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巴西米纳斯吉拉斯州甲型肝炎、麻疹、腮腺炎和风疹以及水痘疫苗接种覆盖率的时间趋势分析。

Childhood vaccination coverage of hepatitis A, measles, mumps and rubella, and varicella: temporal trend analysis in Minas Gerais, Brazil.

机构信息

Universidade Federal de São João del Rei - Divinópolis (MG), Brasil.

Universidade Federal de Viçosa - Viçosa (MG), Brasil.

出版信息

Rev Bras Epidemiol. 2022 May 6;25:e220010. doi: 10.1590/1980-549720220010.2. eCollection 2022.

Abstract

OBJECTIVE

To analyze the temporal trend of vaccination coverage for hepatitis A, measles, mumps and rubella, and varicella in a Brazilian state from 2014 to 2020.

METHODS

An ecological, time-series study that considered data from 853 municipalities in the state of Minas Gerais that compose the 14 regions of the state, these being the territorial units of analysis. Records of applied doses of hepatitis A, measles, mumps and rubella, and varicella vaccines registered in the Brazilian Immunization Information System were analyzed. Trends were estimated by Prais-Winsten regression and 95% confidence intervals of measures of variation were calculated.

RESULTS

Low vaccine coverage of hepatitis A, measles, mumps and rubella, and varicella was identified. Coverages above 95% were observed only in 2015 for the vaccine against hepatitis A (98.8%) and, in 2016, for varicella (98.4%). The measles, mumps and rubella vaccine showed coverage of less than 95% in all analyzed years. Decreases of 13.6 and 4.3% between the years 2019 and 2020 were identified for the measles, mumps and rubella, and hepatitis A vaccines, respectively. There was a decreasing trend in hepatitis A vaccination coverage in the South (p=0.041), East (p=0.030), and North (p=0.045) regions; and for the measles, mumps and rubella in Jequitinhonha Valley (p=0.002), East (p=0.004), and North (p=0.024) regions. Increasing coverage was observed only for varicella in eight regions of the state.

CONCLUSIONS

The data point to heterogeneity in the temporal behavior of vaccination coverage in Minas Gerais. The downward trend in some regions causes concern about the possibility of resurgence of diseases, such as measles, which until then had been controlled.

摘要

目的

分析 2014 年至 2020 年巴西米纳斯吉拉斯州甲型肝炎、麻疹、腮腺炎、风疹和水痘疫苗接种覆盖率的时间趋势。

方法

这是一项生态时间序列研究,考虑了米纳斯吉拉斯州 853 个市的数据,这些市构成了该州的 14 个地区,是分析的领土单位。分析了巴西免疫信息系统登记的甲型肝炎、麻疹、腮腺炎、风疹和水痘疫苗接种剂量记录。通过普赖斯-温斯坦(Prais-Winsten)回归估计趋势,并计算变异措施的 95%置信区间。

结果

发现甲型肝炎、麻疹、腮腺炎、风疹和水痘疫苗的接种率较低。2015 年甲型肝炎疫苗(98.8%)和 2016 年水痘疫苗(98.4%)的覆盖率超过 95%。在所有分析年份,麻疹、腮腺炎、风疹疫苗的覆盖率均低于 95%。2019 年至 2020 年,麻疹、腮腺炎、风疹疫苗分别下降 13.6%和 4.3%。甲型肝炎疫苗的接种覆盖率在南部(p=0.041)、东部(p=0.030)和北部(p=0.045)地区呈下降趋势;麻疹、腮腺炎、风疹疫苗在杰赛明洪尼亚谷(p=0.002)、东部(p=0.004)和北部(p=0.024)地区呈下降趋势。只有八个州的地区水痘疫苗的覆盖率呈上升趋势。

结论

数据显示米纳斯吉拉斯州疫苗接种覆盖率的时间行为存在异质性。一些地区的下降趋势令人担忧,因为麻疹等疾病可能会再次出现,而麻疹此前已得到控制。

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