**3. Results**

During the zero-dose identification, head counting of children under two was conducted in all households (100%) in the two most populous islets (Cap-Cameroon and Toube)—284 children under two years of age were identified. However, six children were excluded from the analysis because their parents were unavailable during the survey, and the available relatives could not provide information about their vaccination status.

The mean age of children included in the study was 11.6 months (SD = ±6.7), with male children overrepresented (53.2%). A considerable proportion of the children (92.8%) were born at home with the aid of traditional birth attendants. As such, most of them had no proof of dates of birth (birth certificates), 93.5%, making information on child age

heavily reliant on the caregiver's recall. Children had immigrant mothers for the most part (87.1%) and were mainly from the Cap-Cameroon health area (57.6%).

Of the 278 children retained for the final analysis, 8.3% were ASD children (1.8% completely vaccinated and 6.5% incompletely vaccinated), while 91.7% were zero-dose cases. ASD cases were mainly vaccinated during a national vaccination campaign (78.3%), with BCG being the most utilized antigen (73.9%). The details of the socio-demographic characteristics of all the children surveyed, the distribution of zero-dose children by sociodemographic factors, and the chi-square test results are outlined in Table 2 below. Table 3 highlights the vaccination profile of the surveyed children. This univariate analysis revealed that the child's age, birth site, owning a birth certificate, and nationality of both parents are significantly associated with zero-dose vaccination status. There was no significant difference in the distribution of zero-dose children among the variables of the other sociodemographic factors. However, the birth order, mother's age, mother's religion, and mother's educational level were included in the multivariate analysis based on *p* < 0.2 to increase the chance of capturing variables that might be associated with the zero-dose vaccination status.


**Table 2.** Distribution of zero-dose vaccination status by socio-demographic factors.

#### **Table 2.** *Cont.*


**Table 3.** Vaccination status of the children surveyed.

