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[法国十二个县三岁儿童麻疹、腮腺炎和风疹疫苗接种率评估。时间趋势及相关因素]

[Evaluation of measles, mumps and rubella vaccine coverage in 3 year old children in twelve French counties. Time-trends and related factors].

作者信息

Rotily M, Guagliardo V, Fontaine D, Garros B, Mayer C, Arrighi J, Woronoff A S, Ledesert B, Lepec R, Chabaud F, Janvrin M P, Baudier F

机构信息

Observatoire Régional de la Santé PACA-INSERM U379, 23, rue Stanislas Torrents, 13006 Marseille, France.

出版信息

Rev Epidemiol Sante Publique. 2001 Sep;49(4):331-41.

Abstract

BACKGROUND

The aims of our study were to estimate the measle-mumps-rubella (MMR) vaccine coverage in 3 years old children in 12 French countees, to document the evolution between 1997 and 1999 in two groups of 6 countees (pilot group and control group) before and after the implementation of promotion programmes in the pilot group, and to identify factors related to measle-mumps-rubella vaccination.

METHODS

Two telephone surveys were carried out in 1997 and 1999 among children randomly selected in the birth rolls of 12 French countees. Parents of 3 years old children were interviewed on measle-mumps-rubella vaccination, knowledge and opinions on vaccinations, utilisation of health care and socio-demographic characteristics.

RESULTS

The participation rate was 97% in both surveys. Among the 7382 respondent parents, 98% had immediate access to the child's medical file and could document the vaccine status. The vaccine coverage did not increase significantly between 1997 and 1999 (86.7% versus 87.2%), both in control (89.3% vs. 90.2%) and pilot groups (84.3% vs. 84.3%). A logistic regression model showed that several factors were independently and significantly related to measle-mumps-rubella vaccination (utilisation of homeopathic medicines, mother's age, number of children, physician speciality (general practitioner or pediatrician) and opinion on vaccinations).

CONCLUSION

Our study shows that there is a stagnation of vaccine coverage in several French countees, which makes unlikely the national objective of viruses eradication. This epidemiological situation makes very likely outbreaks of measles, mumps and rubella in these countees. National and local pilot programmes did not succeed to promote vaccination in countees with a low measle-mumps-rubella vaccine coverage. Our study identified sub-groups of parents who should be targeted by promotion programmes.

摘要

背景

我们研究的目的是估计法国12个县3岁儿童的麻疹-腮腺炎-风疹(MMR)疫苗接种率,记录1997年至1999年在两组各6个县(试点组和对照组)中,试点组实施推广计划前后的变化情况,并确定与麻疹-腮腺炎-风疹疫苗接种相关的因素。

方法

1997年和1999年对法国12个县出生登记册中随机抽取的儿童进行了两次电话调查。对3岁儿童的父母就麻疹-腮腺炎-风疹疫苗接种情况、对疫苗接种的知识和看法、医疗保健的使用情况以及社会人口统计学特征进行了访谈。

结果

两次调查的参与率均为97%。在7382名受访父母中,98%能够立即获取孩子的医疗档案并记录疫苗接种状况。1997年至1999年期间,对照组(89.3%对90.2%)和试点组(84.3%对84.3%)的疫苗接种率均未显著提高(分别为86.7%和87.2%)。逻辑回归模型显示,有几个因素与麻疹-腮腺炎-风疹疫苗接种独立且显著相关(顺势疗法药物的使用、母亲年龄、子女数量、医生专业(全科医生或儿科医生)以及对疫苗接种的看法)。

结论

我们的研究表明,法国几个县的疫苗接种率停滞不前,这使得实现全国消除病毒的目标不太可能。这种流行病学状况很可能导致这些县爆发麻疹、腮腺炎和风疹。国家和地方试点项目未能成功促进麻疹-腮腺炎-风疹疫苗接种率低的县的疫苗接种。我们的研究确定了推广计划应针对的父母亚组。

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