Belmaker I, Dukhan L, Elgrici M, Yosef Y, Shahar-Rotberg L
Ministry of Health, Regional Health Office, Southern Region, Post office box 10050, Beer-Sheva, Israel.
Lancet. 2006 Mar 25;367(9515):987-91. doi: 10.1016/S0140-6736(06)68425-0.
The Bedouin Arab population of southern Israel is in transition from a semi-nomadic lifestyle to permanent settlement, with many characteristics of a third-world population. A major outbreak of measles in the winter of 1990-91, with an incidence of 415.6 per 100,000 and a case fatality rate of 2.2 % among the Bedouin, led to the establishment of a national committee, which recommended an intervention programme. We report on the effect of the programme implementation on the reduction of vaccine-preventable communicable diseases in a Bedouin Arab population.
We compared immunisation coverage and incidence of reportable vaccine-preventable communicable diseases before and after implementation of the intervention programme.
Implementation of the intervention programme was associated with a marked increase in immunisation coverage, from 53% for first measles immunisation among those born in 1988, and reaching 2 years of age in 1990 at the start of the outbreak, to 90% at age 2 years among those born in 2001. We noted a decrease in all vaccine-preventable communicable diseases, except for pertussis, during this period.
The implementation of a targeted programme to improve immunisation coverage, and other concomitant changes in health-care delivery, was temporally associated with reduction of vaccine-preventable communicable diseases in a population of Bedouin Arabs in Israel who are living in semi-nomadic conditions. The success of the programme could be applicable to semi-nomadic populations living in other areas of the middle east.
以色列南部的贝都因阿拉伯人群正从半游牧生活方式向永久定居转变，具有许多第三世界人口的特征。1990 - 1991年冬季发生了一次大规模麻疹疫情，贝都因人中的发病率为每10万人415.6例，病死率为2.2%，这促使成立了一个全国委员会，该委员会建议实施一项干预计划。我们报告了该计划实施对减少贝都因阿拉伯人群中疫苗可预防传染病的效果。
我们比较了干预计划实施前后的免疫接种覆盖率和可报告的疫苗可预防传染病的发病率。
干预计划的实施与免疫接种覆盖率的显著提高相关，从1988年出生、在疫情开始的1990年达到2岁时首次麻疹免疫接种覆盖率的53%，提高到2001年出生的儿童2岁时的90%。在此期间，我们注意到除百日咳外，所有疫苗可预防传染病的发病率均有所下降。
实施一项有针对性的计划以提高免疫接种覆盖率，以及医疗保健服务方面的其他相应变化，在时间上与以色列半游牧条件下的贝都因阿拉伯人群中疫苗可预防传染病的减少相关。该计划的成功可能适用于生活在中东其他地区的半游牧人群。
