Effect of food coupon incentives on timely completion of DTP immunization series in children from a low-income area in Karachi,Pakistan: A longitudinal intervention study

This study introduced food/medicine vouchers as an incentive to mothers of infants visiting Expanded Program on Immunization (EPI) centers in a low socio-economic area. The timely completion of diphtheria, tetanus and pertussis vaccines combined (DTP) series immunization rates between intervention and control cohorts were compared. The DTP up-to-date immunization coverage at 18 weeks of age increased two-fold (RR 2.20, 95% CI: 1.95–2.48, p < 0.001) in the incentive cohort compared to the no-incentive cohort. While increasing immunization coverage is a complex structural and behavioral process, food/medicine coupon may improve routine immunization coverage in developing countries.     

北京市2004～2011年常住儿童免疫规划疫苗接种率调查

目的 了解北京市2004～2011年常住儿童免疫规划疫苗接种情况变化趋势,以指导今后常规免疫工作.方法 按容量比例概率抽样法,每年在全市范围内,以区县为单位,随机抽取至少30个村居,每个村居随机抽查1～3岁7名常住儿童,调查其免疫规划疫苗基础免疫、百白破(DPT)和麻疹(MV)疫苗的加强免疫接种情况.结果 北京市常住儿童免疫预防接种率逐年提高,2011年,预防接种建卡率、建证率;卡证符合率、卡介苗(BCG)、脊髓灰质炎(脊灰,OPV)基础全程、DPT基础全程、MV基础、乙型肝炎(乙肝,HepB)基础全程、风疹(Rubella)基础、流行性腮腺炎(流腮,Mumps)基础、流行性脑脊髓膜炎(流脑,MPV)基础、流行性乙型脑炎(乙脑,JEV)基础和甲型肝炎(甲肝,HepA)基础免疫、DPT、MV加强免疫合格接种率均达97％以上;四苗(BCG、OPV、DPT、MV)基础免疫全程及时接种率达90.46％、HepB首针及时接种率达97.33％.结论 北京市常住儿童中已建立起较为牢固的免疫规划疫苗相关疾病的免疫屏障,但仍需继续加强流动儿童的免疫预防服务工作.     

Use of an immunization information system to assess the effectiveness of pentavalent rotavirus vaccine in US children

Immunization information systems (IISs) are accessible sources of immunization data. We validated immunization information from a local IIS against provider records and assessed the system's utility in evaluating vaccine effectiveness against rotavirus disease using a case-control study. Among the 91% of case and control patients with immunization records, 49% were in the IIS, and 97% had a provider record. Good agreement was observed across record sources (к = 0.65). Vaccine effectiveness (VE) was 82% using IIS data compared to 82–88% using provider data. Controls identified through the IIS provided VE estimates similar to hospital control patients. IISs could represent a valuable source of data for effectiveness evaluations.     

地理信息系统技术在浙江省钉螺监测中的应用

目的 探索地理信息系统(GIS)在浙江省血吸虫病中间宿主钉螺监测中的应用.方法 收集浙江省2005-2009年血吸虫病调查资料,建立GIS螺情数据库,应用ArcGIS9.2软件,导入GIS数据库各项属性并制作所需钉螺面积空间分布电子图和差值图.结果 2005-2009年共有28个县先后查出钉螺,5年累计查出有螺村1580个,有螺面积513.28 hm2.建立了十一五期间全省GIS螺情数据库;根据钉螺面积大小标记不同颜色,制作了电子分布图,实现全省钉螺分布信息电子化;2009年与2005年有螺面积比较,差值空间分布图显示有螺面积压缩或增加的县数分别占48.0%(12/25)和52.0%(13/25);在国家级血吸虫病监测点建立了有螺环境卫星迭加图,呈现17个螺点,每个螺点显示螺情有关信息.结论 应用GIS制作的钉螺面积分布图、差值空间分布图能直观地显示螺情变化,为掌握血吸虫病疫情以及制定防治策略提供科学依据.     

应用地理信息系统技术对江苏省艾滋病疫情的空间分析

目的 探讨江苏省各县(区)HIV感染者空间分布规律,试建立疫情预测模型.方法 建立江苏省各县(市)HIV感染者人数疫情数据库,根据地理信息分析HIV感染者相关的地理特征,对HIV感染者人数进行趋势分析、空间自相关分析、空间线性回归分析.结果 (1)江苏省HIV感染者总体呈随机分布,但局部地区存在感染者聚集现象,发现南京市城区的感染者人数表现为负自相关,苏州和无锡市城区两地为正自相关.铜山县、吴江市、南京市浦口区和城区、溧水县、无锡市城区、苏州市城区为江苏省HIV感染者高度聚集的热点区域.(2)建立江苏省HIV感染者疫情分布图和趋势分析图,全省HIV感染者分布在地理东西方向上的变化不大,南北方向上,苏南地区疫情远远比苏北和苏中地区严重.(3)运用最小二乘法进行HIV感染者人数的空间线性回归分析,江苏省HIV感染者人数与地理经纬度之间的线性回归关系无统计学意义(t=-1.045 103,P=0.299 904;t=-1.443 668,P=0.153 714).结论 应根据江苏省HIV感染者空间分布特点,制定预防和控制疫情传播的措施.

Abstract：

Objective To analyze the spatial distribution of AIDS in every city of Jiangsu province, trying to describe the geographic characteristics of AIDS and to develop a prediction model.Methods Numbers of patients in Jiangsu province were collected, to establish the database for the geographic information system, then setting up a 'risk map' of the disease. Spatial, autocorrelation.Linear spatial analyses were used to study the patients' numbers. Results (1)Results from the autocorrelation analysis showed that the distribution of AIDS was clustered at some places and was at random on the whole. The results also indicated that the distribution of AIDS in Nanjing was of negative correlation, while that in Suzhou and Wuxi were of positive correlation but in Tongshan, Wujiang, Pukou, Nanjing, Lishui, Wuxi and Suzhou showed seven locations of clusters with disease was more severe in the southern than in the northern parts of Jiangsu province. (3)Ordinary Least Squares method was finally used in the linear spatial regression and the results were: t=-1.045 103 (P=0.299 904); t=-1.443 668 (P=0.153 714) respectively. Conclusion According to the feature spatial distribution of the disease, effective measures should be taken to prevent and to keep the prevalence of AIDS under control.     

The economic value of increasing geospatial access to tetanus toxoid immunization in Mozambique

BackgroundWith tetanus being a leading cause of maternal and neonatal morbidity and mortality in low and middle income countries, ensuring that pregnant women have geographic access to tetanus toxoid (TT) immunization can be important. However, immunization locations in many systems may not be placed to optimize access across the population. Issues of access must be addressed for vaccines such as TT to reach their full potential.MethodsTo assess how TT immunization locations meet population demand in Mozambique, our team developed and utilized SIGMA (Strategic Integrated Geo-temporal Mapping Application) to quantify how many pregnant women are reachable by existing TT immunization locations, how many cannot access these locations, and the potential costs and disease burden of not covering geographically harder-to-reach populations. Sensitivity analyses covered a range of catchment area sizes to include realistic travel distances and to determine the area some locations would need to cover in order for the existing system to reach at least 99% of the target population.ResultsFor 99% of the population to reach health centers, people would be required to travel up to 35 km. Limiting this distance to 15 km would result in 5450 (3033–7108) annual cases of neonatal tetanus that could be prevented by TT, 144,240 (79,878–192,866) DALYs, and $110,691,979 ($56,180,326–$159,516,629) in treatment costs and productivity losses. A catchment area radius of 5 km would lead to 17,841 (9929–23,271) annual cases of neonatal tetanus that could be prevented by TT, resulting in 472,234 (261,517–631,432) DALYs and $362,399,320 ($183,931,229–$522,248,480) in treatment costs and productivity losses.ConclusionTT immunization locations are not geographically accessible by a significant proportion of pregnant women, resulting in substantial healthcare and productivity costs that could potentially be averted by adding or reconfiguring TT immunization locations. The resulting cost savings of covering these harder to reach populations could help pay for establishing additional immunization locations.     

外来儿童免疫接种率及影响因素调查

[目的 ]　了解上海市闸北区外来儿童免疫状况。　 [方法 ]　 2 0 0 1年 6月在上海市闸北区开展外来儿童接种率及影响因素调查 ,共调查 8个街道 ,3 72名儿童。　 [结果 ]　建卡率 78.8% ,建证率 83 .9% ,1岁以上儿童四苗接种率66.4% ,乙肝疫苗接种率 62 .9%。影响儿童接种的主要因素有 :所在街道的地理位置、父亲的文化程度、儿童在调查地的居住时间、家长的免疫预防知晓情况等。　 [结论 ]　加大宣传力度 ,建立各部门协作的外来儿童管理体系是提高接种率的关键     

地理信息系统在医学地理研究中的应用

地理信息系统通过对地理数据的集成、存储、检索、操作和分析,生成并输出各种地理信息,从而为各部门提供信息以及辅助决策。现代医学地理学研究中大量与宏观系统有关的数据都具有空间分布特点,使地理信息系统成为医学地理学研究中有力的辅助工具。     

中国湖区五省血吸虫病聚集区域地理信息系统综合探测分析

目的 综合探测2008年中国湖区5省血吸虫病传播的聚集区域,为血吸虫病防治提供依据,也为相关疾病聚集区域探测方法的建立提供参考.方法 基于县级地理信息系统(GIS)基础上构建空间数据库,运用全局空间自相关Moran's I、局部空间自相关Getis-Ord Gj与SaTScarn软件综合探测血吸虫病聚集区域,并对结果进行比较.结果 全局空间自相关结果提示从整体研究区域来看,血吸虫病感染率分布呈现空间聚集性(P＜0.05);局部空间自相关结果提示有50个县(区)的局部空间自相关结果有统计学意义(P＜0.05),且z值均＞0,提示存在高值聚集;SaTScan统计结果探测出5个聚集区域,与局部空间自相关的结果较为吻合.结论 湖区5省沿江地区仍然是中国血吸虫病防治的重点,尤以湖北、湖南两省交界地带空间聚集性最高、范围最大.     

中国湖区五省血吸虫病聚集区域地理信息系统综合探测分析

目的 综合探测2008年中国湖区5省血吸虫病传播的聚集区域, 为血吸虫病防治提供依据, 也为相关疾病聚集区域探测方法的建立提供参考。方法 基于县级地理信息系统(GIS)基础上构建空间数据库, 运用全局空间自相关Moran’s1、局部空间自相关Getis-OrdGi与SaTScan软件综合探测血吸虫病聚集区域, 并对结果进行比较。结果 全局空间自相关结果提示从整体研究区域来看, 血吸虫病感染率分布呈现空间聚集性(P<0.05);局部空间自相关结果提示有50个县(区〉的局部空间自相关结果有统计学意义(PC0.05), 且z值均>0, 提示存在高值聚集;SaTScan统计结果探测出5个聚集区域, 与局部空间自相关的结果较为吻合。结论 湖区5省沿江地区仍然是中国血吸虫病防治的重点, 尤以湖北、湖南两省交界地带空间聚集性最高、范围最大。     

地理信息系统在公共卫生领域的应用

地理信息系统（GIS）是一门综合性学科,具有海量空间数据管理分析、可视化结果展示等特点,已经广泛应用在不同的领域.近年来,GIS在流行病学研究、疾病监测、突发公共卫生事件应对、环境健康研究和卫生决策等方面发挥着重要作用,具有较好的应用前景.此文就GIS在公共卫生领域的应用研究进行综述.     

应用地理信息系统分析北京市海淀区肾综合征出血热的空间分布

目的 分析北京市海淀区肾综合征出血热(HFRS)的空间分布。方法 以北京市海淀区1：10万地形图为背景，在AxcInfo8．1软件中建立行政边界图层，在地图上标出海淀区1997～2002年HFRS患者的住址；应用SaTScan3．0软件对各乡(镇)、街道HFRS的发病情况进行空间聚类分析，确定高流行区域范围，并在地理信息系统(GIS)中通过空间分析对不同的发病情况采用不同的颜色和等值线显示。结果 空间聚类分析显示北京市海淀区HFRS病例呈聚集性分布，高发区聚集在苏家坨乡、永丰乡、上庄乡、温泉镇及聂各庄乡所属区域(RR=4，43，P=0．001．)；建立北京市海淀区HFRS空间分布专题地图。结论 北京市海淀区HFRS的空间分布为非随机分布，其分布特征与地理环境因素密切相关。     

Health-care provision factors associated with child immunization coverage in a city centre and a rural area in Kabul,Afghanistan

A total of 1327 households were surveyed in Kabul province, Afghanistan to evaluate child immunization coverage and its association with distance to health facilities, attendance at antenatal care, the place of delivery and contact by outreach activity. The proportion of fully immunized children, those who had received at least 1 dose of BCG, 3 doses of DPT, and 1 dose of measles vaccine, was 84.5% in the city centre and 60.7% in the rural area. Fully immunized status was positively associated with close proximity to a health facility (odds ratio [OR] = 1.92, [95%CI, 1.08, 3.39]), and attendance at antenatal care (OR = 1.39, [95%CI, 1.00, 1.93]) in the city centre, and outreach contact (OR = 11.6, [95%CI, 6.92, 19.4]) in the rural area after adjustment for demography, socio-economic factors, participation in health education and experiences of hardship. Attendance at antenatal care in the rural area (OR = 1.91, [95%CI, 1.35, 2.72]), and institutional delivery in the city centre and rural area (OR = 2.83, [95%CI, 1.20, 6.71]; OR = 2.17, [95%CI, 1.01, 4.64], respectively) were positively associated with antigen specific coverage. Improving multiple community conditions including health-care provision and socio-economic factors through close partnership among various sectors promotes the immunization program.     

地理信息系统应用于中国大陆高致病性禽流感的空间分布及环境因素分析

目的应用地理信息系统(GIS)技术分析中国大陆高致病性禽流感的空间分布特征和探讨疫情发生的相关环境因素。方法收集中国2004年1、2月份高致病性禽流感疫情资料建立数据库,在ArcGIS 8.3软件中与省级、县级行政区划数字地图建立关联,对禽流感疫情的分布进行空间聚类分析、空间统计分析和追踪分析;收集中国气象资料、植被遥感影像及候鸟迁移数据,分析禽流感疫情发生的相关环境因素。结果空间聚类分析显示中国大陆2004年1、2月份禽流感高发区聚集在圆心为东经113.261°、北纬23.119°、半径为1090.52 km的区域内(RR=2.646,P=0.001);空间统计分析显示中国大陆禽流感疫情大都发生在各省(自治区、直辖市)的省会城市及周边地区,并主要分布于一级河流、湖泊周边及沿海区域;环境因素分析显示禽流感疫情发生的当天气温较低、相对湿度和平均气压较高,疫区与中国东、中部候鸟迁徙区的联系密切,疫区1—2月份平均归一化差值植被指数(NDVI)为0 36±0.11。结论中国大陆高致病性禽流感的空间分布为非随机分布,且具有明显的地域聚集性。     

应用地理信息系统研究我国肾综合征出血热疫区类型与主要宿主动物构成的关系

目的 分析中国肾综合征出血热(HFRS)疫区的性质与主要宿主动物种群构成的关系。方法 收集中国122个地区1991～1999年HFRS病例血清分型资料和41个监测点的宿主动物种类及数量资料,在ArcGIS 8.1软件的支持下,建立中国HFRS病例分型地理信息系统(GIS)和监测点宿主动物构成GIS,并以此为基础通过反距离加权插值法(IDW)建立中国HFRS主要疫区分型地图,叠合监测点宿主动物构成图;对各监测点的宿主动物构成进行分层聚类分析。结果 中国HFRS不同类型疫区呈现明显的区域性分布,总体表现为从东北至西南方向Ⅰ型汉坦病毒(HV)为主的混合型疫区与Ⅱ型HV为主的混合型疫区交替分布的特征;监测点野外宿主动物种类较多且各地区鼠种构成差异较大,居民区宿主动物种类相对较少,且优势鼠种大多局限于2～3种宿主动物;监测点宿主动物构成的聚类分析结果显示其疫区类型与所在疫区病例血清型基本一致。结论 以空间数据库为基础的GIS及其空间分析能根据HFRS样点信息很好地预测各主要疫区的分型特征。     

Geographical display of health information: study of hepatitis C infection in Karachi, Pakistan

The prevalence of hepatitis C and other infections is increasing in urban areas of developing countries. Data on such diseases are often limited to facility-based information. However, even this is not available in a usable form to health care providers, health managers and policy makers. We present a simple technique for visually displaying facility based prevalence information on hepatitis C using basic geographic information system (GIS) techniques. We display the prevalence of hepatitis C for the city of Karachi, Pakistan for the first time. The distribution tends to indicate that there are areas of higher prevalence located in specific districts. There is also a trend of higher prevalence in less affluent urban areas. Such simple applications of mapping technology are useful for rapidly summarizing and displaying information in a contextually and spatially meaningful fashion, and its use should be encouraged for displaying health indicators in developing countries.     

地理信息系统在疟疾控制研究中的应用

及时、准确地预测和预报疟疾疫情是控制疟疾流行的关键。地理信息系统在疟疾控制中的推广应用,为开展疟疾现场研究提供了有力的技术手段,并为决策者制定预防策略,赢取宝贵时间,以采取相应防治措施,减少社会和人民的经济损失。因此,近年来地理信息系统在疟疾控制与研究中发挥着日趋重要的作用。     

安徽省疟疾发病地理信息系统研究

目的建立疟疾发病地理信息系统模型，对疟疾发病情况进行空间分析。方法收集1950～2005年疟疾发病资料，使用EpiInfo3．3．2软件建立数据库并拟合地理信息系统模型。结果1970～1999年，疟疾发病率最高达到12156．42／10万，最低仅为1．32／10万，总体呈逐年下降趋势，平均下降速度为27．01％；2000～2005年，疫情出现回升，6年间疟疾发病率平均上升速度61．91％。结论安徽省疟疾历史上严重流行区在长江以北，重点在沿淮淮北地区；现阶段疟疾高发地区仍然徘徊在淮河流域及其以北地区，但发病范围可能有所扩大。     

Association of vaccine hesitancy and immunization coverage rates in the European Union

While previous studies have validated vaccine hesitancy scales with uptake behavior at the individual level, the conditions under which aggregated survey data are useful are less clear. We show that vaccine public opinion data aggregated at the subnational level can serve as a valid indicator of aggregate vaccine behaviour. We use a public opinion survey (Eurobarometer EB 91.2) with data on vaccine hesitancy for the EU in 2019. We link this information to (subnational) regional immunization coverage rates for childhood vaccines – DTP3, MCV1, and MCV2 -- obtained from the WHO for 2019. We conduct multilevel regression analyses with data for 177 regions in 20 countries. Given the variation in vaccine hesitancy and immunization rates between countries and within countries, we affirm the valuable role that surveys can play as a public health surveillance tool when it comes to vaccine behavior. We find statistically significantly lower regional vaccine immunization rates in regions where vaccine hesitancy is more pronounced. Our results suggest that different uptake rates across subnational regions are due, at least in part, to differences in attitudes towards vaccines and vaccination. The results are robust to several alternative specifications.