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印度北阿坎德邦德拉敦地区农村新生儿免疫接种首次剂量的覆盖率及影响因素:一项基于社区的横断面研究

Coverage and Determinants of Birth Dosage of Newborn Immunization in Rural Areas of Dehradun District, Uttarakhand, India: A Community-Based Cross-Sectional Study.

作者信息

Kumar Prakash, Kumar Abhishek, Saini Bhavana, Singh Mahendra, Saxena Vartika

机构信息

Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

出版信息

Indian J Community Med. 2023 Sep-Oct;48(5):727-733. doi: 10.4103/ijcm.ijcm_9_23. Epub 2023 Sep 7.

Abstract

BACKGROUNDS

The Universal Immunization Program of India is one of the most cost-effective interventions in public health. Missing or delaying vaccination may elicit an uncertain immune response in the body, making the population susceptible to vaccine-preventable diseases. The objectives of this study were to determine the coverage of newborn immunization for birth doses under the National Immunization Schedule and its epidemiological determinants in the rural areas of the Dehradun district, Uttarakhand.

MATERIALS AND METHODS

A community-based cross-sectional study was conducted for a period of one year with a sample size of 570. World Health Organization (WHO) 30 Cluster sampling technique was used with 19 children in each cluster. The data on determinants were collected using a semi-structured, pre-designed schedule through a house-to-house survey. Multivariate analysis was conducted to identify factors associated with immunization coverage, taking the significance level as < 0.05.

RESULTS

The coverage of the Bacillus Calmette-Guérin vaccine, oral polio vaccine zero dose and hepatitis B birth dose were 100%, 91.9%, and 58.8%, respectively in the study area with an overall prevalence of incomplete coverage of newborn immunization as 42.5%. The most cited reason for children being unimmunized with birth doses was the unavailability of vaccines at the birthplace center (29.6%).

CONCLUSIONS

The prevalence of incomplete coverage of newborn immunization was quite high, which was undermining the holistic approach of the National Immunization Program. Vaccine availability and accessibility at the birthplace with capacity building and training of the healthcare workers may be considered to ensure coverage of birth doses.

摘要

背景

印度的通用免疫计划是公共卫生领域最具成本效益的干预措施之一。错过或延迟接种疫苗可能会在体内引发不确定的免疫反应,使人群易患疫苗可预防疾病。本研究的目的是确定北阿坎德邦德拉敦地区农村地区国家免疫规划下新生儿出生剂量免疫接种的覆盖率及其流行病学决定因素。

材料与方法

进行了为期一年的基于社区的横断面研究,样本量为570。采用世界卫生组织30群集抽样技术,每个群集选取19名儿童。通过挨家挨户调查,使用半结构化、预先设计的调查表收集决定因素的数据。进行多变量分析以确定与免疫接种覆盖率相关的因素,显著性水平设定为<0.05。

结果

在研究区域,卡介苗、口服脊髓灰质炎疫苗零剂次和乙肝疫苗出生剂量的接种率分别为100%、91.9%和58.8%,新生儿免疫接种不完全覆盖率的总体患病率为42.5%。儿童未接种出生剂量疫苗最常被提及的原因是出生地中心没有疫苗(29.6%)。

结论

新生儿免疫接种不完全覆盖率相当高,这正在破坏国家免疫计划的整体方法。可以考虑在出生地提供疫苗并确保可及性,同时对医护人员进行能力建设和培训以确保出生剂量的接种覆盖率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee69/10637594/7dd52ac97267/IJCM-48-727-g001.jpg

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