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阿富汗12至23个月儿童完全免疫接种的社会经济和人口决定因素

Socio-economic and demographic determinants of full immunization among children of 12-23 months in Afghanistan.

作者信息

Farzad Fraidoon, A Reyer Joshua, Yamamoto Eiko, Hamajima Nobuyuki

机构信息

Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Nagoya J Med Sci. 2017 Feb;79(2):179-188. doi: 10.18999/nagjms.79.2.179.

Abstract

Immunization is one of the most cost-effective interventions to reduce vaccine-preventable diseases morbidity and mortality. Vaccination coverage is very low in Afghanistan; National Risk and Vulnerability Assessment (NRVA) Survey 2008 estimated the coverage of fully immunized children to be 37%. The current study was designed to examine the factors influencing full immunization among children aged 12-23 months. Demographic and vaccination data of 2,561 children of 12-23 months was extracted from the Afghanistan Health Survey (AHS) 2012. The data was analyzed by logistic regression to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI). The study found that 38.8% of the children were fully immunized. The coverage for specific vaccines was 80.9% for BCG, 72.0% for OPV3, 64.8% for measles, and 50.1% for Penta3. Urban residence (AOR = 0.60, 95% CI 0.40-0.90 relative to rural), children of poorer families (AOR = 1.36, 95% CI 1.10-1.67 relative to poorest), some education (AOR = 1.59, 95% CI 1.20-2.11 relative to no education) and antenatal care (AOR = 1.70, 95% CI 1.44-2.01 relative to not received) were found to be significant predicators of full immunization. This study indicated that the full-immunization rate in Afghanistan was quite low compared to the national target of 90% coverage. Therefore, strategies taking into account the identified factors seem to be vital to improve vaccination coverage.

摘要

免疫接种是降低疫苗可预防疾病发病率和死亡率最具成本效益的干预措施之一。阿富汗的疫苗接种覆盖率非常低;2008年国家风险和脆弱性评估(NRVA)调查估计,完全免疫儿童的覆盖率为37%。本研究旨在探讨影响12至23个月龄儿童完全免疫的因素。从2012年阿富汗健康调查(AHS)中提取了2561名12至23个月龄儿童的人口统计学和疫苗接种数据。通过逻辑回归分析数据,以估计调整后的优势比(AOR)和95%置信区间(CI)。研究发现,38.8%的儿童完全免疫。卡介苗的特定疫苗接种覆盖率为80.9%,口服脊髓灰质炎疫苗3型为72.0%,麻疹疫苗为64.8%,五联疫苗3为50.1%。城市居住(相对于农村,AOR = 0.60,95% CI 0.40 - 0.90)、贫困家庭儿童(相对于最贫困家庭,AOR = 1.36,95% CI 1.10 - 1.67)、接受过一定教育(相对于未接受教育,AOR = 1.59,95% CI 1.20 - 2.11)和接受过产前护理(相对于未接受,AOR = 1.70,95% CI 1.44 - 2.01)被发现是完全免疫的重要预测因素。本研究表明,与90%覆盖率的国家目标相比,阿富汗的完全免疫率相当低。因此,考虑到已确定因素的策略对于提高疫苗接种覆盖率似乎至关重要。

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