改善儿童免疫覆盖率的干预措施在低收入和中等收入国家
Angela Oyo-Ita1, Olabisi Oduwole2, Dachi Arikpo3
1Department of Community Health, University of Calabar Teaching Hospital, Calabar, Nigeria.
The Cochrane database of systematic reviews
|December 6, 2023
概括
诸如健康教育和家庭记录之类的策略显示,改善儿童免疫覆盖率在低收入和中等收入国家是有前途的. 然而,需要更严格的研究来证实它们的有效性,并为政策提供信息.
科学领域:
- 全球健康 全球健康
- 儿科 儿科 儿科
- 公共卫生干预 公共卫生干预
背景情况:
- 儿童免疫对于降低发病率和死亡率至关重要.
- 实现高疫苗覆盖率仍然存在挑战,特别是在低收入和中等收入国家.
- 新的疫苗引入加剧了覆盖率的困难,需要基于证据的战略.
研究的目的:
- 评估旨在增加儿童疫苗需求和供应的干预措施.
- 评估维持高儿童免疫覆盖率的战略.
- 在资源有限的环境中综合有效免疫策略的证据.
主要方法:
- 随机对照试验 (RCT),非随机对照试验,对照前后研究和中断时间序列的系统审查和元分析.
- 研究包括5岁以下的儿童,护理人员和低收入和中等收入国家的医疗保健提供者.
- 使用随机效应元分析提取和分析数据,用GRADE评估证据确定性.
主要成果:
- 卫生教育和家庭记录显示了改善DTP3/Penta 3疫苗覆盖率的低确定性证据.
- 社区领导者的参与与提供者的干预相结合,适度增加了DTP3/Penta 3的采用率.
- 免疫接种与其他服务的整合显示了改善全面疫苗接种的低确定性证据.
结论:
- 卫生教育,家庭记录,社区领导人的参与和综合服务显示出改善疫苗接种的潜力.
- 大多数干预措施的证据确定性从中等到非常低.
- 进一步高质量的RCT对于产生政策和实践的强有力的证据至关重要.
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