Challenges in Estimating Vaccine Coverage in Refugee and Displaced Populations: Results From Household Surveys in Jordan and Lebanon.
Challenges in Estimating Vaccine Coverage in Refugee and Displaced Populations: Results From Household Surveys in Jordan and Lebanon.
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DOI：
10.3390/vaccines5030022
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发表时间：
2017-08-12
期刊：
影响因子：
7.8
通讯作者：
Doocy S
中科院分区：
文献类型：
--
作者：
Roberton T;Weiss W;Jordan Health Access Study Team;Lebanon Health Access Study Team;Doocy S
确保流离失所者的持续免疫是人道主义紧急情况的一个关键目标。通常情况下，人道主义行为体在免疫接种运动后衡量单一疫苗的覆盖率;很少有人衡量所有疫苗的常规覆盖率。我们对约旦和黎巴嫩难民营外的叙利亚难民进行了家庭调查，采用随机抽样和受调查者驱动的抽样相结合的方式，以衡量东道国疫苗接种计划中所有疫苗的覆盖率。我们以批判的眼光分析了数据的局限性和对类似研究的影响。在有12-23个月婴儿的家庭中，约旦55.1%的答复者和黎巴嫩46.6%的答复者能够出示儿童的扩大免疫卡。在约旦，只有24.5%的叙利亚难民儿童和黎巴嫩的12.5%的难民儿童通过常规疫苗接种服务获得了全面免疫接种（在约旦和黎巴嫩，接受了来自非运动来源的麻疹、脊髓灰质炎1 -3和百白破疫苗1-3，在约旦接受了卡介苗）。约旦（33.5%）和黎巴嫩（40.1%）的受访者报告说，难以获得儿童疫苗接种。我们估计的免疫接种率低于预期，这引起了对叙利亚难民疫苗覆盖率差距的严重关切。虽然我们的估计可能低于真实覆盖率，但鉴于运动的额外好处（我们的调查中没有得到），显然需要提高免疫服务的认识、可及性和接受率。目前衡量难民和流离失所人口疫苗覆盖率的方法存在局限性。为了更好地了解这些群体的健康需求，我们需要研究：回忆方法的有效性，运动和常规免疫计划之间的联系，以及改善难以接触人群的抽样。
Ensuring the sustained immunization of displaced persons is a key objective in humanitarian emergencies. Typically, humanitarian actors measure coverage of single vaccines following an immunization campaign; few measure routine coverage of all vaccines. We undertook household surveys of Syrian refugees in Jordan and Lebanon, outside of camps, using a mix of random and respondent-driven sampling, to measure coverage of all vaccinations included in the host country’s vaccine schedule. We analyzed the results with a critical eye to data limitations and implications for similar studies. Among households with a child aged 12–23 months, 55.1% of respondents in Jordan and 46.6% in Lebanon were able to produce the child’s EPI card. Only 24.5% of Syrian refugee children in Jordan and 12.5% in Lebanon were fully immunized through routine vaccination services (having received from non-campaign sources: measles, polio 1–3, and DPT 1–3 in Jordan and Lebanon, and BCG in Jordan). Respondents in Jordan (33.5%) and Lebanon (40.1%) reported difficulties obtaining child vaccinations. Our estimated immunization rates were lower than expected and raise serious concerns about gaps in vaccine coverage among Syrian refugees. Although our estimates likely under-represent true coverage, given the additional benefit of campaigns (not captured in our surveys), there is a clear need to increase awareness, accessibility, and uptake of immunization services. Current methods to measure vaccine coverage in refugee and displaced populations have limitations. To better understand health needs in such groups, we need research on: validity of recall methods, links between campaigns and routine immunization programs, and improved sampling of hard-to-reach populations.
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