The quality of immunization data from routine primary health care reports: a case from Nepal
The quality of immunization data from routine primary health care reports: a case from Nepal
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DOI：
10.1093/heapol/13.2.131
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发表时间：
1998-06-01
影响因子：
3.2
通讯作者：
Hansen, EH
中科院分区：
文献类型：
--
作者：
Onta, SR;Sabroe, S;Hansen, EH
据报告，尼泊尔在过去十年中实现了高免疫覆盖率，预计这将降低该国的儿童死亡率。本研究在尼泊尔中西部山区进行，旨在评估尼泊尔免疫数据的质量。一年内接种不同疫苗的儿童人数来自三个来源：⑴三个初级保健服务网点的免疫登记册，其中记录了每名接种疫苗的儿童; ⑵根据免疫登记册编制的初级保健月报; ⑶根据上述初级保健月报编制的卫生和保健组织月报（卫生和保健组织月报是官方统计数据的来源）。初级保健报告中的儿童人数高于所有疫苗免疫登记册中的人数。在卡介苗、白喉、百日咳、破伤风和麻疹方面，卫生组织报告中的免疫接种数量高于初级保健报告中的数量;而脊髓灰质炎的接种数量则低于初级保健报告中的数量。卫生组织报告中的免疫接种总数比免疫登记册中的高，卡介苗高31%，百白破联合疫苗高44%，小儿麻痹症高155%，麻疹高71%。我们的结论是，官方报告高估了该地区的免疫覆盖率。因此，免疫方案可能不会导致预期的发病率和死亡率下降，尽管对该方案进行了投资，而且据报告覆盖率很高。
Reported high immunization coverage achieved in Nepal over the last ten years is expected to reduce child mortality in the country. The present study, carried out in a hill district in mid-west Nepal, aimed to assess the quality of immunization data in Nepal. The number of children who received different vaccines during one year was obtained from three sources: 1) the Immunization Register of three Primary Health Care Service Outlets (PHCSOs) where each immunized child is recorded; 2) monthly PHC Reports, which are based on the Immunization Register; 3) monthly DHO Reports, which are based on the above PHC Reports (the DHO reports are the source of official statistics). The number of children in the PHC Reports was higher than the number in the Immunization Registers for all vaccines. The number of immunizations in the DHO Reports was higher than the number in the PHC Reports for BCG, DPT, and measles; the number was lower for poliomyelitis. The overall number of immunizations was higher in the DHO Reports than in the Immunization Registers, by 31% for BCG, 44% for DPT, 155% for polio, and 71% for measles. We conclude that the official report overestimates the immunization coverage in the district. The immunization programme, therefore, might not result in the expected reduction of morbidity and mortality despite the investment in the programme and reported high coverage.