Thórdarson T T, Haraldsson Asgeir, Jónsson Halldór, Chola Richard G, Gunnlaugsson Geir
Department of Medicine, University of Iceland, 101 Reykjavík, Iceland.
Laeknabladid. 2005 Sep;91(9):649-54.
To assess the immunization coverage of children in the Monkey Bay head zone, Malawi where the Icelandic International Development Agency (ICEIDA) has been working to improve health care services in the recent years.
A 30 by 7 cluster sample survey, as defined by WHO's Expanded Programme on Immunization (EPI) was conducted to estimate immunization coverage of children aged 12-23 months for tuberculosis (BCG), diphtheria, tetanus and pertussis (DTP), polio (OPV) and measles immunizations. The Head Zone consists of 97 villages with a population of around 105,000 inhabitants. Five health centres provide immunization services in the area. In total were 217 children in 30 clusters randomly selected and their immunization status by card or history registered.
Immunization coverage by card or history was 97% for BCG, and 99%, 95% and 85% for DTP1, DTP2 and DTP3 respectively. Coverage of OPV1, OPV2 and OPV3 by card or history was 99%, 93% and 85% respectively. Coverage for measles by card or history was 78%. Fully immunized children by card or history were 152 or 70%. Two children had not received any immunizations. Drop-out rate from DTP1 to DTP3 vaccination by immunization card or history was 14.5%, and drop-out from DTP1 to Measles by card or history was 21%.
These results indicate that access to childhood immunization in the Monkey Bay head zone is good while drop-out rate is high. This indicates that access to health services is adequate. However, the coverage of measles appears to be insufficient to prevent outbreaks, and must be improved. The efficacy in delivering immunization can be improved and enhanced utilization of the services offered should be sought.
评估马拉维猴湾地区儿童的免疫接种覆盖率，近年来冰岛国际开发署（ICEIDA）一直在该地区努力改善医疗服务。
按照世界卫生组织扩大免疫规划（EPI）的定义，开展了一项30×7的整群抽样调查，以估计12至23个月大儿童的结核病（卡介苗）、白喉、破伤风和百日咳（百白破）、脊髓灰质炎（口服脊髓灰质炎疫苗）和麻疹免疫接种覆盖率。该地区由97个村庄组成，人口约105,000人。五个卫生中心在该地区提供免疫接种服务。总共从30个整群中随机选取了217名儿童，并通过卡片或病史记录了他们的免疫接种状况。
卡介苗通过卡片或病史记录的免疫接种覆盖率为97%，百白破1、百白破2和百白破3的覆盖率分别为99%、95%和85%。口服脊髓灰质炎疫苗1、口服脊髓灰质炎疫苗2和口服脊髓灰质炎疫苗3通过卡片或病史记录的覆盖率分别为99%、93%和85%。麻疹通过卡片或病史记录的覆盖率为78%。通过卡片或病史记录完全免疫的儿童有152名，占70%。两名儿童未接受任何免疫接种。根据免疫接种卡片或病史记录，从百白破1到百白破3的疫苗接种退出率为14.5%，从百白破1到麻疹的退出率为21%。
这些结果表明，猴湾地区儿童免疫接种的可及性良好，但退出率较高。这表明获得卫生服务的机会是充足的。然而，麻疹的覆盖率似乎不足以预防疫情爆发，必须加以提高。可以提高免疫接种的效果，并寻求提高所提供服务的利用率。
