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2009 - 2016年意大利福贾市65岁及以上成年人的当地贫困状况与季节性流感疫苗接种覆盖率

Local deprivation status and seasonal influenza vaccination coverage in adults ≥ 65 years residing in the Foggia municipality, Italy, 2009-2016.

作者信息

Fortunato F, Iannelli G, Cozza A, Del Prete M, Pollidoro F V, Cocciardi S, DI Trani M, Martinelli D, Prato R

机构信息

Department of Medical and Surgical Sciences, University of Foggia, Italy.

出版信息

J Prev Med Hyg. 2019 Feb 28;59(4 Suppl 2):E51-E64. doi: 10.15167/2421-4248/jpmh2018.59.4s2.1167. eCollection 2018 Dec.

Abstract

INTRODUCTION

In Italy, vaccination against seasonal influenza has been recommended for the elderly since 1980, but coverage is still far below the WHO minimum target level of 75%. Effective interventions to improve influenza vaccination should take into account socioeconomic determinants of inequalities in vaccine uptake. This study aimed to assess differences in vaccination coverage, by socioeconomic status, among people ≥ 65 years of age residing in the Foggia municipality, Italy.

METHODS

A Socio-Economic-Health Deprivation Index (SEHDI) was constructed by using a multivariate analysis model. The resident population, for census block, was classified in 5 deprivation groups. Differences in demographic and socioeconomic indicators, the standardized mortality ratios (SMRs), and the average vaccination coverage among deprivation groups were evaluated with the linear F-test. The association between census variables and influenza vaccination coverage, in each deprivation group, was assessed using the Pearson bivariate correlation.

RESULTS

The SEHDI allowed to identify factors related to ageing, housing, household size and composition, and education. Forty percent of people residing in the Foggia municipality lived in conditions of socioeconomic and health deprivation. Belonging to families with 3 or 4 members was associated with increased coverage rates. In the most deprived group, vaccination uptake was positively associated with the dependency ratio.

CONCLUSIONS

The results of this study have shown that there is still large room for improving influenza vaccination coverage among subjects belonging to the most deprived areas. Surveillance of trends in influenza vaccine uptake by socioeconomic groups is a feasible contribution to implementing effective, tailored to the frail older persons, vaccine utilization programs.

摘要

引言

在意大利,自1980年起就建议老年人接种季节性流感疫苗,但接种率仍远低于世界卫生组织设定的75%的最低目标水平。改善流感疫苗接种的有效干预措施应考虑到疫苗接种不平等现象的社会经济决定因素。本研究旨在评估意大利福贾市65岁及以上居民中按社会经济地位划分的疫苗接种率差异。

方法

采用多变量分析模型构建社会经济健康剥夺指数(SEHDI)。按普查街区将常住人口分为5个剥夺组。使用线性F检验评估各剥夺组在人口统计学和社会经济指标、标准化死亡率(SMR)以及平均疫苗接种率方面的差异。在每个剥夺组中,使用Pearson双变量相关性评估普查变量与流感疫苗接种率之间的关联。

结果

SEHDI有助于识别与老龄化、住房、家庭规模和构成以及教育相关的因素。居住在福贾市的40%的人口生活在社会经济和健康剥夺状况下。属于有3或4名成员的家庭与更高的接种率相关。在最贫困组中,疫苗接种率与抚养比呈正相关。

结论

本研究结果表明,在最贫困地区的人群中,提高流感疫苗接种率仍有很大空间。按社会经济群体监测流感疫苗接种趋势,有助于实施针对体弱老年人的有效、量身定制的疫苗使用计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d19/6419308/6f6394198613/jpmh-2018-04-e51-g001.jpg

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