Validity of reported vaccination coverage in 45 countries
Validity of reported vaccination coverage in 45 countries
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DOI：
10.1016/s0140-6736(03)14411-x
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发表时间：
2003-09-27
期刊：
影响因子：
168.9
通讯作者：
Thieren, M
中科院分区：
文献类型：
--
作者：
Murray, CJL;Shengelia, B;Thieren, M
背景监测和评估国家卫生规划中的覆盖率变得越来越重要，我们旨在评估官方报告的白喉-破伤风-百日咳疫苗（DTP 3）接种覆盖率的准确性，方法我们比较了官方报告的DTP 3覆盖率的国家数据与家庭人口与健康调查（DHS）的数据。在1990年到2000年间，我们调整了调查数据，以反映有效疫苗接种的数量（即按照WHO推荐的时间表接种的疫苗），使用样本选择的概率模型。该模型预测了儿童有效接种疫苗的概率，包括那些没有记录疫苗接种的儿童，在校正了有和没有记录疫苗接种信息的儿童之间的差异后。然后，我们评估了调查偏差和官方报告的数据和那些从DHS estimates.Findings之间的差异的程度-我们的研究结果表明，官方报告的DTP 3覆盖率高于家庭调查报告。这种差异的大小随着报告的三联疫苗覆盖率的增加而增加。时间趋势分析的结果表明，报告的覆盖率的变化与家庭调查报告的变化不相关。解释虽然报告的数据可能是最广泛的信息，用于评估疫苗接种覆盖率，其有效性测量覆盖率随时间的变化是非常值得怀疑的。住户调查可用于验证服务提供者收集的数据。衡量所有卫生干预措施覆盖面的战略应立足于认真评估各种来源数据的有效性。
Background Monitoring and assessment of coverage rates in national health programmes is becoming increasingly important, We aimed to assess the accuracy of officially reported coverage rates of vaccination with diphtheria-tetanus-pertussis vaccine (DTP3), which is commonly used to monitor child health interventions.Methods We compared officially reported national data for DTP3 coverage with those from the household Demographic and Health Surveys (DHS) in 45 countries between :1990 and 2000. We adjusted survey data to reflect the number of valid vaccinations (ie, those administered in accordance with the schedule recommended by WHO) using a probit model with sample selection. The model predicted the probability of valid vaccinations for children, including those without documented vaccinations, after correcting for bias from differences between the children with and without documented information on vaccination. We then assessed the extent of survey bias and differences between officially reported data and those from DHS estimates.Findings Our results suggest that officially reported DTP3 coverage is higher than that reported from household surveys. This size of the difference increases with the rate of reported coverage of DTP3. Results of time-trend analysis show that changes in reported coverage are not correlated with changes reported from household surveys.Interpretation Although reported data might be the most widely available information for assessment of vaccination coverage, their validity for measuring changes in coverage over time is highly questionable. Household surveys can be used to validate data collected by service providers. Strategies for measurement of the coverage of all health interventions should be grounded in careful assessments of the validity of data derived from various sources.