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巴西南部基于电子免疫登记系统的 2 岁以下儿童疫苗接种覆盖率。

Vaccination coverage among children under two years of age based on electronic immunization registry in Southern Brazil.

机构信息

Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil.

出版信息

Rev Saude Publica. 2011 Feb;45(1):90-8. doi: 10.1590/s0034-89102010005000054. Epub 2010 Dec 10.

Abstract

OBJECTIVE

To evaluate the immunization program for 12 and 24-month-old children based on electronic immunization registry.

METHODS

A descriptive study of a random sample of 2,637 children born in 2002 living in the city of Curitiba, Southern Brazil was performed. Data was collected from local electronic immunization registers and the National Live Birth Information System, as well as from a household survey for cases with incomplete records. Coverage at 12 and 24 months was estimated and analyzed according to the socioeconomic characteristics of each administrative district and the child's enrollment status in the health care service. The coverage, completeness, and record duplication in the registry were analyzed.

RESULTS

Coverage of immunization was 95.3% at 12 months, with no disparities among administrative districts, and 90.3% at 24 months, with higher coverage in a district with lower socioeconomic conditions (p < 0.01). The proportion of vaccines, according to type, given before and after the recommended age reached 0.9% and 32.2%, respectively. In the surveyed sample, electronic immunization registry coverage was 98%, underreporting of vaccine doses was 11%, and record duplication was 20.6%. Groups with highest coverage included children with permanent records, children with three or more appointments through the National Unified Health Care System, and children seen within Primary Health Care Facilities fully adopting the Family Health Strategy.

CONCLUSIONS

Vaccination coverage in Curitiba was high and homogeneous among districts, and health service enrollment status was an important factor in these results. The electronic immunization registry was a useful tool for monitoring vaccine coverage; however, it will be important to determine cost-effectiveness prior to wide-scale adoption by the National Immunization Program.

摘要

目的

基于电子免疫登记系统评估 12 个月和 24 个月龄儿童的免疫计划。

方法

本研究为巴西南部库里提巴市出生的 2637 名 2002 年儿童的随机样本描述性研究。数据来自当地电子免疫登记系统和国家活产信息系统,以及记录不完整的病例的家庭调查。根据每个行政区的社会经济特征和儿童在医疗保健服务中的注册状况,估计和分析了 12 个月和 24 个月时的覆盖率,并对登记处的覆盖率、完整性和记录重复情况进行了分析。

结果

12 个月时免疫覆盖率为 95.3%,各行政区之间无差异,24 个月时覆盖率为 90.3%,在社会经济条件较低的行政区覆盖率较高(p<0.01)。根据类型,推荐年龄之前和之后给予的疫苗比例分别为 0.9%和 32.2%。在所调查的样本中,电子免疫登记覆盖率为 98%,疫苗剂量漏报率为 11%,记录重复率为 20.6%。覆盖率最高的群体包括有常住记录的儿童、通过国家统一卫生保健系统预约 3 次或以上的儿童以及在全面采用家庭健康战略的初级保健机构就诊的儿童。

结论

库里提巴的疫苗接种覆盖率高,各行政区之间分布均匀,卫生服务注册状况是这些结果的一个重要因素。电子免疫登记系统是监测疫苗覆盖率的有用工具;然而,在国家免疫计划广泛采用之前,确定其成本效益将是很重要的。

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