Immunization coverage and risk factors for failure to immunize within the Expanded Programme on Immunization in Kenya after introduction of new Haemophilus influenzae type b and hepatitis b virus antigens.
Immunization coverage and risk factors for failure to immunize within the Expanded Programme on Immunization in Kenya after introduction of new Haemophilus influenzae type b and hepatitis b virus antigens.
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DOI：
10.1186/1471-2458-6-132
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发表时间：
2006-05-17
影响因子：
4.5
通讯作者：
Scott, J. Anthony G.
中科院分区：
文献类型：
--
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.
肯尼亚于2001年11月引进了一种五价疫苗，包括百白破、b型流感嗜血杆菌和乙型肝炎病毒抗原，并加强了免疫服务。我们估计了肯尼亚Kilifi地区在接种前后的免疫覆盖率、疫苗接种的及时性和未能接种疫苗的风险因素。2002年11月，我们对在引入五价疫苗之前或之后计划接种疫苗的200名儿童进行了世卫组织整群抽样调查。2004年3月，我们对204名9-23月龄儿童进行了简单随机抽样调查。通过疫苗卡和母亲召回数据的逆Kaplan-Meier生存分析估计覆盖率，并通过审查国家和省级疫苗商店的行政记录加以证实。通过比例风险模型估计距离诊所、季节性降雨、母亲年龄和家庭规模对及时免疫的贡献。白百破三剂和五价疫苗接种前后的免疫覆盖率分别为100%和91%。根据SRS调查，三剂五价疫苗的覆盖率为88%。第一次、第二次和第三次接种疫苗的中位年龄分别为8周、13周和18周。2001-2003年期间向基利菲县分发的小瓶将为92%的出生队列提供三次免疫接种。免疫接种率随从家到疫苗诊所的距离每增加一公里（比值0.95，可信区间0.91-1.00）、雨季（比值0.73,95%可信区间0.61-0.89）和家庭规模而降低，逐渐增加至4名儿童（比值0.55,95%可信区间0.41-0.73）。在引入五价疫苗之前和之后，疫苗覆盖率很高，但大多数剂量接种较晚。覆盖范围受季节因素和家庭规模的限制。
Kenya introduced a pentavalent vaccine including the DTP, Haemophilus influenzae type b and hepatitis b virus antigens in Nov 2001 and strengthened immunization services. We estimated immunization coverage before and after introduction, timeliness of vaccination and risk factors for failure to immunize in Kilifi district, Kenya. In Nov 2002 we performed WHO cluster-sample surveys of >200 children scheduled for vaccination before or after introduction of pentavalent vaccine. In Mar 2004 we conducted a simple random sample (SRS) survey of 204 children aged 9–23 months. Coverage was estimated by inverse Kaplan-Meier survival analysis of vaccine-card and mothers' recall data and corroborated by reviewing administrative records from national and provincial vaccine stores. The contribution to timely immunization of distance from clinic, seasonal rainfall, mother's age, and family size was estimated by a proportional hazards model. Immunization coverage for three DTP and pentavalent doses was 100% before and 91% after pentavalent vaccine introduction, respectively. By SRS survey, coverage was 88% for three pentavalent doses. The median age at first, second and third vaccine dose was 8, 13 and 18 weeks. Vials dispatched to Kilifi District during 2001–2003 would provide three immunizations for 92% of the birth cohort. Immunization rate ratios were reduced with every kilometre of distance from home to vaccine clinic (HR 0.95, CI 0.91–1.00), rainy seasons (HR 0.73, 95% CI 0.61–0.89) and family size, increasing progressively up to 4 children (HR 0.55, 95% CI 0.41–0.73). Vaccine coverage was high before and after introduction of pentavalent vaccine, but most doses were given late. Coverage is limited by seasonal factors and family size.
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影响因子：
13.6
作者：
PASQUINI, P;BISANTI, L;RAPICETTA, M
通讯作者：
RAPICETTA, M
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通讯作者：
Kew, MC
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158.5
作者：
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通讯作者：
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作者：
KOK, PW
通讯作者：
KOK, PW