2016年山东省莘县留守儿童预防接种现状及影响因素分析

目的 了解山东省莘县留守儿童预防接种现状及影响因素,为控制当地留守儿童传染病的流行提供科学依据。 方法 2016年6-9月采用分阶段抽样的方法,在山东省莘县选取1 200名留守儿童,通过自行设计的问卷调查留守儿童预防接种情况,运用logistic回归分析影响留守儿童预防接种相关因素。 结果 留守儿童“五苗”接种率为91.41%,合格接种率为81.35%。卡介苗(Bacille Calmette-Guerin, BGG)接种率及合格接种率最高,分别为95.67%、90.16%;以麻疹疫苗(measles vaccine, MV)最低,分别为87.75%、76.08%。单因素分析结果显示,不同年龄组、看护人身份、家庭月收入、是否为独生子女、是否建有儿童预防接种卡,“五苗”合格接种率差异均有统计学意义(P<0.05)。logistic回归分析发现留守儿童留守儿童年龄为3~岁、4~岁、5~岁、看护人身份为外/祖父母、独生子女、建卡是影响接种是否合格的独立影响因素。年龄为3~岁(OR=1.609,95%CI:1.029~2.516)、4~岁(OR=1.846,95%CI:1.414~2.408)、5~岁(OR=2.305,95%CI:1.071~4.960),看护人身份为外/祖父母(OR=2.157,95%CI:1.071~4.344)接种不合格风险度更高,独生子女(OR=0.638,95%CI:0.411~0.991)、建卡(OR=0.601,95%CI:0.390~0.928)接种不合格风险度更低。 结论 山东省莘县留守儿童预防接种现状不容乐观。儿童MV的合格接种率最低,仍存在麻疹暴发的隐患。建议应加强当地基层预防保健能力建设和广大农村预防接种知识宣教,开展入学儿童的预防接种证查验,提高儿童的疫苗接种率和合格接种率。

Status quo and influencing factors of vaccination among left-behind children in Shen County,Shandong Province,2016

Objective To investigate the current status of vaccination among the left-behind children in Shen County, Shandong Province and its influencing factors so as to provide a scientific basis for controlling the prevalence of infectious diseases among local left-behind children. Methods A multistage sampling method was used to select 1,200 left-behind children in Shen County, Shandong Province from June to September, 2016. Self-designed questionnaires were employed to investigate the current situation of vaccination among the left-behind children, and logistic regression analysis was performed to identify the factors influencing their vaccination status. Results The vaccination rate and qualified inoculation rate for the five vaccines (inculding bacille calmette-guerin (BGG) vaccine, hepatitis B (HepB) vaccine, oral poliomyelitis attenuated live vaccine (OPV), diphtheria-tetanus-pertussis (DTP) vaccine and measles vaccine (MV)) in the left-behind children were 91.41% and 81.35%,with the highest rates for BGG vaccine (95.67%, 90.16%) and the lowest for MV (87.75%, 76.08%). Univariate analysis indicated that there were statistically significant differences in the qualified inoculation rate of the five vaccines among different age groups, caregivers with different identity, different monthly household income groups as well as between only-child group and non-only-child group and between vaccination card group and non-vaccination card group (all P<0.05).Logistic regression analysis revealed that the age of 3-, 4- and 5- years, caregivers being grandparents, being the only child and establishment of vaccination cards were independent influencing factors of vaccination.The left behind children at the age 3- years(OR=1.609,95%CI:1.029-2.516), 4- years(OR=1.846,95%CI:1.414-2.408),5- years (OR=2.305,95%CI:1.071-4.960), with caregivers being grandparents (OR=2.157,95%CI:1.071-4.344) had higher risk of unqualified inoculation. However, the left behind children being the only child (OR=0.638,95%CI:0.411-0.991) and having vaccination card (OR=0.601,95%CI:0.390-0.928) had lower risk of unqualified inoculation. Conclusions The current situation of immunization in the left-behind children in Shen County is not optimistic. The qualified inoculation rate of MV in the left-behind children is the lowest, and there is still a risk of measles outbreak. It is necessary to strengthen the service capacity building of grass-roots medical institutions and the propaganda of immunization knowledge in the rural areas and conduct school children’s vaccination certificate inspection so as to improve the children’s vaccination rate and qualified inoculation rate.