Mansour Ziad, Said Racha, Brandt Lina, Khachan Joseph, Rady Alissar, Fahmy Kamal, Danovaro-Holliday M Carolina
Connecting Research to Development, Beirut, Lebanon.
World Health Organization Lebanon Country Office, Beirut, Lebanon.
Gates Open Res. 2018 Dec 16;2:71. doi: 10.12688/gatesopenres.12898.1.
The effect of immunization does not only depend on its completeness, but also on its timely administration. Routine childhood vaccinations schedules recommend that children receive the vaccine doses at specific ages. This article attempts to assess timeliness of routine vaccination coverage among a sub-sample of children from a survey conducted in 2016. This analysis was based on data from a cross-sectional multistage cluster survey conducted between December 2015 and June 2016 among caregivers of children aged 12-59 months in all of Lebanon using a structured survey questionnaire. The analysis used Kaplan-Meier curves and logistic regression to identify the predictors of age-appropriate immunization. Among the 493 randomly selected children, timely administration of the third dose of polio vaccine, diphtheria-tetanus-pertussis (DTP)-containing vaccine and hepatitis B (HepB) vaccine occurred in about one-quarter of children. About two-thirds of children received the second dose of a measles-containing vaccine (MCV) within the age interval recommended by the Expanded Programme on Immunization (EPI). Several factors including socio-demographic, knowledge, beliefs and practices were found to be associated with age-appropriate vaccination; however, this association differed between the types and doses of vaccine. Important factors associated with timely vaccination included being Lebanese as opposed to Syrian and being born in a hospital for hepatitis B birth dose; believing that vaccination status was up-to-date was related to untimely vaccination. The results suggest that there is reason for concern over the timeliness of vaccination in Lebanon. Special efforts need to be directed towards the inclusion of timeliness of vaccination as another indicator of the performance of the EPI in Lebanon.
免疫接种的效果不仅取决于其完整性，还取决于其接种的及时性。儿童常规疫苗接种时间表建议儿童在特定年龄接种疫苗剂量。本文试图评估2016年一项调查中部分儿童样本的常规疫苗接种及时性。该分析基于2015年12月至2016年6月在黎巴嫩全国范围内对12 - 59个月儿童的照料者进行的横断面多阶段整群调查数据，使用结构化调查问卷。该分析采用Kaplan - Meier曲线和逻辑回归来确定适龄免疫接种的预测因素。在493名随机选取的儿童中，约四分之一的儿童及时接种了第三剂脊髓灰质炎疫苗、含白喉 - 破伤风 - 百日咳（DTP）疫苗和乙型肝炎（HepB）疫苗。约三分之二的儿童在扩大免疫规划（EPI）建议的年龄区间内接种了第二剂含麻疹疫苗（MCV）。发现包括社会人口统计学、知识、信念和行为等几个因素与适龄接种疫苗有关；然而，这种关联在疫苗类型和剂量之间有所不同。与及时接种疫苗相关的重要因素包括是黎巴嫩人而非叙利亚人，以及在医院出生以接种乙型肝炎出生剂量疫苗；认为疫苗接种状态是最新的与不及时接种疫苗有关。结果表明，黎巴嫩疫苗接种的及时性令人担忧。需要做出特别努力，将疫苗接种的及时性作为黎巴嫩EPI绩效的另一个指标。
