Effect of community mentoring on measles-containing vaccine (MCV) coverage among children aged 9 to 23 months of adolescent mothers in the Binza Météo health zone: A systematic review

Alpha-Sandul Landu Makesi; Emery Kafinga Luzolo; Gabriel Nsakala Viodiena; Albert Bushabu Kongo; Jean Paul Koto-Te-Nyiwa Ngbolua; Leyka Mukandu Basua Babintu

doi:10.51168/x9npxb04

Autori

Alpha-Sandul Landu Makesi Doctoral School of Health Sciences, Kinshasa, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo , National Pedagogical University, Faculty of Health Sciences, Department of Paediatrics, Kinshasa, Democratic Republic of the Congo
Emery Kafinga Luzolo Doctoral School of Health Sciences, Kinshasa, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo
Gabriel Nsakala Viodiena Doctoral School of Health Sciences, Kinshasa, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo , National Pedagogical University, Faculty of Health Sciences, Department of Paediatrics, Kinshasa, Democratic Republic of the Congo
Albert Bushabu Kongo Doctoral School of Health Sciences, Kinshasa, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo , Department of Medical Biology, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo
Jean Paul Koto-Te-Nyiwa Ngbolua Doctoral School of Health Sciences, Kinshasa, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo , University of Kinshasa, Faculty of Science and Technology, Department of Biology, Kinshasa, Democratic Republic of the Congo
Leyka Mukandu Basua Babintu Doctoral School of Health Sciences, Kinshasa, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo , National Pedagogical University, Faculty of Health Sciences, Department of Paediatrics, Kinshasa, Democratic Republic of the Congo

DOI:

https://doi.org/10.51168/x9npxb04

Cuvinte cheie:

Community mentoring, vaccination, measles, adolescent mothers, Democratic Republic of the Congo

Rezumat

Background: Measles-containing vaccine (MCV) coverage in the Democratic Republic of the Congo (DRC) remains below the 95% elimination threshold, and adolescent childbearing is common. Children of adolescent mothers may be at increased risk of under-vaccination, yet evidence on community mentoring for this group in Kinshasa is scarce.

Objective: To synthesize evidence on the potential contribution of community mentoring to MCV coverage among children of adolescent mothers, in order to inform a field study in the Binza Météo Health Zone.

Methods: Following PRISMA 2020, PubMed/MEDLINE, the Cochrane Library, Google Scholar, African Journals Online, three trial registries and institutional websites were searched for studies published between 2010 and 2025. Two reviewers independently screened records, extracted data and assessed risk of bias using Joanna Briggs Institute checklists and AMSTAR-2. Findings were synthesized narratively across five themes, and certainty of evidence was rated with GRADE.

Results: Nineteen studies were included. None simultaneously addressed community mentoring, MCV coverage and adolescent mothers. Indirect evidence showed that a mentor mother programme improved retention of mother–infant pairs in care (71.2% vs 20.6% at 18 months), and that community health worker interventions increased complete childhood vaccination by 10.1 percentage points in Kenya and by 20.4 percentage points in Pakistan (adjusted RR 1.39). Young maternal age was associated with incomplete vaccination in Ethiopia (AOR 4.23) and Kinshasa, but not in all settings. Certainty of evidence was low to very low.

Conclusion: Community mentoring could plausibly improve MCV coverage among children of adolescent mothers, but direct evidence is lacking.

Need for future research: A context-specific cluster-randomized or quasi-experimental study in the Binza Météo Health Zone is needed to test this hypothesis and to measure the effect of community mentoring on card-verified MCV1 and MCV2 coverage.

Biografii autori

Alpha-Sandul Landu Makesi, Doctoral School of Health Sciences, Kinshasa, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo, National Pedagogical University, Faculty of Health Sciences, Department of Paediatrics, Kinshasa, Democratic Republic of the Congo
Emery Kafinga Luzolo, Doctoral School of Health Sciences, Kinshasa, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo
Gabriel Nsakala Viodiena, Doctoral School of Health Sciences, Kinshasa, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo, National Pedagogical University, Faculty of Health Sciences, Department of Paediatrics, Kinshasa, Democratic Republic of the Congo
Albert Bushabu Kongo, Doctoral School of Health Sciences, Kinshasa, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo, Department of Medical Biology, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo
Jean Paul Koto-Te-Nyiwa Ngbolua, Doctoral School of Health Sciences, Kinshasa, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo, University of Kinshasa, Faculty of Science and Technology, Department of Biology, Kinshasa, Democratic Republic of the Congo
Leyka Mukandu Basua Babintu, Doctoral School of Health Sciences, Kinshasa, Higher Institute of Medical Techniques (ISTM) of Kinshasa, Democratic Republic of the Congo, National Pedagogical University, Faculty of Health Sciences, Department of Paediatrics, Kinshasa, Democratic Republic of the Congo

Referințe

1. Abebe, A. M., Mengistu, T., & Mekuria, A. D. (2019). Measles cases, immunization coverage and its determining factors among 12–23-month-old children in Bassona Worena Woreda, Amhara Region, Ethiopia, 2018. BMC Research Notes, 12, 71. https://doi.org/10.1186/s13104-019-4104-8

2. Aromataris, E., & Munn, Z. (Eds.). (2020). JBI manual for evidence synthesis. JBI. https://doi.org/10.46658/JBIMES-20-01

3. Atuyambe, L., Mirembe, F., Tumwesigye, N. M., Annika, J., Kirumira, E. K., & Faxelid, E. (2008). Adolescent and adult first-time mothers’ health-seeking practices during pregnancy and early motherhood in Wakiso District, central Uganda. Reproductive Health, 5, 13. https://doi.org/10.1186/1742-4755-5-13

4. Bangura, J. B., Xiao, S., Qiu, D., Ouyang, F., & Chen, L. (2020). Barriers to childhood immunisation in sub-Saharan Africa: A systematic review. BMC Public Health, 20, 1108. https://doi.org/10.1186/s12889-020-09169-4

5. Boisson-Walsh, A., Thompson, P., Fried, B., Shea, C. M., Ngimbi, P., Babakazo, P., & Yotebieng, M. (2023). Determinants of childhood immunisation uptake in Kinshasa, Democratic Republic of the Congo: Ordered regressions to assess timely infant vaccines administered at birth and at 6 weeks. Global Health Research and Policy, 8, 50. https://doi.org/10.1186/s41256-023-00338-7

6. Bokoko Bikoko, G., Eya Matangelo Eloko, G., Libima Mokolo, J., Kandolo Tshimungu, F., Ohambe Omanyondo, M.-C., & Ngbolua, K.-T.-N. (2025). Determinants of vaccination dropout among children aged 6 to 59 months in the Mbandaka urban-rural health zone, Democratic Republic of the Congo. Revue Congolaise des Sciences et Technologies, 4(1). https://doi.org/10.59228/rcst.025.v4.i1.138

7. Budu, E., Ahinkorah, B. O., Aboagye, R. G., Armah-Ansah, E. K., Seidu, A.-A., Adu, C., Ameyaw, E. K., & Yaya, S. (2021). Maternal healthcare utilisation and complete childhood vaccination in sub-Saharan Africa: A cross-sectional study of 29 nationally representative surveys. BMJ Open, 11(3), e045992. https://doi.org/10.1136/bmjopen-2020-045992

8. Campbell, M., McKenzie, J. E., Sowden, A., Katikireddi, S. V., Brennan, S. E., Ellis, S., Hartmann-Boyce, J., Ryan, R., Shepperd, S., Thomas, J., Welch, V., & Thomson, H. (2020). Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline. BMJ, 368, l6890. https://doi.org/10.1136/bmj.l6890

9. Carbone, N. B., Njala, J., Jackson, D. J., Eliya, M. T., Chilangwa, C., Tseka, J., Zulu, T., Chinkonde, J. R., Sherman, J., Zimba, C., Mofolo, I. A., & Herce, M. E. (2019). I would love if there was a young woman to encourage us…: Adapting the Mothers2Mothers Mentor Mother Model for adolescent mothers living with HIV in Malawi. PLOS ONE, 14(6), e0217693. https://doi.org/10.1371/journal.pone.0217693

10. Carlucci, J. G., Yu, Z., González, P., Bravo, M., Amorim, G., das Felicidades Cugara, C., Guambe, H., Mucanhenga, J., Silva, W., Tique, J. A., Sardella Alvim, M. F., Graves, E., De Schacht, C., & Wester, C. W. (2022). The effect of a Mentor Mothers programme on the prevention of vertical transmission of HIV in Zambézia Province, Mozambique: A retrospective interrupted time series analysis. Journal of the International AIDS Society, 25(6), e25952. https://doi.org/10.1002/jia2.25952

11. Chilot, D., Belay, D. G., Shitu, K., Gela, Y. Y., Getnet, M., Mulat, B., et al. (2022). Measles second-dose (MCV2) uptake among children aged 24–35 months in sub-Saharan Africa: A multilevel analysis from recent Demographic and Health Surveys. BMC Public Health, 22, 2070. https://doi.org/10.1186/s12889-022-14478-x

12. Cheng, A., Ghanem-Uzqueda, A., Hoff, N. A., Ashbaugh, H., Doshi, R. H., Mukadi, P., Budd, R., Higgins, S. G., Randall, C., Gerber, S., Kabamba, M., Mwamba, G. N., Okitolonda-Wemakoy, E., Muyembe-Tanfum, J. J., & Rimoin, A. W. (2022). Tetanus seroprotection among children in the Democratic Republic of the Congo, 2013–2014. PLOS ONE, 17(5), Article e0268703. https://doi.org/10.1371/journal.pone.0268703

13. Dipela, B. (2023). Factors contributing to the failure of mothers of children aged 0 to 15 months to complete the vaccination schedule in the N’djili health zone in Kinshasa, DRC [PhD thesis, Catholic University of Louvain].

14. Gavi, the Vaccine Alliance. (2021). In the DRC, the Mashako plan : an innovative approach to improving vaccination coverage among Congolese children.

15. Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008). GRADE: An emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 336(7650), 924–926. https://doi.org/10.1136/bmj.39489.470347.AD

16. Hu, Y., Wang, Y., Chen, Y., Liang, H., & Chen, Z. (2018). Measles vaccination coverage, determinants of delayed vaccination and reasons for non-vaccination among children aged 24–35 months in Zhejiang province, China. BMC Public Health, 18, 1298. https://doi.org/10.1186/s12889-018-6226-7

17. Igumbor, J. O., Ouma, J., Otwombe, K., Musenge, E., Anyanwu, F. C., Basera, T., Mbule, M., Scheepers, E., & Schmitz, K. (2019). Effect of a Mentor Mother Programme on retention of mother-baby pairs in HIV care: A secondary analysis of programme data in Uganda. PLOS ONE, 14(10), e0223332. https://doi.org/10.1371/journal.pone.0223332

18. Jain, M., Shisler, S., Lane, C., Bagai, A., Brown, E., Engelbert, M., et al. (2022). Use of community engagement interventions to improve child immunisation in low- and middle-income countries: A systematic review and meta-analysis. BMJ Open, 12, e061568. https://doi.org/10.1136/bmjopen-2022-061568

19. Jain, M., Duvendack, M., Shisler, S., Parsekar, S. S., & Anda Leon, M. D. (2024). Effective interventions for improving routine childhood immunisation in low- and middle-income countries: A systematic review of systematic reviews. BMJ Open, 14(3), e074370. https://doi.org/10.1136/bmjopen-2023-074370

20. Kebede, S. A., Tsega, Y., Cherie, N., Molla, A., & Stecher, C. (2025). Determinants of incomplete immunization among 12–23 months old children in Ethiopia: A multilevel analysis. PLOS ONE, 20(4), e0321947. https://doi.org/10.1371/journal.pone.0321947

21. Kumar, C., Singh, P. K., Singh, L., & Rai, R. K. (2016). Socioeconomic disparities in coverage of full immunisation among children of adolescent mothers in India, 1990–2006: A repeated cross-sectional analysis. BMJ Open, 6(8), e009768. https://doi.org/10.1136/bmjopen-2015-009768

22. Lame, P., Milabyo, A., Tangney, S., Mbaka, G. O., Luhata, C., Le Gargasson, J.-B., Mputu, C., Hoff, N. A., Merritt, S., Nkamba, D. M., Sall, D. S., Otomba, J. S., El Mourid, A., Lusamba, P., Senouci, K., Bor, E., Rimoin, A. W., Kaba, D., Mwamba, G., & Mukamba, E. (2023). A successful national and multipartner approach to increase immunization coverage: The Democratic Republic of Congo Mashako Plan 2018–2020. Global Health: Science and Practice, 11(2), e2200326. https://doi.org/10.9745/GHSP-D-22-00326

23. Landu Makesi, A.-S., Kafinga, L. E., & Omanyondo, O. M.-C. (2024). Pregnant women’s perceptions of the COVID-19 vaccine in Kinshasa, DR Congo. A multi-centre qualitative study conducted in the Binza Météo Health Zone. Revue Congolaise des Sciences & Technologies, 3(3), 319–335. https://doi.org/10.59228/rcst.024.v3.i3.100

24. Lewin, S., Booth, A., Glenton, C., Munthe-Kaas, H., Rashidian, A., Wainwright, M., Bohren, M. A., Tunçalp, Ö., Colvin, C. J., Garside, R., Carlsen, B., Langlois, E. V., & Noyes, J. (2018). Applying GRADE-CERQual to qualitative evidence synthesis findings: Introduction to the series. Implementation Science, 13(Suppl 1), 2. https://doi.org/10.1186/s13012-017-0688-3

25. Murad, M. H., Mustafa, R. A., Schünemann, H. J., Sultan, S., & Santesso, N. (2017). Rating the certainty in evidence in the absence of a single estimate of effect. Evidence-Based Medicine, 22(3), 85–87. https://doi.org/10.1136/ebmed-2017-110668

26. National Institute of Statistics (DRC) & ICF International. (2014). Demographic and Health Survey in the Democratic Republic of the Congo 2013–2014 (EDS-DRC II). Kinshasa/Rockville.

27. Nzioki, J. M., Ouma, J., Ombaka, J. H., & Onyango, R. O. (2017). Community health worker interventions are key to optimal infant immunisation coverage: evidence from a pre-test–post-test experiment in Mwingi, Kenya. Pan African Medical Journal, 28, 21. https://doi.org/10.11604/pamj.2017.28.21.11255

28. Owais, A., Hanif, B., Siddiqui, A. R., Agha, A., & Zaidi, A. K. (2011). Does improving maternal knowledge of vaccines impact infant immunization rates? A community-based randomized-controlled trial in Karachi, Pakistan. BMC Public Health, 11, 239. https://doi.org/10.1186/1471-2458-11-239

29. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., . . . Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71

30. Prost, A., Colbourn, T., Seward, N., Azad, K., Coomarasamy, A., Copas, A., Houweling, T. A. J., Fottrell, E., Kuddus, A., Lewycka, S., MacArthur, C., Manandhar, D., Morrison, J., Mwansambo, C., Nair, N., Nambiar, B., Osrin, D., Pagel, C., Phiri, T., . . . Costello, A. (2013). Women's groups practising participatory learning and action to improve maternal and newborn health in low-resource settings: A systematic review and meta-analysis. The Lancet, 381(9879), 1736–1746. https://doi.org/10.1016/S0140-6736(13)60685-6

31. Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., Moher, D., Tugwell, P., Welch, V., Kristjansson, E., & Henry, D. A. (2017). AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 358, j4008. https://doi.org/10.1136/bmj.j4008

32. Shroufi, A., Mafara, E., Saint-Sauveur, J. F., Taziwa, F., & Viñoles, M. C. (2013). Mother to Mother (M2M) peer support for women in Prevention of Mother to Child Transmission (PMTCT) programmes: A qualitative study. PLOS ONE, 8(6), e64717. https://doi.org/10.1371/journal.pone.0064717

33. Sodjinou, V. D., Mengouo, M. N., Douba, A., Tanifum, P., Yapi, M. D., Kuzanwa, K. R., Otomba, J. S., & Masresha, B. (2022). Epidemiological characteristics of a protracted and widespread measles outbreak in the Democratic Republic of Congo, 2018–2020. Pan African Medical Journal, 42, 282. https://doi.org/10.11604/pamj.2022.42.282.34410

34. Tadesse, A. W., Sahlu, D., & Benayew, M. (2022). Second-dose measles vaccination and associated factors among under-five children in urban areas of North Shoa Zone, Central Ethiopia, 2022. Frontiers in Public Health, 10, 1029740. https://doi.org/10.3389/fpubh.2022.1029740

35. World Health Organization & United Nations Children's Fund. (2023). Democratic Republic of the Congo: WHO and UNICEF estimates of immunization coverage: 2022 revision. World Health Organization.

36. Xie, Y. J., Liao, X., Lin, M., Yang, L., Cheung, K., Zhang, Q., Li, Y., Hao, C., Wang, H. H. X., Gao, Y., Zhang, D., Molassiotis, A., Siu, G. K. H., & Leung, A. Y. M. (2024). Community engagement in vaccination promotion: Systematic review and meta-analysis. JMIR Public Health and Surveillance, 10, e49695. https://doi.org/10.2196/49695