Study On Situation Of Timely Coverage Rate And Retevant Factors Of Children Immunization In Coal-mine Area Of East Jining

ObjectiveTo investigate the timely coverage rate of children immunization in coal-mine area of east Jining, and evaluate the status of its implementation; To analyse main factors that influence timely coverage rate of children immunization and provide a scientific basis for enlarged program of immunization (EPI).Methods1. Use the information of vaccination clinic of the coal-mine area in east Jining to make a census of 2378 children who were born from Jan 1, 1998 to Dec 31, 2006 and had lived in the area for more than 3 months to get the data of vaccination of five basic vaccines, Bacillus Camette-Guerin (BCG), the oral polio vaccine (OPV), the DTP vaccine (DPT), measles vaccine (MV) and hepatitis B vaccine (HepB); two seasonal vaccines, epidemic cerebrospinal meningitis group A polysaccharide vaccine and Japanese encephalitis B vaccine; five own expense vaccines, rubella vaccine, mumps vaccine, hepalitis A vaccine, varicella vaccine and MMR vaccine.2. Stratified cluster sampling was used and 667 parents were surveyed with a self-designed questionnaire about their character of demography, their knowledge of and attitude to EPI and whether they felt satisfied with the services of vaccination clinic.Results1. The results displayed that the entire coverage rates and the timely coverage rates of 5 basic vaccines, BCG, OPV, DPT, MV and HepB were 98.6%, 90.2%, 92.4%, 83.9%, 90.5% and 18.2%, 73.4%, 79.8%, 73.9%, 78.5%, respectively. The coverage rates and the timely coverage rates of two seasonal vaccines, epidemic cerebrospinal meningitis group A polysaccharide vaccine and Japanese encephalitis B vaccine were 87.6%, 90.3% and 84.1%, 87.4%, while that of 5 own expense vaccines were 82.3%, 81.2%, 83.6%, 11.5%, 13.04% and 80.7%, 78.5%, 79.7%,10.4%, 13.03%, respectively. The coverage rates of all vaccines in local children were higher than that in floating children.2. Mean scores of knowledge of EPI among parents were 72.58±18.68. Higher educational status did parents get, more knowledge of EPI they grasped (F=9.278, p <0.01).The grasp of EPI knowledge is better in local population than that in floating population (t=2.089, p=0.037). The income of the family, whether registered permanent residence or not and the sex of their children did no effect to the scores of EPI knowledge.3. Most parents got the knowledge of EPI from 'introduction of doctors and health protection staffs', which was the source they hope. 'Propaganda pictorial and propaganda on the blackboard in vaccination clinic' was the second source for parents to get their knowledge of EPI, which they hope to be 'notice board or placard of their community'.4. 95.7% of parents attached great importance to vaccination, while 4.3% were indifferent to it. The results of stepwise logistic regression analysis displayed that the main factors which affected the attitude of parents most were the sex of their children (OR=0.143), the scores of their knowledge of EPI (OR=0.950) and the number of children in their family (OR=4.885).5. 12.3% , 48.5% and 33.3% of parents felt satisfied , relatively satisfied and common satisfied with the services of vaccination clinic, while 4.2% and 1.6% of parents felt rather and extremely unsatisfied with it. The results of polytomous logistic regression on ordinal response displayed that variables which could affect subjects' satisfaction were the sanitation of vaccination clinic, the respect got from clinic staffs, the skill of doctors, the answers from doctors and nurses to questions asked by parents, the introduction of vaccination relevant knowledge, the method to be noticed, whether to be given examination before inoculation and whether to be told the key points after inoculation.6. The results of stepwise logistic regression analysis displayed that factors which affected timely coverage of basic vaccines were parents' grasp of EPI knowledge (OR=0.973), children's transfer of living area (OR=1.687), parents' attitude to EPI (OR=5.382), education status of mother (OR=0.827), children's suffering from diseases (OR=1.240), numbers of inoculation (OR=1.601) and whether parents felt satisfied with the services of vaccination clinic (OR=1.312).ConclusionThough basic coverage rates in the coal-mine area remained at a relatively high level, the inoculation of all vaccines was uneven. Coverage rates of basic vaccines, seasonal vaccines and single dose vaccines were higher than that of seasonal vaccines, own expense vaccines and multi-dose vaccines separately, while timely coverage rates of all vaccinates were significantly lower than coverage rate. In order to improve the grasp of knowledge of EPI among parents, greater efforts should be made to propagandize the importance of EPI. Furthermore, the main measures to improve the timely coverage rates of vaccines were strengthening supervision on floating children, development of combined vaccines, strengthening technical training among professionals and improving the services of vaccination clinic.