Abstract of Master’s Dissertation
No.1
CourseHealth Innovation

NameGibson Omwansa Javes

ThesisInvestigating the Effectiveness of Rotavirus Vaccination in Stunting Prevention

Title

Among Children 6-23 Months: A Case-Control Study in Kwale County

Abstract of Master’s Dissertation
Background:
Stunting is a chronic malnutrition defined by a deficit in height/length for age. Globally,
the stunting problem has been declining except in Africa. It is controversial whether therotavirus vaccine which is intended to prevent the main cause of malnutrition (diarrhoea)
in children could help in reducing the prevalence of stunting in Kenya. The study will
demystify this controversy and contribute knowledge toward improving child health inKenya and similar settings.
Objectives:General Objective:

To assess the effectiveness of rotavirus vaccination on stunting prevention
among children between 6-23 months and assess other risk factors for stunting.

Specific Objectives:
To assess the rotavirus vaccination status in cases and control as a risk forstunting among children 6-23 months in Kwale county.

To assess growth faltering in cases and controls among children 6-23 months inKwale county.

To investigate other risk factors for stunting among cases and controls 6-23
months in Kwale county.

Methods:
A case controls study in Kwale county randomized 574 children aged 6-23 months
through a door-to-door survey. The outcome variable was stunting assessed on heightfor age.

Abstract of Master’s Dissertation
No.2
CourseHealth Innovation

Name

Gibson Omwansa Javes

The primary exposure was rotavirus vaccination status in terms of timing andcompleteness. The secondary exposures were other risk factors for stunting based on
previous literature. Unmatched analysis was performed using STATA for descriptive,bivariate, and multivariate levels. The hierarchical regression modelling was used todetermine the block of variables that explained the stunting outcome.
Results:
Malnutrition cases were prevalent among study participants where stunting was themost common at 54% while wasting and underweight were 34% and 17% respectively.
Around 33% of study participants were stunted, while 94% were fully vaccinated.
Timely or delayed first dose vaccination did not have an impact on stunting. However,the delay of the second dose was a protective factor (COR= 0.8, 95% CI:0.59-1.20).
Additionally, missing the second dose of rotavirus vaccination was associated with 30%
increased odds of stunting although both the results were not significant (AOR=1.3,95% CI:0.52-3.29).
Following the adjustment of results for age, location, water treatment, infections,undernutrition forms, birthweight, food quality, caregiver working status, and crowding,the vaccination status was ineffective in preventing stunting. However, a delayed
reception of first and second doses to around 8-9 and 12-13 weeks respectively after
birth were associated with relatively few diarrhoea days and better length for age. Adelay is necessary to allow waning of maternal antibodies and the development of achild's immunity to promote optimal seroconversion following vaccination. However,these results might be by chance due to the smaller sample size in the delayed
categories, thus bigger studies in future are recommended.
Conclusion:
Stunting prevalence had risen in Kwale county. However, changing the schedule forrotavirus reception could be a useful approach to preventing diarrhoea and so is therisk for stunting. However, it is prudent to consider the timing when a child in thesetting contracts the first episode of rotavirus infections before changing thevaccination schedule. Nevertheless, it is important to consider a holistic approach toaddress the stunting problem.