4种评价方法对广东省常规免疫报告接种率可靠性的评价分析

目的了解广东省常规免疫数据报告质量,为指导今后常规免疫接种率监测工作和制定策略提供科学依据。方法收集广东省2010-2012年儿童卡介苗(BCG)、乙肝疫苗(HepB)、脊灰疫苗(PV)、百白破疫苗(DPT)、含麻疹成分疫苗(MCV)、乙脑疫苗(JE)、A群流脑疫苗(MenA)和甲肝疫苗(HepA)常规免疫接种数据,采用D值法、R值法、脱漏率以及与疫苗用量比较法对报告接种率的可靠性进行评价。结果 2010-2012年广东省8种免疫规划疫苗报告接种率在91.31%~99.71%之间,估算接种率在39.38%~106.18%之间。各年HepB、PV、DPT、MCV的D值评价均为可信,HepA的D值评价均为不可信,JE的D值评价均为可疑,2011、2012年BCG和MenA的D值评价均为可疑。HepB、PV和JE的R值评价均为可信,HepA的R值评价均为不可信,2011、2012年BCG和MenA的R值评价为可疑。各年流动儿童HepB和MenA的脱漏率,以及2010年本地儿童MenA的脱漏率均超过10%。DPT和JE的估算损耗系数与参考损耗系数较为接近,而HepA的估算损耗系数与参考损耗系数有较大差别。结论广东省常规免疫报告接种数据存在漏报和虚报情况,报告接种率不能真实反映实际接种情况,数据报告质量有待提高。

Evaluation on surveillance of routine immunization coverage rate in Guangdong province by four methods

Objective To understand the quality of surveillance of routine immunization coverage rate in Guangdong province, and provide scientific basis for establishing effective surveillance strategies. Methods The Guangdong routine immunization coverage data were collected from 2010-2012, using 4 methods including difference（D）, ratio（R）, dropout rate and compared with the vaccine usage to evaluate reported routine immunization coverage. The investigated vaccines included bacilli calmette-guerin（BCG）, hepatitis B vaccine（HepB）, poliomyelitis vaccine（PV）, diphtheria, pertussis and tetanus combined vaccine（DPT）, measles containing vaccine（MCV）, japanese encephalitis vaccine（JE）, group A meningococcal polysaccharide vaccine（MenA） and hepatitis A vaccine（HepA）. Results The reported coverage rates of routine immunization of 8 vaccines varied from 91.31% to 99.71%, while the estimated rates varied from 39.38% to 106.18%during 2010-2012. The D value showed the reported immunization coverage rate of HepB, PV, DPT and MCV were credible,and JE（2010-2012）, BCG（2011-2012）, MenA（2011-2012） and HepA（2010-2012） were incredible or doubtful. The R value showed the target population of HepB, PV and JE of routine immunization were credible, and BCG（2011-2012） and MenA（2011-2012） were incredible or doubtful. The dropout rates of immune population were both above 10% in HepB and MenA of migrant children during 2010-2012. The estimated loss coefficient of DPT and JE were close to the reference value,and that of HepA was out of range. Conclusion Underreporting and over-reporting of routine immunization coverage data existed in Guangdong province.