Reasons for reductions in routine childhood immunisation uptake during the COVID-19 pandemic in low- and middle-income countries: A systematic review.
Reasons for reductions in routine childhood immunisation uptake during the COVID-19 pandemic in low- and middle-income countries: A systematic review.
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DOI：
10.1371/journal.pgph.0001415
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Seddon, James A
中科院分区：
文献类型：
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作者：
Cardoso Pinto, Alexandra M;Shariq, Sameed;Ranasinghe, Lasith;Sundar Budhathoki, Shyam;Skirrow, Helen;Whittaker, Elizabeth;Seddon, James A
2019年冠状病毒病（COVID-19）大流行导致全球儿童常规免疫接种覆盖率大幅下降，特别是在低收入和中等收入国家。这项研究总结了中低收入国家常规儿童免疫接种中断的原因。系统评价（PROSPERO CRD42021286386）遵循PRISMA 2020指南进行。检索了6个数据库：MEDLINE、Embase、Global Health、CINAHL、Scopus和MedRxiv，检索日期为11/02/2022。从2020年1月起发表的观察性和定性研究被纳入研究，探讨了中低收入国家在COVID-19大流行期间错过免疫接种的原因。研究评估使用国家心脏、肺和血液研究所和关键评估技能计划工具。中断的原因用描述性代码定义；横断面（定量）数据汇总为按研究人群加权的平均应答百分比，定性数据汇总为叙述。共有13项研究描述了中断背后的原因；横断面（定量）法7种，定性法5种，混合法1种。确定了17个中断原因。在定量研究中（总受访者= 2,853），确定的最常见原因是对COVID-19的恐惧和由此导致的对卫生中心的回避（41.2%,SD±13.3%），其次是交通困难，使家庭和卫生保健专业人员无法到达疫苗接种服务（11.1% SD±16.6%）。大多数原因是寻求医疗保健的人数减少（83.4%），而不是医疗保健服务问题（15.2%）。定性研究显示，寻求医疗保健（49.5%）和提供医疗保健（50.5%）的问题更为平衡，对COVID-19的恐惧仍然是一个主要的确定问题（总受访者= 92）。最常见的中断原因是父母对COVID-19的恐惧和逃避卫生服务。因此，卫生系统必须优先考虑公共卫生信息，以鼓励接种疫苗和恢复错过的免疫接种。
The coronavirus disease 2019 (COVID-19) pandemic has resulted in a substantial decline in routine immunisation coverage in children globally, especially in low- and middle-income countries (LMICs). This study summarises the reasons for disruptions to routine child immunisations in LMICs. A systematic review (PROSPERO CRD42021286386) was conducted following PRISMA 2020 guidelines. Six databases were searched: MEDLINE, Embase, Global Health, CINAHL, Scopus and MedRxiv, on 11/02/2022. Observational and qualitative studies published from January 2020 onwards were included if exploring reasons for missed immunisations during the COVID-19 pandemic in LMICs. Study appraisal used National Heart, Lung, and Blood Institute and Critical Appraisal Skills Programme tools. Reasons for disruption were defined with descriptive codes; cross-sectional (quantitative) data were summarised as mean percentages of responses weighted by study population, and qualitative data were summarised narratively. A total of thirteen studies were included describing reasons behind disruptions; 7 cross-sectional (quantitative), 5 qualitative and 1 mixed methods. Seventeen reasons for disruptions were identified. In quantitative studies (total respondents = 2,853), the most common reasons identified were fear of COVID-19 and consequential avoidance of health centres (41.2%, SD ±13.3%), followed by transport challenges preventing both families and healthcare professionals from reaching vaccination services (11.1% SD ±16.6%). Most reasons stemmed from reduced healthcare-seeking (83.4%), as opposed to healthcare-delivery issues (15.2%). Qualitative studies showed a more even balance of healthcare-seeking (49.5%) and healthcare-delivery issues (50.5%), with fear of COVID-19 remaining a major identified issue (total respondents = 92). The most common reasons for disruption were parental fear of COVID-19 and avoidance of health services. Health systems must therefore prioritise public health messaging to encourage vaccine uptake and recovery of missed immunisations.