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Open AccessArticle

Coverage and Timeliness of Birth Dose Vaccination in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

by Oumar Bassoum 1,2,†, Moe Kimura 3,4,†, Anta Tal Dia 1,2, Maud Lemoine 3 and Yusuke Shimakawa 5,*
1
Faculté de Médecine, de Pharmacie et d’Odontologie, Université Cheikh Anta Diop de Dakar, Dakar-Fann 5005, Senegal
2
Institut de Santé et Développement, Université Cheikh Anta Diop de Dakar, Dakar-Fann 16390, Senegal
3
Department of Metabolism, Digestion and Reproduction, Section of Hepatology and Gastroenterology, Imperial College, London W2 1NY, UK
4
Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
5
Unité d’Épidémiologie des Maladies Émergentes, Institut Pasteur, 25-28 rue du Dr Roux, 75015 Paris, France
*
Author to whom correspondence should be addressed.
These authors contributed equally.
Vaccines 2020, 8(2), 301; https://doi.org/10.3390/vaccines8020301
Received: 16 May 2020 / Revised: 6 June 2020 / Accepted: 6 June 2020 / Published: 11 June 2020
(This article belongs to the Special Issue Timely Administration of the Hepatitis B Birth Dose Vaccine)
Background: Depending on the epidemiological context of each country, three vaccines are recommended by the World Health Organization (WHO) to be administered as soon as possible after birth (birth vaccines); namely, BCG, zero dose of oral polio vaccine (OPV0), and birth dose of hepatitis B vaccine (HepB-BD). The timely administration of these vaccines immediately after birth might pose significant challenges in sub-Saharan Africa, where about half of childbirths occur outside health facilities. We therefore conducted a systematic review and meta-analysis to estimate the coverage rate of these vaccines at a specific timing in neonates in sub-Saharan Africa. Methods: We searched PubMed, Embase, CINAHL, and Web of Science for studies conducted in sub-Saharan Africa and published up to March 31, 2017, which provided a coverage rate of the birth vaccines at any specific time points within 28 days after birth. Two investigators independently screened the titles and abstracts and extracted data from the eligible full-text articles. This study was registered in PROSPERO (CRD42017071269). Results: Of 7283 articles identified, we finally included 31 studies with 204,111 infants in the meta-analysis. The pooled coverage rates at day 0–1 after birth were 14.2% (95% CI: 10.1–18.9) for BCG and 1.3% (0.0–4.5) for HepB-BD. No data were available for OPV0 at day 0–1. The coverage at day 28 was 71.7% (63.7–79.2) for BCG, 60.8% (45.8–74.7) for HepB-BD, and 76.1% (67.1–84.0) for OPV0. No significant difference in the vaccine coverage was observed between infants born in healthcare facilities and those born outside facilities. Conclusions: The rates of vaccine coverage immediately after birth were very low for BCG and HepB-BD, and no data for OPV0. We need additional data to better define barriers and facilitators for the timely administration of the birth vaccines in sub-Saharan Africa, since the delay in its provision may increase the burden of these vaccine-preventable diseases. View Full-Text
Keywords: birth dose vaccination; BCG; polio vaccine; hepatitis B vaccine; sub-Saharan Africa; systematic review birth dose vaccination; BCG; polio vaccine; hepatitis B vaccine; sub-Saharan Africa; systematic review
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Bassoum, O.; Kimura, M.; Tal Dia, A.; Lemoine, M.; Shimakawa, Y. Coverage and Timeliness of Birth Dose Vaccination in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. Vaccines 2020, 8, 301.

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