| ObjectivesThis study was investigated the routine immunization status of children in rural areas of Guangxi.It aimed to find out the five kinds of routine immunization about non-inoculation,advance vaccination,delayed vaccination,timely inoculation,timely full inoculation and delayed vaccination median delay time of Hepatitis B vaccine,BCG vaccine,OPV vaccine,DPT vaccine and Measles-Containing Vaccine in rural areas,and analyzed the impact of the vaccination service model on the quality of vaccination in children and provided reference for the policy of children immunization in rural areas of Guangxi.MethodsThe study was a cross-sectional study.A multi-stage stratified sampling method was used to sample 120 villages in Guangxi from June 2015 to August2015.A total of 1062 children aged from 18 to 48 months were investigated.The contents of the survey include the name,the gender,the date of birth,the date of the routine immunization including the first,second and third dose of Hepatitis B vaccine,the first dose of BCG vaccine,the first,second and third dose of OPV vaccine,the first,second,third and four dose of DPT vaccine,the first,second dose of MCV Vaccine.In order to establish a database,all data was input by Epidata3.1,in subsequent double entry and proofreading verification.R software survey package was performed to analysis the inoculation rate of Hepatitis B vaccine,BCG vaccine,OPV vaccine,DPT vaccine and MCV Vaccine,inoculation rate,early inoculation rate,delayed inoculation rate,timely inoculation rate,timely full inoculation rate and 95% confidence.Weighted Kaplan-Meier analyses were used to estimate the median delay time for delayed vaccination,Hepatitis B vaccine,OPV vaccine,DPT vaccine,MCV vaccine in time and the whole vaccination rate of different doses of different doses of time inoculation rate using chi-square test to p = 0.05 for the test level.Results1.Children’s basic information Male 580(54.61%),female 482(45.39%);18-24 months 88(8.29%),25-36 months 542(51.04%),37-48 months 432(40.68%).2.Hepatitis B vaccineThe first vaccination coverage rate is 100%(95%CI,100-100),timely vaccination rate is 71.8%(95%CI,66.8-76),delayed vaccination rate is 28.2%(95%CI,23.7-33),median delay time is 1 day(95% CI,1-31).The secondary vaccination coverage rate is100%(95%CI,100-100),timely vaccination rate is 87.5%(95%CI,86-89),early vaccination rate is3.83%(95%CI,2.17-7),delayed vaccination rate is 8.63%(95%CI,6.89-11),median delay time is 20 day(95%CI,7-53).The third vaccination coverage rate is 100%,timely vaccination rate is66.1%(95%CI,58.9-73),early vaccination rate is5.46%(95%CI,3.07-10),delayed vaccination rate is 28.5%(95%CI,22.3-36),median delay time is 25day(95%CI,11-58).Three times dose complete vaccination rate is 100%(95%CI,100-100),timely full vaccination rate is 46.61%(95%CI,40.5-53),advance,delayed or not vaccinated rate is 53.4%(95%CI,47.2-59).3.BCG vaccineThe BCG vaccination coverage rate is 100%(95%CI,100-100),timely inoculation rate is 69.3%(95%CI,64.1-74),delayed vaccination rate is 30.7%(95%CI,26-36),median delay time is 1 day(95%CI,1-31).4.OPV vaccineThe first vaccination coverage rate is 100%(95%CI,100-100),timely vaccination rate is80.7%(95%CI,75.7-85),early vaccination rate is 3.84%(95%CI,2.43-6),delayed vaccination rate is 15.5%(95%CI,12.4-19),median delay time is 28 day(95%CI,9-63).The secondary vaccination coverage rate is 99.9%(95%CI,99.7-100),timely vaccination rate is 74.2%(95%CI,67.4-80),early vaccination rate is1.98%(95%CI,1.04-4),non-vaccination rate is0.06%(95%CI,0.01-0),delayed vaccination rate is 23.7%(95%CI,18.5-30),median delay time is 23 day(95%CI,8-53).The third vaccination coverage rate is 99.8%(95%CI,99.3-100),timely vaccination rate is 66.4%(95%CI,58.7-73),early vaccination rate is 2.29%(95%CI,1.31-4),non-vaccination rate is0.16%(95%CI,0.03-1),delayed vaccination rate is 31.1%(95%CI,24.4-39),median delay time is 30 day(95%CI,12-64).Three times dose complete vaccination rate is 99.8% (95%CI,99.3-100),timely full vaccination rate is 63%(95%CI,54.6-71),advance,delayed or not vaccinated rate is 37%(95%CI,29.4-45).5.DPT vaccineThe first vaccination coverage rate is 99.9%(95%CI,99.7-100),timely vaccination rate is 81.3%(95%CI,73.7-87),early vaccination rate is 1.87%(95%CI,0.92-4),delayed vaccination rate is 16.8%(95%CI,11.6-24),median delay time is 19 day(95%CI,5-48).The secondary vaccination coverage rate is 99.7%(95%CI,95.8-100),timely coverage rate is 72.7%(95%CI,64.1-80),early coverage rate is 1.89%(95%CI,1.12-3),delayed coverage rate is 25.4%(95%CI,18.7-33),median delay time is 29 day(95%CI,12-74).The third vaccination coverage rate is 99.8%(95%CI,99.0-100),timely vaccination rate is 59.9%(95%CI,49.9-69),early vaccination rate is 2.4%(95%CI,1.17-5),non-vaccination rate is 0.16%(95%CI,0.02-1),delayed vaccination rate is 37.6%(95%CI,28.7-47),median delay time is 36 day(95%CI,13-83).The fourth vaccination coverage rate is 93.1%(95%CI,89.2-96),timely vaccination rate is 76.1%(95%CI,69.9-81),early vaccination rate is 5%(95%CI,3.9-6),non-vaccination rate is 6.89%(95%CI,4.3-11),delayed vaccination rate is12.1%(95%CI,8.2-17),median delay time is 104 day(95%CI,42-262).Four times dose complete vaccination rate is 93.1%(95%CI,89.2-96),timely full vaccination rate is 46.8%(95%CI,39.2-55),advance,delayed or not vaccinated rate is 53.2%(95%CI,45.4-61).6.MCV VaccineThe first vaccination coverage rate is 97.8%(95%CI,95.4-99),timely vaccination rate is 61.8%(95%CI,55.1-68),early vaccination rate is 2.52%(95%CI,0.93-7),non-vaccination rate is2.24%(95%CI,1.09-5),delayed vaccination rate is 33.4%(95%CI,28.3-39),median delay time is 29 day(95%CI,9-68).The secondary vaccination coverage rate is 94.4%(95%CI,91.2-96),timely vaccination rate is 78.6%(95%CI,69.8-85),early vaccination rate is5.02%(95%CI,2.86-9),non-vaccination rate is 5.87%(95%CI,3.86-9),delayed vaccination rate is 10.52%(95%CI,5.91-18),median delay time is 130 day(95%CI,55-315).Two times dose complete vaccination rate is 92.9%(95%CI,88.7-96),timely full vaccination rate is 46.6%(95%CI,40.5-53),advance,delayed or not vaccinated rate is 53.4%(95%CI,47.2-59).7.There were significant differences in the chi-square test of Hep B vaccine,OPV vaccine,DTP vaccine and MCV vaccine(x~2=86.830,P<0.05).There was no significant difference between Hep B vaccine and DTP vaccine In addition,the other two differences between the two vaccines were statistically significant.8.Analysis of chi-square test results of timely distribution of different doses of the same vaccineThe overall distribution of hepatitis B vaccine was x~2=151.320,P<0.05,the difference was statistically significant,the three doses were different from the two chi-square test differences were statistically significant.The overall distribution of poliomyelitis vaccination rate x~2 = 54.202,P<0.05,the difference was statistically significant,three doses were two different chi-square test differences were statistically significant.The overall distribution of Pseudomonas davidii vaccine wasx~2=54.202,P<0.05,the difference was statistically significant,the three doses were the two chi-square test results in addition to the first dose and fourth dose(x~2=150.520,P<0.05)were not statistically significant,the other two differences were statistically significant.The overall distribution of measles vaccine in time was c 2=80.284,P<0.05,the difference was statistically significant.ConclusionsThe coverage rate of routine immunization in rural children in Guangxi was maintained at a high level,but the vaccination rate was not high in single dose vaccine.The vaccination rate of multi-dose vaccine was low in time,and the median delay time was longer.In addition,by comparing the timely vaccination rate with the vaccination dose and the inoculation time,it was found that the timely vaccination rate of the vaccine decreased with the increase of the vaccination dose.The immunization schedule recommended the later vaccination time,the lower the timely vaccination rate,The longer the time.In the rural areas,the township health centers,rural doctors,families and so on,and the rural geographical environment in Guangxi affect the quality of child vaccination.It is recommended that the relevant departments should be vaccinated with the timely rate of vaccination should be included in the vaccination assessment indicators;To take financial incentives to improve the enthusiasm of preventive health care workers and rural doctors;actively provide and effectively promote the joint vaccine,simplify the immunization program,improve the immunization schedule,increase the best time to delay vaccination,give full play to the vaccine Vaccination services in the "correspondent" role;immunization knowledge to promote the move forward to eliminate the child guardian vaccination hesitation;For children in remote mountainous areas to carry out flexible convenience of home vaccination services and other measures to improve the timely vaccination of children in rural areas in full vaccination rate. |
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