在印度,12-23个月的儿童中,出生顺序如何影响全面免疫覆盖率? 来自国家家庭健康调查的证据
Tanmoy Ghosh1, Puja Das1, Apurba Sarkar2
1Department of Geography, University of Gour Banga, Malda, West Bengal, India.
PloS one
|February 4, 2026
概括
印度的儿童免疫覆盖率随着出生次数的增加而下降. 第一个和第二个出生的人有更好的完全免疫率,而后来出生的人面临着显著的差异,需要有针对性的公共卫生干预.
科学领域:
- 公共卫生 公共卫生
- 人口统计学 人口统计学
- 流行病学 流行病学
背景情况:
- 尽管印度有免费的疫苗接种计划,但在幼儿中免疫覆盖率仍然存在差异.
- 增加出生顺序被确定为影响12-23个月龄儿童免疫状况的重要因素.
研究的目的:
- 调查印度12-23个月龄的儿童出生顺序与完全免疫的可能性之间的关联.
- 确定与免疫差异相关的社会人口因素.
主要方法:
- 利用了来自国家家庭健康调查 (NFHS) 5 (2019-21) 的数据,采用了43436名儿童的全国代表性样本.
- 采用了空间自相对应的双变量局部指标 (LISA) 和多层逻辑回归模型.
- 根据出生顺序和共变量,评估免疫覆盖范围的空间和统计模式.
主要成果:
- 空间分析显示,第一个和第二个出生顺序与完全免疫接种之间存在积极的关联.
- 随着出生顺序的增加,完全免疫的几率显著下降 (第二:或0.91到6+:或0.41).
- 女性儿童,穆斯林家庭和印度东北部家庭的免疫可能性也较低.
结论:
- 出生顺序是印度儿童免疫覆盖率的关键决定因素,晚出生的孩子面临着巨大的不利因素.
- 迫切需要有针对性的公共卫生干预措施来解决家庭和结构障碍,特别是对多个孩子的母亲来说.
- 确保所有儿童平等获得免疫接种,无论出生位置如何,对于实现普遍健康目标至关重要.
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