Measuring coverage in MNCH: design, implementation, and interpretation challenges associated with tracking vaccination coverage using household surveys.
Measuring coverage in MNCH: design, implementation, and interpretation challenges associated with tracking vaccination coverage using household surveys.
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DOI：
10.1371/journal.pmed.1001404
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发表时间：
2013
期刊：
影响因子：
15.8
通讯作者：
Rhoda DA
中科院分区：
文献类型：
--
作者：
Cutts FT;Izurieta HS;Rhoda DA
在公共科学图书馆医学评论中，Felicity Cutts 及其同事通过调查描述了低收入和中等收入国家疫苗接种覆盖率估算所面临的挑战，并提出了改进这一重要公共卫生指标测量的方法。疫苗接种覆盖率是一项重要的公共卫生指标，通过行政报告和/或调查来衡量。使用调查来衡量低收入和中等收入国家的疫苗接种覆盖率容易受到许多挑战。这些挑战包括选择偏差和信息偏差，这不能通过增加样本量来解决，以及覆盖估计的精度，这是由调查样本量和抽样方法决定的。选择偏差可能是由于不准确的抽样框架或不适当的现场程序造成的，而且由于疫苗接种覆盖率调查中可能遗漏的人群也可能被疫苗接种小组遗漏，因此通常会夸大覆盖率估计值。重要的是，经常用于衡量疫苗接种覆盖率的大型多用途家庭调查投入了大量精力来减少选择偏差。当儿童的疫苗接种状况由于其疫苗接种记录、数据转录、调查问题提出方式或监护人回忆没有书面记录的儿童疫苗接种错误而被错误分类时，就会出现信息偏差。最近的调查很大程度上依赖于监护人的回忆，令人担忧的是，随着免疫接种计划变得更加复杂和多变，未来信息偏差可能会变得更加可能。最后，一些调查直接使用血清学测定来评估免疫力。血清调查对于评估公共卫生风险很重要，但目前无法直接验证覆盖率估计。为了提高基于调查的疫苗接种覆盖率估计，我们建议应改进记录工具和实践，并且调查应纳入设计、实施和分析的最佳实践。
In a PLOS Medicine Review, Felicity Cutts and colleagues describe the challenges facing the estimation of vaccination coverage in low- and middle-income countries using surveys and recommend ways to improve the measurement of this important public health indicator. Vaccination coverage is an important public health indicator that is measured using administrative reports and/or surveys. The measurement of vaccination coverage in low- and middle-income countries using surveys is susceptible to numerous challenges. These challenges include selection bias and information bias, which cannot be solved by increasing the sample size, and the precision of the coverage estimate, which is determined by the survey sample size and sampling method. Selection bias can result from an inaccurate sampling frame or inappropriate field procedures and, since populations likely to be missed in a vaccination coverage survey are also likely to be missed by vaccination teams, most often inflates coverage estimates. Importantly, the large multi-purpose household surveys that are often used to measure vaccination coverage have invested substantial effort to reduce selection bias. Information bias occurs when a child's vaccination status is misclassified due to mistakes on his or her vaccination record, in data transcription, in the way survey questions are presented, or in the guardian's recall of vaccination for children without a written record. There has been substantial reliance on the guardian's recall in recent surveys, and, worryingly, information bias may become more likely in the future as immunization schedules become more complex and variable. Finally, some surveys assess immunity directly using serological assays. Sero-surveys are important for assessing public health risk, but currently are unable to validate coverage estimates directly. To improve vaccination coverage estimates based on surveys, we recommend that recording tools and practices should be improved and that surveys should incorporate best practices for design, implementation, and analysis.
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影响因子：
3.7
作者：
Babirye JN;Engebretsen IM;Makumbi F;Fadnes LT;Wamani H;Tylleskar T;Nuwaha F
通讯作者：
Nuwaha F
DOI：
10.1126/science.1210554
发表时间：
2011-12-09
期刊：
Science (New York, N.Y.)
影响因子：
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作者：
Bharti N;Tatem AJ;Ferrari MJ;Grais RF;Djibo A;Grenfell BT
通讯作者：
Grenfell BT
影响因子：
2.3
作者：
Grais, Rebecca F.;Rose, Angela M. C.;Guthmann, Jean-Paul
通讯作者：
Guthmann, Jean-Paul
影响因子：
6.2
作者：
Cutts, F T;Hall, A J
通讯作者：
Hall, A J
影响因子：
3.3
作者：
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通讯作者：
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