了解82个低收入和中等收入国家零剂量免疫接种的家庭级风险因素
Brooke Amara Farrenkopf1, Xiaobin Zhou1, Anita Shet1
1International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
数以百万计的儿童错过了常规疫苗接种,成为"零剂量"儿童. 缺乏获得孕产妇医疗保健的机会显著增加了这种风险,突出了综合医疗服务的错失机会.
科学领域:
- 全球健康 全球健康
- 儿科 儿科 儿科
- 免疫接种计划 免疫接种计划
背景情况:
- 据估计,全球约有1800万儿童没有接种疫苗,被称为"零剂量"儿童,这代表了免疫服务的重大不平等.
- 了解零剂量儿童所面临的特征和障碍至关重要,以改善获得常规免疫接种的机会.
研究的目的:
- 为了描述零剂量儿童的种群.
- 为了确定与零剂量免疫状态相关的家庭级因素.
主要方法:
- 对2011-2020年82个国家的人口和健康调查 (DHS) 和多指标集群调查 (MICS) 数据的分析.
- 定义零剂量状态为12-23个月龄的儿童缺乏BCG,含DTP,小儿麻症和麻疹疫苗.
- 多变量后勤回归以确定与零剂量状态相关的社会人口统计和医疗保健准入因素,并对多国分析进行调整的调查权重.
主要成果:
- 研究中7.5%的儿童是零剂量,其中一半以上集中在非洲国家.
- 零剂量儿童主要来自农村地区 (75.8%),来自最贫穷的家庭 (62.7%),并出生于受到有限产前护理 (ANC) 访问 (66.5%) 或家庭分娩 (58.5%) 的母亲.
- 缺乏孕产妇的破伤风注射 (OR=3.00),ANC访问 (OR=2.46) 和家庭分娩 (OR=1.87) 是零剂量状态的重要风险因素.
结论:
- 获得有限的孕产妇医疗保健是零剂量状态的强有力的预测因素.
- 母婴健康服务的整合为改善疫苗接种覆盖率提供了机会.
- 达到零剂量儿童的策略必须解决现有医疗互动中错过的机会.
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