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巴伊亚州萨尔瓦多市的社会不平等与疫苗接种覆盖率

Social inequalities and vaccination coverage in the city of Salvador, Bahia.

作者信息

Barata Rita Barradas, Pereira Susan M

机构信息

Santa Casa de São Paulo, Faculdade de Ciências Médicas, Departamento de Medicina Social, São PauloSP.

出版信息

Rev Bras Epidemiol. 2013 Jun;16(2):266-77. doi: 10.1590/S1415-790X2013000200004.

Abstract

OBJECTIVE

To estimate the vaccination coverage in children born in the city of Salvador, analyzing these coverages by socioeconomic conditions.

METHOD

A household survey on vaccination coverage was conducted with children born in 2005, in Salvador, Bahia, northeastern Brazil, who were aged between 18 to 36 months at the time of this study. Cluster sampling was performed in multiple stages. Census tracts were stratified using data from the national census conducted in 2000. Data was collected on socio-economic households. The sample size was defined by a specific methodology developed for immunization coverage surveys. The questionnaire was based upon the information contained in the vaccination cards. The estimated vaccination coverage in the various strata considered the sampling complex plan, weighting the observations according to the sampling fraction, the losses and the design effect.

RESULTS

There was inequality in the socioeconomic strata analyzed, where the coverage rate was directly proportional to socioeconomic status. Strata D and E showed statistically significant differences when compared to stratum A. Regarding to the complete scheme, children living in strata D and E have significantly less coverage than those residing in strata B. For vaccines not included in the basic scheme, the differences are very marked, showing less than 3% in stratum D and E.

CONCLUSIONS

Vaccination coverage for the complete schedule at the end of 18 months of age with valid doses, was unsatisfactory and shows significant differences among the socio-economic strata with poor coverage in the poorest groups.

摘要

目的

评估萨尔瓦多市出生儿童的疫苗接种覆盖率,并按社会经济状况分析这些覆盖率。

方法

对2005年在巴西东北部巴伊亚州萨尔瓦多市出生、在本研究时年龄在18至36个月之间的儿童进行了关于疫苗接种覆盖率的家庭调查。采用多阶段整群抽样。根据2000年全国人口普查数据对普查区进行分层。收集了社会经济家庭的数据。样本量由为免疫接种覆盖率调查制定的特定方法确定。问卷基于疫苗接种卡中包含的信息。各阶层的估计疫苗接种覆盖率考虑了抽样复杂计划,根据抽样比例、损耗和设计效应对观察结果进行加权。

结果

在所分析的社会经济阶层中存在不平等现象,覆盖率与社会经济地位成正比。与A阶层相比,D阶层和E阶层显示出统计学上的显著差异。就完整方案而言,居住在D阶层和E阶层的儿童的覆盖率明显低于居住在B阶层的儿童。对于基本方案中未包括的疫苗,差异非常明显,D阶层和E阶层的覆盖率不到3%。

结论

18个月龄结束时完整接种程序且剂量有效的疫苗接种覆盖率不令人满意,并且在社会经济阶层之间存在显著差异,最贫困群体的覆盖率较低。

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