摘要
目的比较2011和2016年中国西部被调查地区12～35月龄儿童乙肝疫苗全程及时接种率及其不公平程度,为促进西部地区儿童乙肝疫苗接种的及时性提供参考。方法采用多阶段按容量比例概率抽样法,通过问卷调查及抄录预防接种证乙肝疫苗接种信息的方法,分别调查2011和2016年中国西部7个省/自治区的14个县1 738和1 244名携带免疫接种证的12～35月龄儿童乙肝疫苗全程及时接种情况。使用多因素Logistic回归探究乙肝疫苗全程及时接种的影响因素,并采用集中指数法评估乙肝疫苗全程及时接种率不公平的程度。结果中国西部被调查地区12～35月龄儿童乙肝疫苗全程及时接种率从2011年的46.6%上升至2016年的59.3%。集中指数从0.07(95%CI=0.04～0.10)降至0.06(95%CI=0.03～0.09)。2016年,在乡医院出生(OR=2.35,95%CI=1.46～3.78)、在家出生(OR=3.71,95%CI=2.34～5.88)、看护人是少数民族(OR=1.81,95%CI=1.39～2.37)和看护人未上过学(OR=1.72,95%CI=1.12～2.65)是儿童乙肝疫苗全程未及时接种的危险因素。结论乙肝疫苗全程及时接种率在2011和2016年期间免疫接种服务的不公平程度有所下降,但依然存在不公平。应更加关注弱势群体,特别是看护人没上过学、看护人为少数民族、在乡级医院出生和在家出生的儿童。
Objective To compare timely hepatitis B vaccination coverage in the year of 2011 and 2016 among children aged 12-35 months in western China. Methods By using multi-stage probability proportional sampling, 1 738 and 1 244 children aged 12-35 months with an immunization card were selected from 14 rural counties of western China in 2011 and 2016, respectively. Socio-economic characteristics were obtained from face-to-face interview and copies of vaccination certificates. Multivariate logistic regression models were performed to identify the determinants of timely hepatitis B vaccination coverage. The Erreygers＇ concentration index（ ECI） was used to quantify the degree of inequality. Results In 2011 and 2016, the overall timely hepatitis B vaccination coverage among children aged 12-35 months in western areas was 46.6% and 59.3%, respectively. The concentration index decreased from 0.07（ 95%CI = 0.04-0.10） to 0.06（ 95%CI = 0.03-0.09）. In 2016, being born in township hospital（ adjust OR =2.35; 95%CI = 1.46-3.78）, being born at home（ adjust OR = 3.71; 95%CI = 2.34-5.88）, having a minority caregiver（ adjust OR= 1.81; 95%CI = 1.39-2. 37） and having an illiterate caregiver（ adjust OR = 1. 72; 95% CI = 1. 12-2. 65） significantly associated with higher risk of untimely hepatitis B vaccination. Conclusion The socioeconomic inequality in timely hepatitis B vaccination decreases during 2011 to 2016, however it still exists. To improve inequality in timely three doses coverage, the government should pay more attention to the disadvantaged groups, especially children who were ethnic minorities, having an illiterate caregiver and were delivered in the township hospital or at home.
作者
刘小莉
杨晨璐
宋绮莹
曲雪琪
陈春屹
周虹
LIU Xiaoli;YANG Chenlu;SONG Qiying;QU Xueqi;CHEN Chunyi;ZHOU Hong(Department of Maternal and Child Health,School of Public Health,Peking University,Beifing（100191）,China)
出处
《中国学校卫生》
CAS
北大核心
2018年第8期1128-1131,共4页
Chinese Journal of School Health
基金
联合国儿童基金会项目(NO.501)
关键词
肝炎疫苗
乙型
接种
因素分析
统计学
儿童
Hepatitis B vaccines
Vaccination
Factor analysis
statistical
Child
