pentavalent, oral polio and pneumococcal conjugate vaccines), secondary series (first dose measles and yellow fever vaccines) or both vaccination series, respectively. Logistic regressions measured the association between risk factors and being unvaccinated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 5% (1567\/30\u2009832) of infants born during the study period and who were residents at the age of 10 mo were unvaccinated. Being unvaccinated at 10 mo of age was associated with children; who did not reside with either parent (adjusted OR 2.26, 95% CI 1.60 to 3.19), whose parents were not the head of household (1.29, 1.09 to 1.52), who had experienced immigration (2.78, 1.52 to 5.08) or who were not of Mandinka ethnicity (between 1.57 and 1.85 for other ethnicities).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Family characteristics are associated with unimmunised children in rural Gambia. Our findings may inform strategies to increase vaccine coverage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/trstmh\/trac051","type":"journal-article","created":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T11:20:22Z","timestamp":1655119222000},"page":"1063-1070","source":"Crossref","is-referenced-by-count":3,"title":["Risk factors associated with non-vaccination in Gambian children: a population-based cohort study"],"prefix":"10.1093","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1190-1456","authenticated-orcid":false,"given":"Benjamin","family":"Young","sequence":"first","affiliation":[{"name":"MRC Unit The Gambia at LSHTM , Fajara, 00000, The Gambia"},{"name":"London School of Hygiene and Tropical Medicine , London, WC1E 7HT, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3573-8457","authenticated-orcid":false,"given":"Golam","family":"Sarwar","sequence":"additional","affiliation":[{"name":"MRC Unit The Gambia at LSHTM , Fajara, 00000, The Gambia"},{"name":"London School of Hygiene and Tropical Medicine , London, WC1E 7HT, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0571-4702","authenticated-orcid":false,"given":"Ilias","family":"Hossain","sequence":"additional","affiliation":[{"name":"MRC Unit The Gambia at LSHTM , Fajara, 00000, The Gambia"},{"name":"London School of Hygiene and Tropical Medicine , London, WC1E 7HT, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4994-2627","authenticated-orcid":false,"given":"Grant","family":"Mackenzie","sequence":"additional","affiliation":[{"name":"MRC Unit The Gambia at LSHTM , Fajara, 00000, The Gambia"},{"name":"London School of Hygiene and Tropical Medicine , London, WC1E 7HT, United Kingdom"},{"name":"Murdoch Children's Research Institute , Melbourne, VIC 3052, Australia"},{"name":"Department of Paediatrics, University of Melbourne , Melbourne, VIC 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,6,13]]},"reference":[{"key":"2022110111181979700_bib1","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1186\/1471-2458-8-381","article-title":"Determinants of vaccination coverage in rural Nigeria","volume":"8","author":"Odusanya","year":"2008","journal-title":"BMC Public Health"},{"key":"2022110111181979700_bib2","first-page":"59","article-title":"Expanded programme on immunization","volume":"41:","author":"Keja","year":"1988;","journal-title":"World Heal Stat Q"},{"key":"2022110111181979700_bib3","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1186\/s12889-018-5762-5","article-title":"Vaccine wastage in the Gambia: a prospective observational study","volume":"18","author":"Usuf","year":"2018","journal-title":"BMC Public Health"},{"key":"2022110111181979700_bib4","article-title":"Available at","volume-title":"UNICEF Immunization","author":"UNICEF. Vaccination and Immunization Statistics - UNICEF DATA","year":"2020"},{"key":"2022110111181979700_bib5","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1146\/annurev.publhealth.20.1.211","article-title":"Eradication of vaccine-preventable diseases","volume":"20","author":"Hinman","year":"1999","journal-title":"Annu Rev Public Health"},{"key":"2022110111181979700_bib6","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1016\/S0140-6736(10)60549-1","article-title":"Global, regional, and national causes of child mortality in 2008: a systematic analysis","volume":"375","author":"Black","year":"2010","journal-title":"Lancet"},{"key":"2022110111181979700_bib7","volume-title":"Number of deaths in children aged &lt;5, by cause","author":"WHO","year":"2018"},{"key":"2022110111181979700_bib8","first-page":"58","article-title":"Factors influencing low immunization coverage among children between 12 - 23 months in East Pokot, Baringo Country, Kenya","volume-title":"Int J Vacc","author":"Kiptoo","year":"2015"},{"key":"2022110111181979700_bib9","author":"WHO","year":"2020"},{"key":"2022110111181979700_bib10","first-page":"12","article-title":"Crude childhood vaccination coverage in West Africa: trends and predictors of completeness","volume":"2","author":"Kazungu","year":"2017","journal-title":"Open Res"},{"key":"2022110111181979700_bib11","doi-asserted-by":"crossref","first-page":"e107280","DOI":"10.1371\/journal.pone.0107280","article-title":"Coverage and timing of children's vaccination: an evaluation of the expanded programme on immunisation in the Gambia","volume":"9","author":"Scott","year":"2014","journal-title":"PLoS One"},{"key":"2022110111181979700_bib12","article-title":"Gambia: WHO and UNICEF estimates of immunization coverage: 2017 revision","author":"WHO & UNICEF"},{"key":"2022110111181979700_bib13","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1186\/s12913-015-1015-9","article-title":"Risk factors for delay in age-appropriate vaccinations among Gambian children","volume":"15","author":"Odutola","year":"2015","journal-title":"BMC Health Serv Res"},{"key":"2022110111181979700_bib14","volume-title":"Review of The Gambia Expanded Programme on Immunization","author":"UNICEF","year":"2001"},{"key":"2022110111181979700_bib15","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/S0140-6736(05)66788-8","article-title":"Elimination of haemophilus influenzae type b (Hib) disease from the Gambia after the introduction of routine immunisation with a hib conjugate vaccine: a prospective study","volume":"366","author":"Adegbola","year":"2005","journal-title":"Lancet"},{"key":"2022110111181979700_bib16","first-page":"135","article-title":"Reasons for non-immunization of children in an urban, low income group in north India","volume":"32","author":"Mathew","year":"2002","journal-title":"Trop Dr"},{"key":"2022110111181979700_bib17","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1136\/bmj.332.7553.1312","article-title":"Differences in risk factors for partial and no immunisation in the first year of life: prospective cohort study","volume":"332","author":"Samad","year":"2006","journal-title":"BMJ"},{"key":"2022110111181979700_bib18","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/1471-2458-6-125","article-title":"Vaccination coverage and reasons for non-vaccination in a district of Istanbul","volume":"6","author":"Torun","year":"2006","journal-title":"BMC Public Heal"},{"key":"2022110111181979700_bib19","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.inhe.2012.07.004","article-title":"Why children are not vaccinated: a review of the grey literature","volume":"4","author":"Favin","year":"2012","journal-title":"Int Heal"},{"key":"2022110111181979700_bib20","doi-asserted-by":"crossref","first-page":"3861","DOI":"10.1016\/j.vaccine.2018.03.063","article-title":"Vaccine hesitancy around the globe: analysis of three years of WHO\/UNICEF joint reporting form data-2015\u20132017","volume":"36","author":"Lane","year":"2018","journal-title":"Vaccine"},{"key":"2022110111181979700_bib21","doi-asserted-by":"crossref","first-page":"5288","DOI":"10.1016\/j.vaccine.2018.07.024","article-title":"Reasons for non-vaccination and incomplete vaccinations among children in Pakistan","volume":"36","author":"Riaz","year":"2018","journal-title":"Vaccine"},{"key":"2022110111181979700_bib22","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1002\/(SICI)1097-0258(19990430)18:8<947::AID-SIM95>3.0.CO;2-B","article-title":"A comparison of mixed effects logistic regression models for binary response data with two nested levels of clustering","volume":"18","author":"Ten Have","year":"1999","journal-title":"Stat Med"},{"key":"2022110111181979700_bib23","first-page":"194","article-title":"Reasons for incomplete vaccination and factors for missed opportunities among rural Nigerian children","volume":"3","author":"Abdulraheem","year":"2011","journal-title":"J Public Heal Epidemiol"},{"key":"2022110111181979700_bib24","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1016\/S0140-6736(09)60317-2","article-title":"Timing of children's vaccinations in 45 low-income and middle-income countries: an analysis of survey data","volume":"373","author":"Clark","year":"2009","journal-title":"Lancet"},{"key":"2022110111181979700_bib25","doi-asserted-by":"crossref","first-page":"3335","DOI":"10.1016\/j.vaccine.2016.05.017","article-title":"Barriers to timely administration of birth dose vaccines in the Gambia, west Africa","volume":"34","author":"Miyahara","year":"2016","journal-title":"Vaccine"},{"key":"2022110111181979700_bib26","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/j.1365-3156.2007.01982.x","article-title":"Ascertainment of childhood vaccination histories in northern Malawi","volume":"13","author":"Jahn","year":"2008","journal-title":"Trop Med Int Heal"},{"key":"2022110111181979700_bib27","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1111\/j.1365-3156.2012.02989.x","article-title":"Unvaccinated children in years of increasing coverage: How many and who are they? Evidence from 96 low- and middle-income countries","volume":"17","author":"Bosch-Capblanch","year":"2012","journal-title":"Trop Med Int Heal"},{"key":"2022110111181979700_bib28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-019-4142-x","article-title":"Household relationships and healthcare seeking behaviour for common childhood illnesses in sub-Saharan Africa: a cross-national mixed effects analysis","volume":"19","author":"Akinyemi","year":"2019","journal-title":"BMC Health Serv Res"},{"key":"2022110111181979700_bib29","doi-asserted-by":"crossref","first-page":"2258","DOI":"10.3945\/jn.108.092437","article-title":"Only children of the head of household benefit from increased household food diversity in northern Ghana","volume":"138","author":"Leroy","year":"2008","journal-title":"J Nutr"},{"key":"2022110111181979700_bib30","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1136\/bmj.311.7003.481","article-title":"Non-specific beneficial effect of measles immunisation: analysis of mortality studies from developing countries","volume":"311","author":"Aaby","year":"1995","journal-title":"BMJ"}],"container-title":["Transactions of The Royal Society of Tropical Medicine and Hygiene"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/trstmh\/article-pdf\/116\/11\/1063\/46712584\/trac051.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/trstmh\/article-pdf\/116\/11\/1063\/46712584\/trac051.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T07:20:04Z","timestamp":1667287204000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/trstmh\/article\/116\/11\/1063\/6607703"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,13]]},"references-count":30,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,6,13]]},"published-print":{"date-parts":[[2022,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/trstmh\/trac051","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.03.19.21253855","asserted-by":"object"}]},"ISSN":["0035-9203","1878-3503"],"issn-type":[{"value":"0035-9203","type":"print"},{"value":"1878-3503","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,11]]},"published":{"date-parts":[[2022,6,13]]}}}