Nielsen Sebastian, Möller Sören, Benn Christine Stabell, Aaby Peter
Bandim Health Project, Open Patient Data Explorative Network, Department of Clinical Research, University of Southern Denmark, Denmark.
Bandim Health Project, Indepth Network, Apartado 861, Guinea-Bissau.
Vaccine X. 2024 Nov 18;21:100588. doi: 10.1016/j.jvacx.2024.100588. eCollection 2024 Dec.
Numerous national health intervention campaigns, e.g. supplementary immunization campaigns/activities (SIAs), have been conducted in low- and middle-income countries (LMIC) in the last decades. These campaigns are rarely evaluated for overall health outcomes. Information on campaigns is critical for evaluations. We investigated; 1) quality of campaign information sources and 2) implication of quality for outcome evaluations.
We focused on three campaign types: oral polio vaccine (OPV), vitamin A supplementation (VAS) and measles vaccine (MV) campaigns in two case countries, for which "gold standard" information on campaigns collected regularly at Health and Demographic Surveillance Systems (HDSS) sites: Guinea-Bissau and Bangladesh. We compared the campaign information from HDSS with information from the World Health Organisation (WHO) and the Rotary Foundation (Rotary, only OPV campaigns). First, campaigns were matched and compared based on intervention type, date of campaign and target age group. Second, we assessed the implications of using various sources of campaign information on the estimated effect of OPV campaigns on all-cause under-3-year mortality in Cox proportional hazards regression models.
The proportion of matched OPV campaigns was highest between HDSS and Rotary. VAS campaigns (only information from HDSS and WHO) matched poorly. The estimated effect of OPV campaigns information on child mortality in Bangladesh went from being statistically significant (HR = 0.69 (0.52-0.90)) using HDSS campaign information to not being significant (HR = 0.93 (0.71-1.21) using WHO campaign information.
Compared with the HDSS, Rotary had the best campaign information on the conduct of OPV campaigns, whereas the WHO quality of campaign information was low for both OPV and VAS. A low quality of campaign information may alter conclusions of health outcome evaluations. Reliable and precise information on campaigns is essential to assess their effects. Public and private campaign stakeholders should track campaign information meticulously and support that publicly data is available for researchers.
在过去几十年里，许多低收入和中等收入国家开展了大量国家卫生干预活动，如补充免疫活动。这些活动很少针对总体健康结果进行评估。活动信息对于评估至关重要。我们调查了：1）活动信息来源的质量；2）质量对结果评估的影响。
我们聚焦于两种案例国家的三种活动类型：口服脊髓灰质炎疫苗（OPV）、维生素A补充（VAS）和麻疹疫苗（MV）活动，在卫生和人口监测系统（HDSS）站点定期收集这两种案例国家活动的“金标准”信息：几内亚比绍和孟加拉国。我们将HDSS的活动信息与世界卫生组织（WHO）和扶轮基金会（仅OPV活动）的信息进行了比较。首先，根据干预类型、活动日期和目标年龄组对活动进行匹配和比较。其次，在Cox比例风险回归模型中，我们评估了使用各种活动信息来源对OPV活动对3岁以下儿童全因死亡率估计效果的影响。
HDSS与扶轮基金会之间匹配的OPV活动比例最高。VAS活动（仅来自HDSS和WHO的信息）匹配度较差。在孟加拉国，使用HDSS活动信息时，OPV活动信息对儿童死亡率的估计效果具有统计学意义（HR = 0.69（0.52 - 0.90）），而使用WHO活动信息时则无统计学意义（HR = 0.93（0.71 - 1.21））。
与HDSS相比，扶轮基金会关于OPV活动开展情况的活动信息最佳，而WHO关于OPV和VAS的活动信息质量较低。活动信息质量低可能会改变健康结果评估的结论。关于活动的可靠和精确信息对于评估其效果至关重要。公共和私人活动利益相关者应仔细跟踪活动信息，并支持向研究人员公开数据。
