Singh J, Jain D C, Sharma R S, Verghese T
National Institute of Communicable Diseases (NICD), Delhi, India.
Bull World Health Organ. 1996;74(3):269-74.
The immunization coverage of infants, children and women residing in a primary health centre (PHC) area in Rajasthan was evaluated both by lot quality assurance sampling (LQAS) and by the 30-cluster sampling method recommended by WHO's Expanded Programme on Immunization (EPI). The LQAS survey was used to classify 27 mutually exclusive subunits of the population, defined as residents in health subcentre areas, on the basis of acceptable or unacceptable levels of immunization coverage among infants and their mothers. The LQAS results from the 27 subcentres were also combined to obtain an overall estimate of coverage for the entire population of the primary health centre, and these results were compared with the EPI cluster survey results. The LQAS survey did not identify any subcentre with a level of immunization among infants high enough to be classified as acceptable; only three subcentres were classified as having acceptable levels of tetanus toxoid (TT) coverage among women. The estimated overall coverage in the PHC population from the combined LQAS results showed that a quarter of the infants were immunized appropriately for their ages and that 46% of their mothers had been adequately immunized with TT. Although the age groups and the periods of time during which the children were immunized differed for the LQAS and EPI survey populations, the characteristics of the mothers were largely similar. About 57% (95% CI, 46-67) of them were found to be fully immunized with TT by 30-cluster sampling, compared with 46% (95% CI, 41-51) by stratified random sampling. The difference was not statistically significant. The field work to collect LQAS data took about three times longer, and cost 60% more than the EPI survey. The apparently homogeneous and low level of immunization coverage in the 27 subcentres makes this an impractical situation in which to apply LQAS, and the results obtained were therefore not particularly useful. However, if LQAS had been applied by local staff in an area with overall high coverage and population subunits with heterogeneous coverage, the method would have been less costly and should have produced useful results.
通过批量质量保证抽样（LQAS）以及世界卫生组织扩大免疫规划（EPI）推荐的30群组抽样方法，对居住在拉贾斯坦邦一个初级卫生保健中心（PHC）地区的婴儿、儿童和妇女的免疫接种覆盖率进行了评估。LQAS调查用于根据婴儿及其母亲的免疫接种覆盖率是否可接受，将27个相互排斥的人口亚单位（定义为卫生次中心地区的居民）进行分类。还将27个次中心的LQAS结果合并，以获得初级卫生保健中心全体人口覆盖率的总体估计，并将这些结果与EPI群组调查结果进行比较。LQAS调查未发现任何一个次中心的婴儿免疫接种水平高到可被归类为可接受；只有三个次中心被归类为妇女破伤风类毒素（TT）覆盖率处于可接受水平。综合LQAS结果得出的初级卫生保健中心人群估计总体覆盖率显示，四分之一的婴儿按年龄进行了适当免疫接种，其母亲中有46%接受了充分的TT免疫接种。尽管LQAS和EPI调查人群的儿童免疫接种年龄组和时间段不同，但母亲的特征基本相似。通过30群组抽样发现，其中约57%（95%可信区间，46 - 67）的母亲接受了TT全程免疫接种，而分层随机抽样的结果为46%（95%可信区间，41 - 51）。差异无统计学意义。收集LQAS数据的实地工作耗时约为EPI调查的三倍，成本高出60%。27个次中心免疫接种覆盖率明显均匀且较低，这使得在此应用LQAS不切实际，因此获得的结果并非特别有用。然而，如果由当地工作人员在总体覆盖率高且覆盖情况各异的人口亚单位地区应用LQAS，该方法成本会更低，且应该会产生有用的结果。
