2000年至2016年非洲白喉咳疫苗覆盖率的绘制:一个空间和时间建模研究
Jonathan F Mosser1, William Gagne-Maynard1, Puja C Rao1
1Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Lancet (London, England)
|April 10, 2019
概括
非洲儿童常规接种疫苗的覆盖率有所提高,但仍存在显著的地理差异. 需要有针对性的干预措施,以解决白喉咳疫苗 (DPT) 接种方面的不平等问题,并提高整个非洲大陆的DPT3覆盖率.
科学领域:
- 全球健康
- 疫苗学
- 流行病学
背景情况:
- 常规儿童疫苗接种是一种非常有效的公共卫生干预措施.
- 为了改善非洲的疫苗接种,
- 准确的当地疫苗覆盖率数据和地理不平等趋势至关重要.
研究的目的:
- 估计非洲各地的常规白喉咳疫苗覆盖率和退学率.
- 分析2000年至2016年的DPT覆盖范围的地理差异.
- 确定疫苗覆盖率低的地区和潜在的系统漏洞.
主要方法:
- 分析了2000年至2016年期间进行的183项调查,涵盖49个非洲国家的881,268名儿童.
- 使用贝叶斯地缘统计模型与2017年全球疾病,伤害和风险因素研究数据进行校准.
- 高空间分辨率 (5x5公里) 的每年估计DPT覆盖率和12-23个月龄的儿童的退学率.
主要成果:
- 估计的第三剂量 (DPT3) 覆盖率在72. 3%的行政单位增加,但仍存在显著的地理差异.
- 2016年,在52个国家中的29个国家,DPT3覆盖率有超过25%的差异;只有摩洛哥和卢旺达达到了全球疫苗行动计划的目标.
- 在萨赫勒,索马里,埃塞俄比亚东部和安哥拉发现了低DPT3覆盖率 (≤50%) 的大地区,原因是DPT1覆盖率低,学率高.
结论:
- 尽管取得了进展,但在全国和地方范围内, DPT 覆盖率仍然明显不平等.
- 这些发现突出了需要有针对性的干预措施来改善疫苗的具体地区.
- 结果支持精确的资源分配,以提高疫苗覆盖率和改善儿童健康结果.
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