Coetzee D J, Ferrinho P, Reinach S G
Department of Community Health, Medical School, University of the Witwatersrand, Johannesburg, South Africa.
Bull World Health Organ. 1993;71(1):33-9.
A community-based survey of the vaccination status of children aged 12-23 months was conducted to evaluate the impact of a child health outreach programme on vaccination coverage in Alexandra township, South Africa. The EPI cluster sampling technique was adapted for this purpose. The sample size, including the number of clusters and the number of units per cluster, was increased to permit stratification of the data and comparison of the results with those obtained in a study conducted prior to the introduction of the outreach services in 1988. At the time of the survey interview, 67% of the children were fully vaccinated (78% against measles) and by 1 year of age, 58% were fully vaccinated (69% against measles). The increase in coverage since the introduction of the programme was statistically significant only for measles (Student's t-test, P < 0.01). A total of 75% of children living in formal dwellings, compared with 51% living in informal dwellings, were fully vaccinated by interview (Fisher's exact test, two tailed, P < 0.0001). Mothers from informal dwellings had a 1.88 times greater chance of not knowing about the outreach services (P < 0.001). Children whose mothers knew where vaccinations were given, attended postnatal clinics, used the outreach services, possessed a road-to-health card from the Alexandra Health Centre, and who resided in a formal dwelling all had a higher chance of being vaccinated.
开展了一项针对12至23个月大儿童疫苗接种状况的社区调查，以评估一项儿童健康推广计划对南非亚历山德拉镇疫苗接种覆盖率的影响。为此采用了扩大免疫规划整群抽样技术。样本量，包括整群数量和每个整群的单位数量，有所增加，以便对数据进行分层，并将结果与1988年引入推广服务之前进行的一项研究所得结果进行比较。在调查访谈时，67%的儿童已完全接种疫苗（78%接种了麻疹疫苗），到1岁时，58%的儿童已完全接种疫苗（69%接种了麻疹疫苗）。自该计划实施以来，覆盖率的提高仅在麻疹疫苗接种方面具有统计学意义（学生t检验，P<0.01）。到访谈时，居住在正规住所的儿童中有75%已完全接种疫苗，而居住在非正规住所的儿童中这一比例为51%（费舍尔精确检验，双侧，P<0.0001）。来自非正规住所的母亲不知道推广服务的可能性要高1.88倍（P<0.001）。母亲知道何处进行疫苗接种、去过产后诊所、使用过推广服务、持有亚历山德拉健康中心的健康记录卡以及居住在正规住所的儿童接种疫苗的可能性都更高。
