应用中断时间序列分析评价流行性乙型脑炎减毒活疫苗大规模预防接种的有效性

  目的  评估含风疹成分疫苗（RV）纳入扩大国家免疫规划（NEPI）对风疹发病趋势的影响。  方法  收集辽宁省2004 — 2016年风疹发病率，利用中断时间序列分析（ITSA）数据的分段回归模型，分析辽宁省风疹发病率变化趋势。  结果  RV纳入NEPI前，风疹月发病率均值为1.22/10万，发病率呈上升趋势，平均逐月增加0.018/10万，差别有统计学意义（P = 0.01）。RV纳入NEPI后，风疹月发病率均值为0.176 2/10万，发病率较疫苗干预前立即下降（β₂ = 1.702 9，P = 0.006 8）。干预后风疹月发病率的斜率为 – 0.006 1，相比干预前下降了0.024 1，但2阶段斜率差别无统计学意义（P = 0.124）。  结论  RV纳入NEPI降低了风疹发病水平，但远期作用尚未显现。

Effect of financially punished audit and feedback in a pediatric setting in China,within an antimicrobial stewardship program,and as part of an international accreditation process

  Objective  To assess the impact of rubella attenuated live vaccine (RV) administration on the trend of rubella incidence after the inclusion of RV into National Expanded Program for Immunization (NEPI).  Methods  We extracted data on rubella incidence rates from 2004 through 2016 in Liaoning province and then explore the trend of incidence before and after the RV administration using interrupted time series analysis and segmented regression model.  Results  Before the inclusion of RV into NEPI, the average monthly rubella incidence was 1.22 per 100 000 population and the incidence rate showed a significant ascending trend with an increment of 0.018 per 100 000 population per month (P = 0.01). After the inclusion of RV into NEPI, the average monthly rubella incidence was 0.176 2 per 100 000 population, with a significant immediate decrease (β₂ = 1.702 9, P = 0.006 8). Although, there was a 0.024 1 decrease in the slope of monthly rubella incidence ( – 0.006 1) after the inclusion of RV into the NEPI, but the slope did not differ significantly compared to that before the inclusion (P = 0.124).  Conclusion  The inclusion of RV into the National Expanded Program for Immunization has decreased rubella incidence but its long-term effect needs to be observed in Liaoning province.