Kc Ashish, Nelin Viktoria, Raaijmakers Hendrikus, Kim Hyung Joon, Singh Chahana, Målqvist Mats
United Nations Children's Fund, Nepal Country Office, PO Box 1187, UN House, Pulchowk, Lalitpur, Kathmandu, Nepal.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Bull World Health Organ. 2017 Apr 1;95(4):261-269. doi: 10.2471/BLT.16.178327. Epub 2017 Feb 2.
To compare immunization coverage and equity distribution of coverage between 2001 and 2014 in Nepal.
We used data from the Demographic and Health Surveys carried out in 2001, 2006 and 2011 together with data from the 2014 Multiple Indicator Cluster Survey. We calculated the proportion, in mean percentage, of children who had received bacille Calmette-Guérin (BCG) vaccine, three doses of polio vaccine, three doses of diphtheria-pertussis-tetanus (DPT) vaccine and measles vaccine. To measure inequities between wealth quintiles, we calculated the slope index of inequality (SII) and relative index of inequality (RII) for all surveys.
From 2001 to 2014, the proportion of children who received all vaccines at the age of 12 months increased from 68.8% (95% confidence interval, CI: 67.5-70.1) to 82.4% (95% CI: 80.7-84.0). While coverage of BCG, DPT and measles immunization statistically increased during the study period, the proportion of children who received the third dose of polio vaccine decreased from 93.3% (95% CI: 92.7-93.9) to 88.1% (95% CI: 86.8-89.3). The poorest wealth quintile showed the greatest improvement in immunization coverage, from 58% to 77.9%, while the wealthiest quintile only improved from 84.8% to 86.0%. The SII for children who received all vaccines improved from 0.070 (95% CI: 0.061-0.078) to 0.026 (95% CI: 0.013-0.039) and RII improved from 1.13 to 1.03.
The improvement in immunization coverage between 2001 and 2014 in Nepal can mainly be attributed to the interventions targeting the disadvantaged populations.
比较2001年至2014年尼泊尔的免疫接种覆盖率及覆盖率的公平分配情况。
我们使用了2001年、2006年和2011年进行的人口与健康调查数据，以及2014年多指标类集调查的数据。我们计算了接种卡介苗（BCG）、三剂脊髓灰质炎疫苗、三剂白喉 - 百日咳 - 破伤风（DPT）疫苗和麻疹疫苗的儿童比例（以平均百分比表示）。为衡量财富五分位数之间的不平等，我们计算了所有调查的不平等斜率指数（SII）和不平等相对指数（RII）。
2001年至2014年，12个月龄儿童接种所有疫苗的比例从68.8%（95%置信区间，CI：67.5 - 70.1）增至82.4%（95%CI：80.7 - 84.0）。虽然在研究期间卡介苗、DPT和麻疹免疫接种的覆盖率在统计学上有所增加，但接种第三剂脊髓灰质炎疫苗的儿童比例从93.3%（95%CI：92.7 - 93.9）降至88.1%（95%CI：
86.8 - 89.3）。最贫困的财富五分位数组的免疫接种覆盖率改善最大，从58%提高到77.9%，而最富裕的五分位数组仅从84.8%提高到86.0%。接种所有疫苗儿童的SII从0.070（95%CI：0.061 - 0.078）改善至0.026（95%CI：0.0
13 - 0.039），RII从1.13改善至1.03。
2001年至2014年尼泊尔免疫接种覆盖率的提高主要归因于针对弱势群体的干预措施。
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