Validity of maternal recall for estimating vaccination coverage in children aged 12 to 23 months in the health district of Podor in 2020 (Senegal)

Abstract

Abstract Methods The study was cross-sectional. Mothers of children aged 12 to 23 months represented the study population. Cluster sampling was carried out. Bacillus Calmette- Guerin vaccine (BCG), hepatitis B vaccine birth dose (HepB-BD), third dose of oral polio vaccine (OPV3), third dose of diphtheria, pertussis, tetanus, hepatitis B and haemophilus influenzae type b vaccine (Penta3) and first dose of measles-rubella vaccine (MR1) were used to assess the validity of maternal recall compared to HBR or HFR. Sensitivity, specificity, concordance, and Cohen's kappa and prevalence-adjusted bias-adjusted Kappa (PABAK) were estimated. Logistic regression revealed the determinants of recall bias. Results A total of 832 mothers were interviewed. Concordance ranged from 79–83.8%; the recall bias from 16.2–21%, the sensitivity from 80.6–86.7%, the specificity from 54–74.5%, the Kappa coefficient from 24.8 to 37.6 and the PABAK from 58 to 67.6. Concerning the vaccination status for BCG (OR = 2.38; p-value = 0.034), HepB-BD (OR = 2.2; p-value = 0.031) and Penta3 (OR = 2.93; p-value = 0.017), recall bias occurred more frequently in rural areas. The vaccination status of male children for HepB-BD (OR = 0.64; p-value = 0.034) was less subject to recall bias. In addition, the lack of prenatal and postnatal education on childhood vaccination was found to be a determinant of recall bias regarding vaccination status for BCG (OR = 2.94; p-value = 0.007) and Penta3 (OR = 1.96; p-value = 0.046), respectively. Conclusion Recall bias is relatively high for all vaccines. Maternal recall would be less valid than HBR or HFR. Further studies would be needed to confirm or refute these results.