Pérez Vallejo A D, Fernández Alonso I M, Gálvez Ibáñez M
Unidad Docente Medicina de Familia, Hospital Clinico, Granada.
Aten Primaria. 1998 Oct 15;22(6):368-70.
a) To find the prevalence of anti-tetanus vaccination in a health district, and b) to detect difficulties in the implementation of corrective measures, after the appearance of three cases of tetanus in 6 months.
An observational descriptive crossover study.
Primary care. Rural health district with 18266 inhabitants.
People of both sexes over 14 from the 3 population nuclei, which had the best records of attendance and vaccination in the health district.
Vaccination coverage at the start and end of the intervention for 328 people chosen by systematic randomised sampling.
clinical records.
At the start of the intervention there was less vaccination coverage among males, over-50s and people living in small nuclei of population. During the study period vaccination coverage increased more in the nuclei where there had been a tetanus case. Vaccines were lacking at the start of the intervention.
A low use of clinical records in the health district was detected, which posed difficulties for the research. Except for one of the population nuclei, very few people at the start of the study were recorded as correctly vaccinated. It is seen that the health service responded slowly to such serious cases as these. It is suggested that primary health care activities should be programmed more in accord with the health problems prevailing in each area. With an illness like tetanus we should not wait for a case to occur before acting.
a) 确定某卫生区破伤风疫苗接种率，b) 在6个月内出现3例破伤风病例后，发现实施纠正措施存在的困难。
观察性描述性交叉研究。
初级保健机构。农村卫生区，有18266名居民。
来自该卫生区就诊和疫苗接种记录最佳的3个人口聚集区的14岁以上男女。
通过系统随机抽样选择328人，在干预开始和结束时统计疫苗接种覆盖率。
临床记录。
干预开始时，男性、50岁以上人群以及居住在小聚居区的人群疫苗接种覆盖率较低。在研究期间，出现过破伤风病例的聚居区疫苗接种覆盖率增长幅度更大。干预开始时疫苗短缺。
发现该卫生区临床记录使用较少，给研究带来困难。除了其中一个人口聚集区，研究开始时很少有人被记录为正确接种了疫苗。可见卫生服务部门对这类严重病例反应迟缓。建议初级卫生保健活动应根据各地区普遍存在的健康问题进行更合理的规划。对于破伤风这样的疾病，我们不应等到病例出现才采取行动。
