庆阳市入学儿童预防接种证查...数据质量核查及影响因素分析_樊婧玉.pdf

疾病预防控制通报2023年2月第38卷第1期 Bull Dis Control Prev Feb.,2023,Vol.38,No.1庆阳市入学儿童预防接种证查验数据质量核查及影响因素分析樊婧玉1，刘贝琴1，景永峰1，石怀禄1，李学平1，杨明宇21.甘肃省庆阳市疾病预防控制中心，甘肃 庆阳745000；2.甘肃省疾病预防控制中心，兰州 730000摘要：目的 评价2021年甘肃省庆阳市入学儿童预防接种证查验及疫苗补种工作成效与报告数据质量，分析影响接种证查验现状的因素，为完善预防接种证查验制度提供依据。方法 采用分层随机抽样方法在庆阳市县直小学、乡级小学、村级小学抽取16所小学，调查2021年秋季入学儿童接种证查验工作质量，用卡方检验比较组间差异，通过问卷星在线填写调查预防接种人员认知影响因素。结果 庆阳市入学儿童632人，接种证实际查验率（90.51%）低于报告查验率（99.53%），差异有统计学意义（2=54.277，P0.05）；实际漏种率（32.28%）高于报告漏种率（17.72%），差异有统计学意义（2=35.713，P0.05）；各种漏种疫苗（卡介苗除外）核查补种率均低于报告补种率；免疫规划疫苗全程接种率查验后（85.13%）较查验前（67.72%）显著提高（2=53.130，P0.05），除卡介苗、A群流脑疫苗外，各查验疫苗接种率均超过90.00%；接种证填写质量不高；预防接种人员查验内容、流程知晓率分别为46.96%、39.23%，其中村医、专干及接种人员查验流程的知晓率分别为33.98%、42.20%，差异有统计学意义（2=5.591，P0.05）；认为查验接种证能提高接种率占90.16%，遵照方案执行查验审核且及时通知家长补种疫苗的占 87.24%，专干及接种人员查验审核遵照方案执行率（90.09%）高于村医（82.20%），差异有统计学意义（2=11.028，P0.05）；二分类Logistic回归分析显示，文化程度（OR=2.23，95%CI：1.084.60）、人员类别（OR=1.64，95%CI：1.132.37）、接种工作年限（OR=0.62，95%CI：0.410.92）影响查验内容及流程知晓率；接种工作年限（OR=0.62，95%CI：0.410.93）、人员类别（OR=1.62，95%CI：1.122.35）和提高接种率认知（OR=3.97，95%CI：1.2113.06）影响接种证查验态度。结论 查验预防接种证可提高入学儿童国家免疫规划（NIP）疫苗接种率，但庆阳市接种证查验工作质量亟待提高，预防接种证、信息化系统数据一致性不高，相关人员接种证查验内容和流程知晓率偏低，查验接种证态度待转变；应加大接种证查验工作培训力度，提高数据报告质量。关键词：接种证查验；数据质量；影响因素中图分类号：R186 文献标识码：A 文章编号：10003711（2023）01007706Quality verification of vaccination certificate inspection and analysis of influencing factors among school children in Qingyang cityFAN Jing-yu，LIU Bei-qin，JING Yong-feng，SHI Huai-lu，LI Xue-ping，YANG Ming-yuQingyang Municipal Center for Disease Control and Prevention,Qingyang,Gansu 745000,ChinaCorresponding author:LIU Bei-qin,E-mail:Abstract:Objective To evaluate the vaccination certificate inspection in the school-enrolled children,the effectiveness of supplementary and the data quality in Qingyang city of Gansu province in 2021,and analyze the influencing factors of the status of vaccination certificate inspection,so as to provide evidence for improving the vaccination certificate inspection system.Methods With the stratified random sampling method,there were 16 primary schools from county-level,township-level and village-level primary schools selected for investigating the quality of vaccination certificate inspection in the children enrolled in autumn in Qingyang city,2021.The difference among different groups was compared with Chi-square test.The influencing factors of the cognition of vaccinators were analyzed through the online questionnaire survey on the questionnaire star platform.Results There were 632 children surveyed in Qingyang city.The actual inspection rate of inoculation certificate was 90.51%,lower than the reported inspection rate(99.53%),with the statistical difference(2=免疫规划 作者简介：樊婧玉（1986-），女，主管护师，从事疾病预防控制工作，E-mail：通信作者：刘贝琴，E-mail：DOI:10.13215/ki.jbyfkztb.2208020 77疾病预防控制通报2023年2月第38卷第1期 Bull Dis Control Prev Feb.,2023,Vol.38,No.154.277,P0.05).The actually missed vaccination rate(32.28%)was higher than the reported missed vaccination rate(17.72%),with statistical difference(2=35.713,P0.05).The verified supplementary vaccination rates of all missed inoculating vaccines(except BCG)were lower than all reported supplementary vaccination rates.The full-course vaccination rate of the immunization vaccines after inspection(85.13%)was significantly higher than that before the inspection(67.72%),with the statistical difference(2=53.130,P0.05).The inspected vaccination rate of each vaccine(except BCG and MPV-A)was higher than 90.00%.The quality of completed inoculation certificate was not good.The awareness rate of inspection content and procedures was 46.96%and 39.23%,respectively in the vaccination personnel.Among them,the awareness rate of village doctors,epidemic prevention staff including vaccinators was 33.98%and 42.20%,respectively,with statistical difference(2=5.591,P0.05).There were 90.16%of the vaccinators believe that checking the vaccination certificate could improve the vaccination rate,and 87.24%of the vaccinators could comply with the inspection program and informed the parents to supplementary inoculate the vaccine.The implementation rate followed the inspection program in the epidemic prevention staff and vaccinators was 90.09%,higher than that in the village doctors(82.20%),with statistical difference(2=11.028,P0.05).The results of binary Logistic regression showed the degree of education(OR=2.23,95%CI:1.08-4.60),different personnel(OR=1.64,95%CI:1.13-2.37)and working years for inoculation(OR=0.62,95%CI:0.41-0.92)influenced the awareness rate of inspection content and process.The working years for inoculation(OR=0.62,95%CI:0.41-0.93),different personnel(OR=1.62,95%CI:1.12-2.35)and the cognition of improving vaccination rate(OR=3.97,95%CI:1.21-13.06)influenced the attitude of vaccination certificate inspection.Conclusions The vaccination certificate inspection can improve the vaccination rate of NIP vaccine in school children.But the quality of the vaccination certificate inspection needs to be urgently improved in Qingyang city.The data consistency is not high between the vaccina