A bibliometric analysis of childhood immunization research productivity in Africa since the onset of the Expanded Program on Immunization in 1974

Thursday, 21st of November 2013

[source]BMC Medicine[|source]

During the past four decades national EPI programs have developed or adapted and implemented a broad range of strategies and activities aimed at bringing services closer to the targeted community, increasing demand for immunization services, reaching previously unreached children, and improving immunization data quality. As a result, the mean proportion of the annual birth cohort that received a full series of three doses of the diphtheria, tetanus and pertussis vaccine (DTP3) reached 77% in sub-Saharan Africa in 2010.

The increase in childhood immunization coverage in Africa over the four decades would, therefore, be expected to have been accompanied by similar growth in childhood immunization research from the continent. Nope.

 

The authors in this article focus on the lack of association between research productivity and immunization coverage as an indication of lack of interactive communication between health decision-makers, program managers and researchers; to ensure that immunization policies and plans are always informed by the best available evidence. More details are available at:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599719/

Abstract

Background: The implementation of strategic immunization plans whose development is informed by available locally-relevant research evidence should improve immunization coverage and prevent disease, disability and death in Africa. In general, health research helps to answer questions, generate the evidence required to guide policy and identify new tools. However, factors that influence the publication of immunization research in Africa are not known. We, therefore, undertook this study to fill this research gap by providing insights into factors associated with childhood immunization research productivity on the continent. We postulated that research productivity influences immunization coverage.

Methods: We conducted a bibliometric analysis of childhood immunization research output from Africa, using research articles indexed in PubMed as a surrogate for total research productivity. We used zero-truncated negative binomial regression models to explore the factors associated with research productivity.

Results: We identified 1,641 articles on childhood immunization indexed in PubMed between 1974 and 2010 with authors from Africa, which represent only 8.9% of the global output. Five countries (South Africa, Nigeria, The Gambia, Egypt and Kenya) contributed 48% of the articles. After controlling for population and gross domestic product, The Gambia, Guinea-Bissau and Sao Tome and Principe were the most productive countries. In univariable analyses, the country,s gross domestic product, total health expenditure, private health expenditure, and research and development expenditure had a significant positive association with increased research productivity. Immunization coverage, adult literacy rate, human development index and physician density had no significant association. In the multivariable model, only private health expenditure maintained significant statistical association with the number of immunization articles.

Conclusions: Immunization research productivity in Africa is highly skewed, with private health expenditure having a significant positive association. However, the current contribution of authors from Africa to global childhood immunization research output is minimal. The lack of association between research productivity and immunization coverage may be an indication of lack of interactive communication between health decision-makers, program managers and researchers; to ensure that immunization policies and plans are always informed by the best available evidence.