零剂量疫苗接种和结构性决定因素的地理空间不平等:撒哈拉以南非洲的见解 (2015-2023)
Handan Wand1, Sarita Naidoo2, Jayajothi Moodley3
1Kirby Institute, University of New South Wales, Kensington, 2052, New South Wales, Australia.
Vaccine
|December 5, 2025
概括
撒哈拉以南非洲的零剂量儿童面临着严重的不平等,其中26%没有接种疫苗. 局部化的"热点"与贫困,缺乏教育和有限的卫生系统接触有关,突出了针对性干预的领域.
科学领域:
- 全球健康 全球健康
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 零剂量儿童,定义为那些没有接种常规疫苗的儿童,代表了公共卫生干预措施的关键差距.
- 在全球范围内,撒哈拉以南非洲 (SSA) 的零剂量儿童负有最高的负担.
- 关于SSA中零剂量患病率的分布和决定因素的局部数据有限.
研究的目的:
- 在撒哈拉以南非洲地区绘制零剂量儿童的空间分布图.
- 确定与零剂量疫苗状态相关的关键结构因素.
- 为改善疫苗公平性和覆盖率制定有针对性的战略提供信息.
主要方法:
- 来自SSA (2015-2023) 的人口和健康调查 (DHS) 数据的分析.
- 使用通用添加模型评估空间异质性.
- 多变量回归模型用于确定零剂量状态和社会人口统计因素之间的关联,包括人口可归因风险百分比 (PAR%).
主要成果:
- 聚合的零剂量流行率为26%,具有显著的抗原特异性变异 (例如,麻疹的43%).
- 观察到零剂量患病率的广泛的国家和地方差异,确定了局部的"热点".
- 农村居住,低社会经济地位,有限的母亲教育和信息获取不足与零剂量状态密切相关. 早期医疗保健接触较弱 (例如,家庭分娩,低产前护理) 也增加了几率.
结论:
- 在SSA,零剂量疫苗接种状况在地理上高度集群,并与结构性不利因素密切相关.
- 疫苗接种方面的不平等与与卫生系统的早期接触有限有关.
- 整合空间,个人和家庭数据对于制定有效策略来减少疫苗不平等并实现免疫计划2030目标至关重要.
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