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评估 2015-2016 年越南湄公河三角洲地区及时接种乙肝和卡介苗首针及基础婴儿免疫接种程序情况。

Assessment of the timely administration of the hepatitis B and BCG birth dose and the primary infant vaccination schedule in 2015-2016 in the Mekong Delta, Viet Nam.

机构信息

Can Tho University of Medicine and Pharmacy, Can Tho, Viet Nam.

Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Belgium.

出版信息

Vaccine. 2018 Sep 11;36(38):5760-5765. doi: 10.1016/j.vaccine.2018.08.002. Epub 2018 Aug 16.

Abstract

INTRODUCTION

Vietnam is implementing hepatitis B (HBV) birth dose (BD) vaccination since 2003 but coverage remains low, especially in the Mekong River Delta. This study aimed to determine the coverage of the HBV BD vaccination, to identify socio-demographic factors influencing HBV BD, and to assess reasons for non-immunization of neonates.

METHODS

A cross-sectional survey was conducted in 2015-2016. Mothers from 526 children aged 6-11 months living in 3 provinces in the Mekong River Delta - representing respectively urban, rural and remote area - were interviewed at home and infant vaccination documents were checked. The three-stage sampling method was adapted from WHO 30-cluster sampling. Predictors of HBV BD administration were identified with multiple regression analysis.

RESULTS

The overall HBV BD coverage (within 24 h) was 46.6% (compared to 44.5% for BCG) and was significantly higher in remote or rural than in urban area (OR 1.87 and 3.36, respectively), and in children whose father had a higher educational level (OR 2.76; 2.29 and 1.86, respectively, for master degree, bachelor and secondary school) as compared to a lower level. Main reasons for not having received HBV BD mentioned by parents were vaccines not offered by health care workers (53.0%), and illness of the infant (27.2%).

CONCLUSION

Although Vietnam started HBV BD vaccination more than 10 years ago, the coverage and timeliness need to improve to reach WHO targets (95% within 24 h after birth). Better training and information of health care workers, and better protocols ensuring timely HBV BD could address these vaccine administration thresholds.

摘要

引言

越南自 2003 年开始实施乙型肝炎(HBV)出生剂量(BD)疫苗接种,但覆盖率仍然很低,尤其是在湄公河三角洲地区。本研究旨在确定 HBV BD 疫苗接种的覆盖率,确定影响 HBV BD 的社会人口学因素,并评估新生儿未免疫的原因。

方法

2015-2016 年进行了横断面调查。在湄公河三角洲的 3 个省,对 526 名 6-11 个月大的儿童的母亲进行了家访,并检查了婴儿的疫苗接种文件。采用世卫组织 30 群抽样法进行了三阶段抽样。采用多元回归分析确定 HBV BD 管理的预测因素。

结果

HBV BD 的总体覆盖率(24 小时内)为 46.6%(与 BCG 的 44.5%相比),在偏远或农村地区明显高于城市地区(OR 分别为 1.87 和 3.36),在父亲具有较高教育水平的儿童中(OR 分别为 2.76;硕士学位、学士学位和中学分别为 2.29 和 1.86)高于较低水平。父母未接种 HBV BD 的主要原因是医护人员未提供疫苗(53.0%)和婴儿患病(27.2%)。

结论

尽管越南十多年前就开始实施 HBV BD 疫苗接种,但要达到世卫组织的目标(出生后 24 小时内接种率达到 95%),还需要提高覆盖率和及时性。更好地培训和告知医护人员,以及更好地确保及时接种 HBV BD 的方案,可以解决这些疫苗接种的障碍。

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