Interventions to improve vaccination coverage among children aged 12-23 months in urban slum areas of Asia: A systematic review and meta-analysis.
Kazi Fayzus Salahin, Ricvan Dana Nindrea, Quazi Monirul Islam et al.
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In 30 seconds
This systematic review and meta-analysis assessed interventions to improve vaccination coverage among children aged 12–23 months in Asian slum areas. Nine quasi-experimental and randomized controlled studies from Bangladesh, India, Indonesia, and Pakistan included 37,405 children. Full vaccination coverage probably improved in one RCT (OR 6.42, 95% CI 4.63-8.90) and in three quasi-experimental studies (OR 9.68, 95% CI 3.91-23.95), although the latter results had high heterogeneity. DPT3 coverage improved in two RCTs (OR 2.68, 95% CI 2.17-3.31). Evidence certainty varied, and study bias was common.
Key findings
- One RCT found higher full vaccination coverage with intervention (OR 6.42, 95% CI 4.63-8.90).
- Three quasi-experimental studies reported improved full vaccination coverage (OR 9.68, 95% CI 3.91-23.95), with high heterogeneity.
- Two RCTs found improved DPT3 coverage (OR 2.68, 95% CI 2.17-3.31; 1872 participants; I² = 0%).
- Quasi-experimental studies showed uncertain effects on DPT3 coverage (OR 3.58, 95% CI 2.99-4.28; 31,817 participants; I² = 78%).
Why it matters
The findings suggest that single- or multicomponent interventions can improve vaccination coverage among children in Asian slum settings, including DPT3 coverage. However, confidence in the results is constrained by methodological bias and, for some analyses, substantial heterogeneity. The review highlights both the potential for targeted strategies and the need for stronger evidence on their effectiveness and sustainability.
What to keep in mind
Included studies had moderate to high or serious risk of bias. Quasi-experimental findings showed high heterogeneity, and the review notes limited sustainability of implemented interventions.