对比抽样方法来评估次国家疫苗接种覆盖率:在中非共和国和刚果民主共和国进行试点研究
Jean-Bosco N Kasonga1, Nicole A Hoff2, Sydney Merritt2
1Kinshasa School of Public Health, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo.
Vaccine
|February 19, 2026
概括
针对疫苗接种覆盖率调查的替代采样方法,包括GIS和KSPH-VCS,对地区级监测有希望,为世卫组织标准提供可行的选择,特别是对综合估计的可行选择.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 调查方法 调查方法
背景情况:
- 疫苗接种覆盖率调查 (VCS) 对于监测免疫计划至关重要,特别是在缺乏可靠行政数据的地区.
- 区级疫苗接种数据有限,阻碍了地方规划和公平监测,尽管这些数据很重要.
- 世界卫生组织的疫苗接种覆盖率集群调查 (WHO-VCCS) 是标准,但需要其他方法以获得地区级精确度.
研究的目的:
- 将三个替代采样方法 (ASA) 与WHO-VCCS在卫生区级别的有效性和精度进行比较.
- 评估金沙萨公共卫生学院VCS (KSPH-VCS),基于地理信息系统 (GIS) 的采样和批量质量保证采样 (LQAS) 的表现.
- 评估这些ASA对地区特定和聚合 (区域/国家) 疫苗接种估计的有用性.
主要方法:
- 在中非共和国和刚果民主共和国的五个卫生区 (城市和农村) 进行了横截面研究.
- 四种采样方法 (WHO-VCCS,KSPH-VCS,基于GIS,LQAS) 同时应用,收集12-23个月龄儿童17个疫苗接种指标的数据.
- 使用绝对差异,置信区间包括,CI宽度比率和世卫组织CI之外估计的比例进行了比较;还分析了后勤回归,DEFF和ICC.
主要成果:
- 基于GIS的采样表明与WHO-VCCS的一致性最高 (49.3%在5 pp.内). 差异),但具有最宽的置信区间 (中位宽度比:2.2).
- KSPH-VCS提供了一个平衡与更窄的CI (中位宽度比:1.7) 和中等有效性 (22.4%在5 pp.内). 差异) 的区别.
- 在LQAS中,世卫组织国际机构以外的估计比例最高 (中位数:18.5个百分点). 在5个地区中,KSPH-VCS和GIS在3个地区与WHO-VCCS在统计上可比;在4个地区,LQAS在4. 所有的ASA在聚合水平上表现类似.
结论:
- 基于KSPH-VCS和GIS的采样是世卫组织-VCCS的可行替代方案,用于监测地区级疫苗接种覆盖率,特别是用于生成具有可接受精度的总计估计.
- 虽然GIS提供了高一致性,但其更广泛的CI需要考虑精度要求.
- 建议进行进一步的研究,以评估这些替代采样方法在不同环境中的成本,可行性和适应性.
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