Trends and Characteristics of Child Non-Vaccination in Guinea from 1999 to 2018.

Introduction: The absence of vaccination among children remains a significant public health challenge in Guinea. The objective of this study was to describe the trends and profiles of unvaccinated children in Guinea in 1999, 2012, and 2018. Methods and Materials: This was a descriptive cross-sectional study conducted from July to December 2024, focusing on children aged 12 to 24 months, as well as their mothers, using secondary data from the 1999, 2012, and 2018 Demographic and Health Surveys, DHIS2 databases, SAP (Excel), and measles laboratory registers (2012-2018). All databases were cleaned, merged, and validated to avoid duplicates or data entry errors, and the information was handled confidentially. Results: Between 1999 and 2018, unvaccinated children were mostly male (52 to 53%) and resided in rural areas (87 to 93%). Firstborn children (up to 90%) and mothers with low levels of education (88 to 96% had no schooling) were the most represented. Access to information was very limited, with 98 to 100% of mothers having no access to printed media, 47 to 58% never listening to the radio, and 78% never watching television. In 2018, 60% of mothers had not attended any prenatal consultations, and 80% of deliveries took place at home. The majority of confirmed measles cases affected unvaccinated children (85%), more than half of whom (52%) were aged 0 to 2 years. The geographic distribution mainly corresponded to certain regions with high non-vaccination rates, including Middle and Upper Guinea. Although the Nzérékoré region reported a lower number of unvaccinated children compared to other regions, it paradoxically had the highest number of measles cases in 2012, accounting for 67% of reported cases. Conclusion: Our findings show that non-vaccination primarily affects children in rural areas, with uneducated, poorly informed mothers and limited access to healthcare. A targeted, community-based approach is essential to improve vaccination coverage and prevent epidemics.