Analysis On EPI Coverage And Its Influencing Factors Among Children In Tianshan District Of Urumqi

Objective:To analyze the qualified vaccination rate and timely vaccination rate among 0-6-year-old children in Tianshan District so as to evaluate expanded programme on immunization(EPI)coverage in Tianshan District,and explore the influencing factors of qualified vaccination rate and timely vaccination rate in Tianshan District in order to provide a basis for effective interventions to improve the vaccination rate.Methods:The registration and card establishing of school-age children were statistically analyzed using the Children Immunization Information Management System(CIIMS),and electronic cards were compared with vaccination certificates.From June 2018 to August 2018,199 administrative villages(communities)of 21management committees(streets)in this district were surveyed by capacity proportion-based probability sampling.A total of 2,100 children born from January 1,2012 to August 31,2017 were surveyed.This survey was carried out household-by-household to register school-age children one by one by filling in questionnaires,including children's name,gender,vaccine name and date of vaccination,parents'educational level and occupation,etc.Parents'educational level and occupation,distance between residence and vaccination clinic,and access to vaccination information were selected as influencing factors.All survey data were checked and arranged and a database was established using Epidata 3.1.To ensure data quality,consistency check was carried out after dual entry.Data were statistically analyzed using IBM SPSS22.0.Single factor analysis was performed using the ~2test and Spearman's rank correlation coefficient.Non-conditional logistic regression analysis was adopted for multivariate analysis.Results:(1)The rate of establishing certificates and cards for children in Tianshan District was 100%,the rate of timely establishing certificates and cards was97.6%,the complete rate of filling in vaccination certificates was 89.93%,and the coincidence rate of electronic cards and vaccination certificates was 91.29%.(2)BCG scar rate was 87.43%in Tianshan District.(3)As for qualified vaccination,BCG vaccination rate was 96.85%,three-dose HepB vaccination rate was 94.37%,92.69%and 84.52%respectively,four-dose OPV vaccination rate was 94.76%,93.22%,88.39%and 74.19%respectively,four-dose DTaP vaccination rate was 88.68%,87.00%,83.37%and 74.91%respectively,MR vaccination rate was 94.17%,MMR vaccination rate was 94.50%,HepA vaccination rate was 87.52%,two-dose MPV-A vaccination rate was 84.69%and 69.71%respectively,two-dose MPV-AC vaccination rate was 76.36%and 67.50%respectively,and DT vaccination rate was 64.38%.The coverage rates of“pentavaccine”and“eight-fold vaccine”were 82.90%and 75.45%,respectively.(4)Significant differences were found in the qualified vaccination rates of class I vaccines among children in different domiciles in Tianshan District.The vaccination rate of local resident children was higher than that of migrant children.(5)The timely vaccination rates of BCG and hepatitis B vaccines for children in Tianshan District were 90.08%and 93.23%,respectively,with significant differences among children in different domiciles.(6)The timely vaccination rates of leprosy vaccine and MMP vaccine for children in Tianshan District were 53.19%and 60.67%,respectively,showing significant differences among children in different domiciles.(7)The basic vaccination rates of DTaP,OPV,group A meningococcal vaccine and group A+C meningococcal vaccine for children in Tianshan District were significantly higher than those of intensified vaccines.(8)The vaccination rates of class II vaccines including varicella vaccine and haemophilus influenzae type B vaccine for children in Tianshan District were 70.11%and 41.50%,respectively,with significant differences.The intervention of kindergartens and schools had a positive impact on the vaccination of these two vaccines.(9)Multivariate logistic regression analysis showed that the influencing factors of low coverage rate of“eight-fold vaccine”included parents'educational level,access to vaccination information and distance from residence to vaccination clinic.The influencing factor for timely vaccination rate of the first dose of hepatitis B vaccine was parents'educational level.The influencing factors for timely vaccination rate of leprosy vaccine were parents'educational level,distance from residence to vaccination unit and access to vaccination information.The influencing factors for timely vaccination rate of MMR vaccine included parents'educational level and access to vaccination information.Conclusions:(1)The current operating mechanism of routine immunization in Tianshan District is relatively standard,with the rate of establishing certificates and cards reaching 100%.Immunization has been accepted and widely cooperated by parents.(2)The qualified vaccination rate of some class I vaccines in Tianshan District is relatively low,which has not yet met the relevant requirements stipulated by the autonomous region.The qualified vaccination rate of related intensified vaccines is significantly lower than that of basic vaccines.(3)The timely vaccination rate of leprosy and MMP vaccines in Tianshan District is not ideal,which indicates that there is still much room for improvement in primary vaccination work.(4)The educational level of parents,access to vaccination information and distance from residence to vaccination unit are the influencing factors for qualified vaccination coverage rate of“eight-fold vaccine”.Parents'educational level and access to vaccination information are the influencing factors for timely vaccination rate of class I vaccines.In the future,vaccination propaganda and health education should be further strengthened,and the service mode and way of information dissemination closer to the residents should be adopted,focusing on migrant families.