Programa de Pós-Graduação em Saúde da Família, Universidade Federal do Maranhão. Centro Pedagógico Paulo Freire, Campus do Bacanga, Sala de Tutoria, 1º andar, Asa Norte. 65080-805 São Luís MA Brasil.
Departamento de Saúde Pública, Universidade Federal do Maranhão. São Luís MA Brasil.
Cien Saude Colet. 2023 Aug;28(8):2335-2346. doi: 10.1590/1413-81232023288.07312023. Epub 2023 May 15.
We aimed to analyze the trend of indicators of the National Immunization Program (acronym in Portuguese. PNI) in children under one-year-old and classify municipalities regarding the risk of transmission of vaccine-preventable diseases (RTVPD) in Maranhão from 2010 to 2021. This ecological time series study was based on secondary data on vaccination coverage (VC). vaccination coverage homogeneity (VCH). proportion of abandonment (PA). and RTVPD. with state coverage for vaccines in the national children's calendar. Prais-Winsten regression estimated trends (α=5%) and the indicators' annual percentage change (APC). We identified fluctuating and discrepant VC between vaccines. with a decreasing trend (p < 0.01). except those against Hepatitis B (p = 0.709) and oral human rotavirus (p = 0.143). The sharpest falls were for Yellow Fever (APC = 12.24%) and BCG (APC = 12.25%) vaccines. All VCH rates were lower than expected. with a drop from 2014 and APC between 5.75% (Pneumococcal 10; p = 0.033) and 14.02% (Poliomyelitis; p < 0.01). We observed an increasing trend in PA for Pentavalent (APC = 4.91%; p < 0.01) and Poliomyelitis (APC = 3.55%; p < 0.01). We identified an increase of 52.54% in the proportion of municipalities in Maranhão from 2015 to 2021. with extremely high (p = 0.025) and high (p = 0.028) RTVPD. The PNI indicators deteriorated. reaffirming the susceptibility to the emergence of vaccine-preventable diseases.
我们旨在分析 2010 年至 2021 年马兰豪州 1 岁以下儿童国家免疫计划（葡萄牙语缩写 PNI）指标的趋势，并根据疫苗可预防疾病的传播风险（RTVPD）对马兰豪州的城市进行分类。这项生态时间序列研究基于疫苗接种覆盖率（VC）、疫苗接种覆盖率同质性（VCH）、放弃率（PA）和 RTVPD 的二级数据，以及国家儿童日历中的疫苗州覆盖率。Prais-Winsten 回归估计趋势（α=5%）和指标的年变化百分比（APC）。我们发现疫苗之间的 VC 波动且不一致，呈下降趋势（p<0.01），但乙型肝炎（p=0.709）和口服人轮状病毒（p=0.143）疫苗除外。黄热病（APC=12.24%）和卡介苗（APC=12.25%）疫苗的降幅最大。所有 VCH 率均低于预期，自 2014 年以来下降，APC 在 5.75%（肺炎球菌 10；p=0.033）和 14.02%（脊髓灰质炎；p<0.01）之间。我们观察到五联疫苗（APC=4.91%；p<0.01）和脊髓灰质炎（APC=3.55%；p<0.01）的 PA 呈上升趋势。我们发现，2015 年至 2021 年，马兰豪州有 52.54%的城市比例增加，具有极高（p=0.025）和高（p=0.028）的 RTVPD。PNI 指标恶化，再次证实了对疫苗可预防疾病的易感性。
