Prevalence and factors associated with zero-dose children amongst nomadic and non-nomadic fulani in Yobe State, NorthEast Nigeria

Abstract

Background: Immunization is a very cost-effective and readily available intervention capable of preventing Vaccines
Preventable Diseases (VPDs). This study aimed to identify and compare the prevalence and factors associated with zero-dose
immunization status among children of nomadic and non-nomadic Fulani in Yobe State, North-East Nigeria.
Methodology: A comparative cross-sectional design was used to study 348 nomadic, and 345 non-nomadic under-five children,
selected using a multi-staged sampling technique. Data were collected using interviewer-administered questionnaires, observation
of child immunization card, and recall by the caregivers, and were analysed using IBM SPSS version 22.0 with a statistical
significance set at P ≤5%.
Results: The maximum age of the nomadic caregivers was 60 and the minimum was 17 years with a mean ±SD of 28.2±7.7
years. The maximum age of the non-nomadic caregivers was 78 and the minimum was 17 years with a mean ±SD of 33.0±10.0
years. The prevalence of zero-dose children among nomadic and non-nomadic Fulani were (70.1%, 242), (61.8%, 63)
respectively. The zero-dose children were significantly higher among nomads (87.2%, p<0.001) and non-nomad (54.4%,
p<0.001) with no available child immunization card. The children of vaccines hesitant caregivers of nomads and non-nomads
were 10 or more times more likely to be zero doses than non-hesitant caregivers (adjusted odds ratio [aOR] =477, 95% CI =
[177–13031]), and (Adjusted odds ratio [aOR] =9.7, 95% CI = [2.1–44.3]) respectively.
Conclusions: The burden of zero-dose was alarmingly high among nomads compared to non-nomad Fulani despite widespread
immunization outreach services in the study area. The government and relevant stakeholders should intensify Context-specific
health promotion activities and outreach services targeting these underserved populations.