Increased immunization coverage addresses the equity gap in Nepal
Increased immunization coverage addresses the equity gap in Nepal
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DOI：
10.2471/blt.16.178327
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发表时间：
2017-04-01
影响因子：
11.1
通讯作者：
Malqvist, Mats
中科院分区：
文献类型：
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作者：
Ashish, K. C.;Nelin, Viktoria;Malqvist, Mats
目的比较尼泊尔2001年和2014年的免疫接种覆盖率和覆盖率的公平分布。方法我们使用2001年、2006年和2011年进行的人口与健康调查数据以及2014年的数据。多指标类集调查。我们计算了接种卡介苗（BCG）、三剂脊髓灰质炎疫苗、三剂白喉-百日咳-破伤风（DPT）疫苗和麻疹疫苗的儿童比例（平均百分比）。为了衡量财富五分位数之间的不平等，我们计算了所有调查的不平等斜率指数（SII）和不平等相对指数（RII）。调查结果从2001年到2014年，在12个月大时接受所有疫苗接种的儿童比例从68. 8%增加到2014年的12个月大时接受所有疫苗接种的儿童比例。（95%置信区间，CI：67.5-70.1）至82.4%（95% CI：80.7-84.0）。在研究期间，虽然卡介苗、百白破三联疫苗和麻疹免疫接种的覆盖率在统计上有所增加，但接种第三剂脊髓灰质炎疫苗的儿童比例从93.3%（95%CI：92.7-93.9）下降到88.1%（95%CI：86.8-89.3）。最贫穷的五分之一人口在免疫覆盖率方面的改善最大，从58%提高到77.9%，而最富有的五分之一人口仅从84.8%提高到86.0%。接受所有疫苗接种的儿童的SII从0.070提高到0.070，（95% CI：0.061-0.078）至0.026（95%置信区间：0.013-0.039）结论尼泊尔2001 - 2014年免疫接种率的提高主要归功于针对弱势群体的干预措施人口。
Objective To compare immunization coverage and equity distribution of coverage between 2001 and 2014 in Nepal.Methods We used data from the Demographic and Health Surveys carried out in 2001, 2006 and 2011 together with data from the 2014. Multiple Indicator Cluster Survey. We calculated the proportion, in mean percentage, of children who had received bacille Calmette-Guerin (BCG) vaccine, three doses of polio vaccine, three doses of diphtheria-pertussis-tetanus (DPT) vaccine and measles vaccine. To measure inequities between wealth quintiles, we calculated the slope index of inequality (SII) and relative index of inequality (RII) for all surveys.Findings From 2001 to 2014, the proportion of children who received all vaccines at the age of 12 months increased from 68.8% (95% confidence interval, CI: 67.5-70.1) to 82.4% (95% CI: 80.7-84.0). While coverage of BCG, DPT and measles immunization statistically increased during the study period, the proportion of children who received the third dose of polio vaccine decreased from 93.3% (95% CI: 92.7-93.9) to 88.1% (95% CI: 86.8-89.3). The poorest wealth quintile showed the greatest improvement in immunization coverage, from 58% to 77.9%, While the wealthiest quintile only improved from 84.8% to 86.0%. The SII for children who received all vaccines improved from 0.070 (95% CI: 0.061-0.078) to 0.026 (95% CI: 0.013-0.039) and RII improved from 1.13 to 1.03.Conclusion The improvement in immunization coverage between 2001 and 2014 in Nepal can mainly be attributed to the interventions targeting the disadvantaged populations.