Timeliness of routine childhood vaccination in 103 low-and middle-income countries, 1978-2021: A scoping review to map measurement and methodological gaps.
Timeliness of routine childhood vaccination in 103 low-and middle-income countries, 1978-2021: A scoping review to map measurement and methodological gaps.
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DOI：
10.1371/journal.pgph.0000325
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发表时间：
2022
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在过去十年中，探索低收入和中等收入国家常规疫苗接种及时性的实证研究取得了进展。然而，有新出现的证据表明，这些研究有关键的测量和方法上的差距，限制了它们的可比性和实用性。因此，有必要确定并记录这些差距，以便为未来关于疫苗接种及时性的研究的设计、实施和报告提供信息。我们综合了文献，以确定中低收入国家疫苗接种及时性评估的方法和测量差距。我们检索了5个电子数据库，检索了1978年1月1日至2021年7月1日期间发表的同行评审的英文和法文文章，这些文章评估了中低收入国家接种疫苗的及时性。两位审稿人按照乔安娜布里格斯研究所的范围审查指导框架，独立筛选标题和摘要，并审查相关文章的全文。从确定的4263篇标题中，我们纳入了来自103个国家的224篇文章。中国（40篇）、印度（27篇）和肯尼亚（23篇）发表的论文数量最多。在三个时效性领域中，研究最多的领域是“延迟接种”[99.5%(223/224)]，其次是“早期接种”[21.9%(49/224)]和“不及时间隔接种”[9%(20/224)]。早期（7种不同定义）、不及时间隔（4种不同定义）和延迟接种（19种不同定义）的定义在研究中有所不同。大多数研究[72.3%(166/224)]将疫苗接种及时性作为分类变量，相比之下，只有9.8%（22/224）的研究将及时性作为连续变量进行操作。很大一部分研究[47.8%(107/224)]排除了没有书面疫苗接种记录的儿童的数据，而不管照料者是否回忆其疫苗接种情况。我们的研究结果表明，关于中低收入国家疫苗接种及时性的研究存在测量和方法上的差距。我们建议制定和实施衡量和报告疫苗接种及时性的指南，以弥合这些差距。
Empiric studies exploring the timeliness of routine vaccination in low-and middle-income countries (LMICs) have gained momentum in the last decade. Nevertheless, there is emerging evidence suggesting that these studies have key measurement and methodological gaps that limit their comparability and utility. Hence, there is a need to identify, and document these gaps which could inform the design, conduct, and reporting of future research on the timeliness of vaccination. We synthesised the literature to determine the methodological and measurement gaps in the assessment of vaccination timeliness in LMICs. We searched five electronic databases for peer-reviewed articles in English and French that evaluated vaccination timeliness in LMICs, and were published between 01 January 1978, and 01 July 2021. Two reviewers independently screened titles and abstracts and reviewed full texts of relevant articles, following the guidance framework for scoping reviews by the Joanna Briggs Institute. From the 4263 titles identified, we included 224 articles from 103 countries. China (40), India (27), and Kenya (23) had the highest number of publications respectively. Of the three domains of timeliness, the most studied domain was ‘delayed vaccination’ [99.5% (223/224)], followed by ‘early vaccination’ [21.9% (49/224)], and ‘untimely interval vaccination’ [9% (20/224)]. Definitions for early (seven different definitions), untimely interval (four different definitions), and delayed vaccination (19 different definitions) varied across the studies. Most studies [72.3% (166/224)] operationalised vaccination timeliness as a categorical variable, compared to only 9.8% (22/224) of studies that operationalised timeliness as continuous variables. A large proportion of studies [47.8% (107/224)] excluded the data of children with no written vaccination records irrespective of caregivers’ recall of their vaccination status. Our findings show that studies on vaccination timeliness in LMICs has measurement and methodological gaps. We recommend the development and implement of guidelines for measuring and reporting vaccination timeliness to bridge these gaps.