Timeliness of childhood vaccinations in Kampala Uganda: a community-based cross-sectional study.
Timeliness of childhood vaccinations in Kampala Uganda: a community-based cross-sectional study.
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DOI：
10.1371/journal.pone.0035432
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Nuwaha F
中科院分区：
文献类型：
--
作者：
Babirye JN;Engebretsen IM;Makumbi F;Fadnes LT;Wamani H;Tylleskar T;Nuwaha F
儿童的存活率取决于几个因素，包括高疫苗接种率。及时接种疫苗确保了对疫苗的最佳免疫反应。然而，在估计人群免疫力时，通常不会强调及时性。除了检查推荐的扩大免疫方案(EPI)疫苗的及时性外，本文还确定了坎帕拉10至23个月儿童过早接种疫苗的预测因素。除了家庭调查访谈问题外，变量的其他数据来源包括收集儿童体重和身高的数据。接种日期是从儿童健康卡上获得的。根据以下时间范围(最低-最高目标年龄)，使用Kaplan-Meier对每种疫苗接种的及时性进行评估：卡介苗(出生-8周)、0脊髓灰质炎(出生-4周)、三种脊髓灰质炎和三种五价疫苗(4周-2个月；8周-4个月；12周-6个月)和麻疹疫苗(38周-12个月)。用COX回归分析找出与接种及时性相关的因素。在821名儿童中，约有一半在建议的时间范围内接种了所有疫苗(45.6%；95%可信区间39.8-51.2)。麻疹疫苗接种率最低(67.5%；95%CI为60.5~73.8)，卡介苗接种率最高(92.7%：95%CI 88.1~95.6)。对于麻疹，10.7%(95%可信区间6.8~16.4)的疫苗接种时间早于推荐时间。未在推荐年龄范围内接种疫苗与每名妇女生育子女数量增加(调整后风险比1.84，95%可信区间1.29-2.64)、未在卫生机构分娩(调整风险比1.58，95%可信区间1.02-2.46)、未婚(调整风险比1.49，95%可信区间1.15-1.94)或处于最低财富五分位数(调整风险比1.38，95%可信区间1.11-1.72)有关。为提高接种疫苗的及时性，有必要制定战略，改善最贫穷、单身、经产妇女和不在保健机构分娩的母亲的接种做法。
Child survival is dependent on several factors including high vaccination coverage. Timely receipt of vaccines ensures optimal immune response to the vaccines. Yet timeliness is not usually emphasized in estimating population immunity. In addition to examining timeliness of the recommended Expanded Programme for Immunisation (EPI) vaccines, this paper identifies predictors of untimely vaccination among children aged 10 to 23 months in Kampala. In addition to the household survey interview questions, additional data sources for variables included data collection of child's weight and length. Vaccination dates were obtained from child health cards. Timeliness of vaccinations were assessed with Kaplan–Meier time-to-event analysis for each vaccine based on the following time ranges (lowest–highest target age): BCG (birth–8 weeks), polio 0 (birth–4 weeks), three polio and three pentavalent vaccines (4 weeks–2 months; 8 weeks–4 months; 12 weeks–6 months) and measles vaccine (38 weeks–12 months). Cox regression analysis was used to identify factors associated with vaccination timeliness. About half of 821 children received all vaccines within the recommended time ranges (45.6%; 95% CI 39.8–51.2). Timely receipt of vaccinations was lowest for measles (67.5%; 95% CI 60.5–73.8) and highest for BCG vaccine (92.7%: 95% CI 88.1–95.6). For measles, 10.7% (95% CI 6.8–16.4) of the vaccinations were administered earlier than the recommended time. Vaccinations that were not received within the recommended age ranges were associated with increasing number of children per woman (adjusted hazard ratio (AHR); 1.84, 95% CI 1.29–2.64), non-delivery at health facilities (AHR 1.58, 95% CI 1.02–2.46), being unmarried (AHR 1.49, 95% CI 1.15–1.94) or being in the lowest wealth quintile (AHR 1.38, 95% CI 1.11–1.72). Strategies to improve vaccination practices among the poorest, single, multiparous women and among mothers who do not deliver at health facilities are necessary to improve timeliness of vaccinations.
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影响因子：
4.5
作者：
Ndiritu, Moses;Cowgill, Karen D.;Ismail, Amina;Chiphatsi, Salome;Kamau, Tatu;Fegan, Gregory;Feikin, Daniel R.;Newton, Charles R. J. C.;Scott, J. Anthony G.
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168.9
作者：
Levine, Orin S.;Bloom, David E.;Greenwood, Brian
通讯作者：
Greenwood, Brian