Study On Immunization Strategy Of Floating Children In Beilun Distict

Backgrounds&ObjectivesWith the region’s economic development, China’s floating population has been expanding rapidly, the following generated a large number of floating children. It’s difficult to implement vaccine immunization to them, affecting children Planning Immunization Programme to proceed effectually. The floating children of different regions have their own charactericts, which of immunization management has become the focus and difficulty of the current National Immunization Programme(NIP). The Beilun District of Ningbo City is located to the mid-coastline of the Mainland China, governing6sub-streets,2towns and1rural township, which is one of the highly-opened areas in Zhejiang Province. With a fast economic development, the "flow-in" floating population had increased from237thousand in2005to518thousand in2010, which was not only adaptting to the needs of the economic and social development in Beilun, but also bringing impacts and new challenges to the public health of this region. In2003, Center for Disease Control and Prevention of Beilun District(CDC) surveyed of1020to7-year-old floating children which resided in local time≥3months, the rate of building immunization cards was only54.90%, all kinds of vaccine coverage rates were lower(37.25%～52.94%), and five kinds of vaccine on NIP whole coverage rate was36.00%, but vaccination coverage rates of local children were more than95%. In2004, the government of Beilun District gradually strengthened the immunization management of floating children, as a field of "Study on floating children immunization strategy and service mode" by Ministry of Health of China and United Nations Children’s Fund (UNICEF) in2005, innovating social management, to establish the team of village-level public health, organized and implemented an immunization strategy of "building the immunization card in field" as the core according to the characteristics of floating children.This paper reviews the immunization management status of floating children from2005to2010in Beilun District, surveying the basic characteristics of floating children and vaccination use, and analyzing impact factors of immunization, to evaluate the effect of immunization strategy on floating children in Beilun District.Materials&Methods1. ObjectsTo select0to7-year-old floating children, the place where his residence is registered is not in Beilun.2. Methods(1)Routine surveillance dataImmunization information of floating children was from2003～2010NIP surveillance data of CDC, Beilun, Ningbo. The measles epidemic data were from1985-2010annual report of infectious disease surveillance&national disease surveillance information management system (which was enabled on January1,2004). Population data were from Public Security Bureau of Beilun.(2)Quantitative survey dataIn October2005, we surveyed999floating children from Xinqi, Daqin, Xiaogang, Chaiqiao Streets which was most populous based on floating population distribution characteristics of Beilun District, to know their vaccination coverage and analyze impact factors, using stratified random sampling principle. The content of investigation included:general information of floating children&guardians, vaccination coverage information, vaccination knowledge-attitude-practice (KAP) of guardians, use of vaccination services. In April2010, we organized an assessment survey of vaccination coverage rates about136floating children, using probability propotrtional to size (PPS) sampling.3. Statistical analysisThe routine surveillance data was analyzed by Microsoft Excel2003, using descriptive epidemiological method. Questionnaires were coded unified, inputting into computers to build database by Epidata3.0software. Objects were grouped by times which he resided in local and ages. Use descriptive analysis to quantitative survey data, and chi-square test to comparisons of categorical data and rates, logistics regression to impact factors of coverage rates, by SPSS13.0software, Probability<0.05was statistically significant difference. Analyze vaccination coverage rate of floating children while the implementation of the interventions is to be or not and epidemic characteristic of vaccine-preventable infectious diseases during this period, to evaluate the effect of immunization strategy on floating children in Beilun District.Results1. The sociological characteristics of floating children in Beilun District(1)Flow-out distict of floating children was stable, which was mainly from the central and western regions, such as Anhui, Sichuan, Guizhou provinces, almost half of them were born in current residence;(2)Parents’age was mainly between20-34years old, lower education level, working with labor output, lower income;(3)Poorer domestic economic conditions;(4)Poorer living environment.2. Immunization status of floating children in Beilun DistrictIn2005, we sampled survey of999floating children in Beilun Distict, total rate of building vaccination certificate was93.19%, the rate of building immunization card by vaccination clinics was86.39%, age≥1year old children’s NIP five kinds of vaccines coverage rate were:71.54%of BCG,70.24%of OPV,67.97%of DPT,80.49%of MV,62.44%of HepB, the whole coverage rate was57.40%; and the whole coverage rate of floating children which resided in local time≥3mouths was60.73%.After five years intervention in Beilun District, it’s total building70331immunization cards of0to7-year-old floating children during2006to2010, NIP five kinds of vaccines vaccination437714person-times. In2010, we sampled again assessment survey of136floating children, all indicators were significantly higher than the2005survey:total rate of building vaccination certificate was93.19%(χ2=5.004, P<0.05), age≥1year old children’s NIP five kinds of vaccines coverage rates were more than95%, the whole coverage rate was53.14%(x2=46.158, P<0.05), and the whole coverage rate of floating children which resided in local time>3monhs was93.65%(χ2=41.097, P<0.05).3. The main impact factors of immunization for floating childrenUsing logistics regression (by backward stepwise:conditional) to analyze2005survey data, we found that the main impact factors of immunization for floating children were:floating children’s age, place of birth, deliver sites, continuous residence time, mother’s education level and occupation, whoever had the vaccination certificate, whether received a vaccination notice, whether had gone to local vaccination clinics and convenient.4. Epidemiological analysis of vaccine-preventable infectious disease for floating childrenDuring2005to2010, a total of457measles cases were reported in Beilun District, including185cases of which have the local household registration and272cases of floating population, each annual average incidence was9.10per10000,11.35per10000; the age distribution of floating population cases is similar to natives, that the adult group aged>20-year-old was on top accounting for41.91%,<1-year-old age group was accounting for29.78,1to7-year-old age group was accounting for16.54%, showing bipolar peaks on<1-year-old infant and adult.Measles epidemic in2005,2008, the annual average incidence was19.19per10000,26.83per10000; floating population cases accounted of total reported was48.15%(52/108),60.27%(132/219);9-monhto7-year-old age group was17.31%(9/52),6.67%(22/132), both were significantly lower than Ningbo’s level(38.80%,χ2=8.626, P<0.05;24.86%,χ2=3.899, P<0.05).ConclusionsThrough implementing an immunization strategy of "building the immunization card in field" as the core according to the characteristics of floating children in Beilun District, the rate of building immunization card and vaccination coverage rates were significant improved, and vaccine-preventable infectious diseases has been effectively controlled. It would be worth promoted in which primary public health network is more well-being.