Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
BMJ Open. 2022 Nov 11;12(11):e050211. doi: 10.1136/bmjopen-2021-050211.
To assess the spatial distribution, trends and determinants of crude full vaccination coverage (FVC) in children aged 12-59 months between 2010 and 2019 in Peru.
DESIGN, SETTING AND ANALYSIS: A cross-sectional study based on the secondary data analysis of the 2010 and 2019 Peruvian Demographic and Health Surveys (DHSs) was conducted. Logit based multivariate decomposition analysis was employed to identify factors contributing to differences in FVC between 2010 and 2019. The spatial distribution of FVC in 2019 was evaluated through spatial autocorrelation (Global Moran's I), ordinary kriging interpolation (Gaussian process regression) and Bernoulli-based purely spatial scan statistic.
FVC, as crude coverage, was defined as having completely received BCG; three doses of diphtheria, pertussis, and tetanus, and polio vaccines; and measles vaccine by 12 months of age.
A total of 5 751 and 14 144 children aged 12-59 months from 2010 and 2019 DHSs, respectively, were included.
FVC increased from 53.62% (95% CI 51.75% to 55.49%) in 2010 to 75.86% (95% CI 74.84% to 76.85%) in 2019. Most of the increase (70.39%) was attributable to differences in coefficients effects. Family size, visit of health workers in the last 12 months, age of the mother at first delivery, place of delivery and antenatal care follow-up were all significantly associated with the increase. The trend of FVC was non-linear and increased by 2.22% annually between 2010 and 2019. FVC distribution was heterogeneous at intradepartmental and interdepartmental level. Seven high-risk clusters of incomplete coverage were identified.
Although FVC has increased in Peru, it still remains below the recommended threshold. The increase of FVC was mainly attributed to the change in the effects of the characteristics of the population. There was high heterogeneity across Peruvian regions with the presence of high-risk clusters. Interventions must be redirected to reduce these geographical disparities.
评估 2010 年至 2019 年期间秘鲁 12-59 月龄儿童完全疫苗接种覆盖率（FVC）的空间分布、趋势和决定因素。
设计、地点和分析：本研究基于 2010 年和 2019 年秘鲁人口与健康调查（DHS）的二次数据分析进行了一项横断面研究。采用基于对数的多元分解分析来确定 2010 年至 2019 年 FVC 差异的贡献因素。通过空间自相关（全局 Moran's I）、普通克里金插值（高斯过程回归）和基于伯努利的纯粹空间扫描统计评估 2019 年 FVC 的空间分布。
FVC 作为粗覆盖率，定义为在 12 个月龄时完全接受卡介苗、三剂白喉、百日咳和破伤风以及脊髓灰质炎疫苗以及麻疹疫苗。
分别纳入 2010 年和 2019 年 DHS 中 12-59 月龄的 5751 名和 14144 名儿童。
FVC 从 2010 年的 53.62%（95%CI 51.75%至 55.49%）增加到 2019 年的 75.86%（95%CI 74.84%至 76.85%）。大部分增加（70.39%）归因于系数效应的差异。家庭规模、过去 12 个月卫生工作者的访问、母亲首次分娩时的年龄、分娩地点和产前保健随访均与增加显著相关。FVC 趋势是非线性的，2010 年至 2019 年间每年增加 2.22%。FVC 分布在部门内和部门间存在异质性。确定了七个不完全覆盖的高风险聚集区。
尽管秘鲁的 FVC 有所增加，但仍低于建议的阈值。FVC 的增加主要归因于人口特征效应的变化。秘鲁各地区之间存在高度异质性，存在高风险聚集区。必须调整干预措施以减少这些地理差异。
