Demographic and Socioeconomic Disparities in Yellow Fever Vaccine Coverage Among Children in Chad: A Multilevel Analysis of a National Survey

Aremu, Olatunde and Durojaiye, Oyewole Christopher and Dalal, Koustuv (2026) Demographic and Socioeconomic Disparities in Yellow Fever Vaccine Coverage Among Children in Chad: A Multilevel Analysis of a National Survey. Health Services Insights, 19. ISSN 1178-6329

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Abstract

Background/Objective
Yellow fever is a vaccine-preventable hemorrhagic disease that causes morbidity and mortality in affected individuals. The burden of yellow fever is disproportionately borne by people in tropical regions worldwide, primarily in sub-Saharan Africa and South America. This study examined the contributions of individual- and contextual socioeconomic factors, as well as demographic and healthcare-use variables, to yellow fever vaccine coverage among children in Chad.
Methods
We used data from the most recent Chad Demographic and Health Survey (CDHS). Multilevel modelling techniques were applied to data on 8,039 children aged 12-59 months across 626 communities to estimate the odds ratio (OR) for receiving the yellow fever vaccine.
Results
Children born to mothers who were professionals had 116% higher odds of receiving the yellow fever vaccine compared to those whose mothers were not working (OR = 2.16; 95% CI, 1.04-3.18). In addition, analysis shows that the odds of receiving the yellow fever vaccine were 128% higher (OR =2.28; 95% CI, 1.80–3.24) among children from the richest households and those born in a healthcare facility (OR = 1.80; 95% CI, 1.40–2.20) than among their counterparts from poorer households and born at home. Children born to mothers with at least secondary education had 11% higher odds of receiving the yellow fever vaccine (OR = 1.11; 95% CI: 0.74–1.42) than those born to illiterate mothers. Children living in a low socioeconomic deprived community had 31% higher odds (OR =1.31; 95% CI: 1.06 to 2.08) when compared to their peers living in a highly socioeconomic deprived community.
Conclusions
This study indicates disparities stemming from healthcare service use and socioeconomic differentials at the individual, household, and community levels and their independent contributions to yellow fever vaccine coverage among children in Chad.

Item Type:	Article
Dates:	Date Event 21 September 2026 Accepted 7 October 2026 Published Online
Uncontrolled Keywords:	inequity, yellow fever, coverage, socioeconomic deprivation, child health
Subjects:	CAH03 - biological and sport sciences > CAH03-01 - biosciences > CAH03-01-01 - biosciences (non-specific)
Divisions:	Life and Health Sciences > Life and Sports Sciences
Depositing User:	Gemma Tonks
Date Deposited:	21 Oct 2026 13:32
Last Modified:	21 Oct 2026 13:32
URI:	https://www.open-access.bcu.ac.uk/id/eprint/17275

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