上海市闵行区外来儿童计划免疫建卡率分析

流动人口骤增是上海城市化发展的必然趋势，做好外来儿童计划免疫服务与管理具有重要的社会卫生学意义。上海市闵行区外来儿童计划免疫建卡车分析表明，父母职业及居住时间对儿童建卡车有着重要影响，而与父母籍贯和文化程度并无联系。建立与健全流动人口卫生工作网络，严格制度化管理，提高卫生服务质量，是实施外来儿童计划免疫的关键。     

上海市闵行区外来儿童计划免疫建卡率分析

流动人口骤增是上海城市化发展的必然趋势,做好外来儿童计划免疫服务与管理具有重要社会卫生学意义。上海市闵行区外来儿童计划免疫建卡率分析表明:父母职业及居住时间对儿童建卡率有着重要影响,而与父母籍贯和文化程度并无联系。建立与健全流动人口卫生工作网络,严格制度化管理,提高卫生服务质量,是实施外来儿童计划免疫的关键。     

上海市浦东新区外来儿童计划免疫情况调查

随着浦东新区的开发开放 ,外来流动人口大量涌入 ,外来儿童计划免疫问题成为本地区计划免疫工作的重点和难点。一方面 ,外来儿童的建卡率和“四苗”接种率均低于本地户籍儿童 ,成为许多计划免疫传染病的高危人群和传染源[1] ,并影响到本地人群 ;另一方面 ,目前现有的计划免疫管理模式尚不能适用于外来儿童 ,使得外来儿童不能同等享受现有卫生资源。为了解浦东新区现有外来儿童基本情况、免疫状况 ,探索适应于新区外来儿童的计划免疫管理模式 ,我们于 2 0 0 2年 7～ 9月进行了外来儿童计划免疫情况的调查。1　对象与方法1.1　对象调查对象为 …     

上海市宝山区流动儿童计划免疫管理模式探讨及效果评价

宝山区地处上海市的北翼,是城乡一体化的滨江新城区。随着社会经济的发展,大量流动人口涌入本区,仅登记在册的外地人口就达35.53万人,占总人口的31.10%。近年来,本区建立了外来儿童计划免疫的三级管理网络,但管理网络尚不够成熟,多部门协作的信息共享机制尚不健全,严重影响着公共卫生体系的整体效率和效果。外来儿童的接种覆盖率、接种及时率远远低于本地儿童,易形成免疫空白,存在着传染病发生和流行的潜在威胁。探索一套切实可行的流动儿童计划免疫服务管理模式已迫在眉睫。     

外来流动人口儿童计划免疫管理初探

我市地处珠江三角洲腹地，交通十分方便。自实施计划免疫以来，本地常住人口儿童接种率一直保持在较高水平．尤其是从1984年起，对本地常住人口儿童实行计划免疫保偿制，进一步确保了计划免疫的成果，“四苗”接种率全部达98％以上，1996年通过了城市初级卫生保健达标省级评审。但是随着改革开放，流动人口剧增，大批外来流动人口儿童涌入本市，对这些儿童计划免疫工作的管理不容忽视，其工作的好坏，直接影响到我市计划免疫的工作成果，因此，近年来特对外来儿童计划免疫管理工作进行了初步探讨。1措施和效果1．1经常性查访和突击性督查相…     

关于流动儿童计划免疫管理模式的探讨

本文通过对流行儿童计划免疫管理的现状及存在的问题进行分析,尝试寻找一个解决流动儿童计划免疫管理的有效模式,为提高流动儿童的计划免疫水平、提高他们的健康素质服务。     

上海市闵行区外来儿童计划免疫管理相关人员的知信行分析

目的 了解闵行区外来儿童家长、乡村医生、协管员及条线工作人员等计划免疫知识、态度、信念和行为(KABP,简称知信行),为探索外来儿童计划免疫的管理模式提供依据.方法 用分层整群随机抽样法在闵行区12个社区中随机抽取计划免疫条线工作人员8名、在外来人口集中的社区华槽和颛桥镇各抽取乡村医生、儿童家长、人口协管员各8名进行2轮焦点组访谈,工作人员为工作2年以上者,外来儿童家长为来沪半年以上者.结果 外来儿童家长对儿童计划免疫重要性的认知情况与行为不能同步,与预防接种相比,儿童家长更注重孩子的读书教育问题;目前的计划免疫宣传方式和宣传内容不适合外来人口;外来儿童增加,计划免疫条线工作人员工作负荷过重;乡村医生与外来人口协管员工作受工作量及专业、权利所限在外来儿童计划免疫工作中有很大局限性.结论 在全国各地区规范预防接种登记、凭证入学等工作可起到"标本兼治"的作用;今后还需要加强电视、广播等大众媒体方面的宣传工作,并将疾病的危害做为切入点来宣传更能引起外来儿童家长的重视;建立外来儿童预防保健与教育一体化政策及建立信息化、智能化外来儿童管理系统,可切实做好外来儿童计划免疫工作并为计划免疫条线工作人员和乡村医生、外来人口协管员营造一个良好的工作氛围.     

上海市外来流动儿童计划免疫管理措施效果评价

[目的]　探讨外来流动儿童计划免疫管理的有效措施和方法。[方法]　首先拟定上海市外来流动儿童计划免疫管理措施,并从组织上保证该措施的实施。半年后,对上海市部分地区进行了外来流动儿童计划免疫管理措施的效果评价。[结果]　82.0%的外来流动儿童能够出示预防接种证,72.4%的外来流动儿童接受了“四苗”初免,“四苗”按时接种率64.5%～69.3%,85.6%的外来流动儿童家长接受过计划免疫宣传教育,他们的计免基础知识答对率达69.0%,且与其子女的接种率呈正相关关系。[结论]　外来流动儿童计划免疫宣教的最适形式依次为广播电视、分发宣传材料和防保人员的个别宣教。     

基层乙肝疫苗纳入儿童计划免疫管理模式探讨

近年来我区病毒性乙型肝炎发病率较高,在法定传染病报告中居首位,接种乙肝疫苗是预防乙型肝炎最有效、最经济的措施。2003年我省将新生儿乙肝疫苗正式纳入儿童计划免疫管理,免费为新生儿接种乙肝疫苗,经过2年多时间的实践,我区摸索出了一条行之有效的管理办法。1管理模式与资料来源1.1管理模式1.1.1管理人员的培训。根据省、市疾控中心的要求,我区每年年初对辖区医疗机构保健科、妇产科、卫生院防疫股等预防接种人员进行相关知识的宣传培训,培训疫苗的管理、接种对象、用法和剂量及禁忌症和副反应处理等相关知识,提高了接种人员对乙肝疫苗及…     

外来儿童计划免疫情况调查和管理

为了解流动人口儿童免疫接种情况和管理中的难点,我们于１９９８年１２月对杭州近郊流动人口较集中的两个村进行了一次０～４岁儿童计免建卡率和“五苗”接种率的调查,并与城乡长住户口儿童免疫接种情况进行比较,旨在为制订流动人口计免管理对策提供依据。调查结果如下。 对象与方法 １．对象选择：在杭州近郊某乡随机抽样两个村为调查点,全面调查户籍在册农家儿童和在杭临时居住（租房、寄住）流动人口中的外来儿童,以０～４足岁为本次调查对象。同时,在城区抽调一个居委会进行比较。 ２．调查方法：设计统一个案调查表,由区卫生防…     

火车旅客免疫规划知识知晓情况调查

目的了解公众对免疫规划知识的知晓情况，为今后制定有效的传播策略提供依据。方法在北京西客站随机抽取1180名乘客，采用问卷调查方法调查公众免疫规划知识的知晓情况。结果接受调查的乘客中，87．6％的人认为打预防针／吃糖丸对小孩有好处，61．0％的人知道国家免疫规划疫苗是免费的，能够全部说出5种免疫规划疫苗的占32．1％；知道儿童出生后24小时内应接种乙肝疫苗的占44．2％。知道出生后1天内要接种卡介苗疫苗的占21．0％。39．0％的调查对象知道接种第一针疫苗后建立预防接种证。64．0％的调查对象知道“接种证需要保留到上小学；60％的对象知道入学、入托时要查验预防接种证。结论公众缺乏免疫规划的基本知识是导致免疫规划疫苗接种率低的主要原因之一。文化程度与免疫规划知识的掌握情况有一定关系。在今后的工作中，要加大对文化水平相对较低人群的宣传力度，提高该人群的疾病规划知识知晓率。     

Differential coverage for vaccines in the expanded program on immunization (EPI) among children in rural Pakistan

BackgroundPakistan has a well-established Expanded Program on Immunization (EPI) however vaccine-preventable diseases still account for high infant and child mortality rates. This study describes the differential vaccine coverage and determinants of vaccine uptake in rural Pakistan.MethodsFrom October 2014 to September 2018, we enrolled children younger than 2 years of age from the Matiari Demographic Surveillance System in Sindh, Pakistan. Socio-demographic and vaccination history were collected from all participants. Vaccine coverage rates and timeliness were reported. Socio-demographic variables for missed and untimely vaccination were studied in multivariable logistic regression.ResultsOf the 3140 enrolled children, 48.4 % received all EPI recommended vaccines. Only 21.2 % of these were age appropriate. Around 45.4 % of the children were partially vaccinated, and 6.2 % were unvaccinated. Highest coverage was seen for the first dose of pentavalent (72.8 %), 10-valent Pneumococcal Conjugate Vaccine (PCV10) (70.4 %) and Oral Polio Vaccine (OPV) (69.2 %) and the lowest coverage was for measles (29.3 %) and rotavirus (1.8 %) vaccines. Primary caretakers and wage earners with a higher level of education were protective against missed and untimely vaccination. Enrollment in the 2nd, 3rd and 4th study year was negatively associated with being unvaccinated whereas distance from a major road was positively associated with non-adherence to schedule.ConclusionVaccine coverage was low among children in Matiari, Pakistan, and majority received delayed doses. Parents’ education status and year of study enrollment was protective against vaccine dropout and delayed vaccination whereas geographical distance from a major road was a predictor. Vaccine promotion and outreach efforts may have had a beneficial impact on vaccine coverage and timeliness.     

外来儿童免疫预防服务管理探讨

目的:了解外来儿童家长免疫预防知识、态度和行为与免疫预防服务现状,以及为外来儿童免疫预防服务中存在的问题,探讨提高外来儿童免疫接种率的途径和方法。方法:采用横断面研究的流行病学方法,问卷调查了1530名外来儿童家长关于免疫预防服务的相关问题。结果:大多数外来儿童家长知道预防接种,并希望通过电视或专业医生了解免疫预防基础知识;有少部分人对免疫预防存在错误的认识;部分免疫预防机构不能给外来儿童提供方便的、令人满意的预防接种服务。结论:要提高外来儿童免疫预防服务质量,就应该实施适合当地外来人口特点的免疫预防管理模式;开展有针对性的、外来人口易于接受的宣传教育工作;提供能够满足外来人口需求的、高质量的免疫预防服务。     

The expanded programme on immunization calendar in Poland

Poland has a long history of prophylactic vaccination against infectious diseases. Hepatitis B vaccination was introduced in Poland between 1989 and 1996 as part of the Expanded Programme on Immunization (EPI). All newborns and those at high risk of hepatitis B virus (HBV) infection currently receive hepatitis B vaccine free of charge. For many years Poland has reached or exceeded the indicators required by the World Health Organization for vaccination programmes, and about 10% of the population has now been vaccinated against hepatitis B. The incidence of hepatitis B has decreased from about 40 per 100,000 in the early 1990s to 12.7 per 100,000 in 1997. It is hoped to modify the EPI in the future to improve vaccination against mumps, rubella and poliomyelitis. The possible benefit of vaccination against Haemophilus influenzae type b is currently being evaluated. Financial constraints, however, mean that not all of the approved vaccinations can be implemented. The EPI is supported by recommended vaccinations in certain groups, who pay for the vaccines. For hepatitis B, these include children, teenagers, those between 20 and 40 years of age, and those at high risk because of lifestyle or occupation.     

三种儿童计划免疫保偿模式的调查研究

连续６年对一保７年、一保１年、１针一保三种儿童计划免疫保偿模式进行调查研究，结果表明：计划免疫保偿制是群众自愿参与健康投资的一种有效形式，具有显著的社会经济效益。１针一保模式是当前市场经济体制下最佳保偿模式。     

贫困山区县实施扩大免疫规划的做法与思考

目的：为贫困山区县实施扩大国家免疫规划提供参考经验。方法：总结回顾贫困山区县绩溪县实施计划免疫的做法以及取得成功的经验。结果：绩溪县自1986年实施计划免疫以来,不断调整实施策略,取得了可喜的成果,提出今后要切实贯彻实施扩大国家免疫规划,专业技术人员需要加强技术督导．政府需将免疫规划经费纳入当地财政预算,结合工作实际适时调整工作策略。结论：山区贫困县在全面落实政策和技术措施的前提下,《扩大国家免疫规划实施方案》同样能如期贯彻实施。     

Prevalence of hepatitis B infection markers in Lebanese children: the need for an expanded programme on immunization

This multi-centre, cross-sectional study was designed to reveal the present status of hepatitis B infection markers among Lebanese children, and provide recommendations regarding childhood immunization policies. A total of 841 children, aged between 6 months and 6.5 years, were enrolled from Lebanon's five districts. Their sera were tested for hepatitis B surface antigen and hepatitis B core IgG. The overall prevalence of hepatitis B virus infection markers was 0.8% with increasing age-specific rates from 0% at 6 months to 1.3 % at > 5 years. There was no statistically significant association between the presence of hepatitis B markers and family characteristics or risk factors for infection. The highest prevalence rates were among children from Beirut suburbs (2.9 %) and South Lebanon (1.6%). The risk of horizontal transmission of hepatitis B to uninfected children increased substantially after the age of 2 years. An expanded programme on immunization that integrates hepatitisB vaccine during the first year of life is needed.     

The Thai expanded programme on immunization: role of immunization sessions and their cost-effectiveness

A cost-effectiveness study of the Thai expanded programme on immunization was carried out in district hospitals and health centres in Thailand during early 1987. The total annual spending on immunization was US $3852 in hospitals and US $813 in health centres. The percentage distribution of annual costs was similar in both facilities. Salaries were the largest component, followed by building and vaccine costs. The frequency of immunization sessions was the most important factor in determining total costs--immunization costs increasing with the frequency of sessions. In hospitals the average number of fully immunized children was 184, compared with 49 in health centres. The cost per fully immunized child varied widely from US $5.30 to US $33.20, and the most cost-effective facilities were those that immunized the greatest number of children. With the present number of health facilities in all areas of the country, which correspond to saturation levels, the most likely way for the Thai programme to reduce costs would be to make better use of staff time by decreasing the frequency of the services offered, thereby increasing the efficiency of each session. Hospitals should adjust the frequency of their immunization sessions according to the number of children being served, but health centres should offer sessions only monthly or once every two months.     

北京市1985～1995年计划免疫接种率监测分析

本文对北京市1985～1995年间计划免疫接种率监测资料与相应传染病发生情况进行比较分析,结果显示免疫接种率达到一定高度的水平时,相应传染病发生率呈急剧下降;免疫接种率与相应传染病呈高度负相关;政府参与、领导重视、报告系统完善、各部门协调和家长对计划免疫的态度等是保持合格免疫接种率高水平的重要影响因素。     

The expanded programme on immunization: a lasting legacy of smallpox eradication

Since the mid-1970s, the widespread establishment and implementation of the Expanded Programme on Immunization (EPI) has led to remarkable achievements in controlling vaccine preventable diseases worldwide. Today, more children than ever are being reached with immunization; interruption of poliomyelitis transmission has occurred in most countries; mortality due to measles, tetanus, diphtheria and pertussis has been reduced to record low levels. In addition, increasing numbers of vaccines are being used for infants and older age persons, such as vaccines against hepatitis A and hepatitis B, Haemophilus influenzae type b, rotavirus, pneumococcus, meningococcus, human papilloma virus (HPV) and varicella. The design of EPI reflects in large part the experience accumulated during the implementation of the intensified campaign for smallpox eradication during the period 1966-1977. At that time, the existing health infrastructure and network was found inadequate to reach most individuals with community wide immunization programmes in most countries. Thus, efforts were made to train dedicated health personnel and allocate specific resources for programme coordination and implementation. With the establishment of EPI, there was a gradual shift in emphasis from vaccination campaign strategies using mobile teams to the delivery of immunization services as part of routine health services of health facilities. Both the campaign and the outreach strategies are nevertheless required to reach those segments of the population not reached by the routine health services and to accelerate the achievement of disease control initiatives such as polio eradication and measles elimination. Whilst the campaign for smallpox eradication was set up as special and time-limited effort, the EPI requires long-term sustainable approaches to protect new cohorts of susceptible persons with vaccination and monitor trends and progress towards disease control with high quality surveillance.