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Understanding interventions for improving routine immunization coverage in children in low- and middle-income countries: a systematic review protocol

机译：了解提高中低收入国家儿童常规免疫接种覆盖率的干预措施：系统的审查方案

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Background Virtually all low- and middle-income countries are dependent on the World Health Organization’s Expanded Program on Immunization for delivery of vaccines to children. The Expanded Program on Immunization delivers routine immunization services from health facilities free of charge. Understanding interventions for improving immunization coverage remains key in achieving universal childhood immunization. Methods We will conduct a systematic review that aims to assess the effectiveness of the full range of potential interventions to improve routine immunization coverage in children in low- and middle-income countries. We will include intervention studies, as well as observational studies. We will search the Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, electronic databases for eligible studies published by 31 August 2013. At least two authors will independently screen search outputs, select studies, extract data and assess the risk of bias (using separate criteria for interventions and observational studies); resolving any disagreements by discussion and consensus. The use of logic models and the Cochrane Complexity Matrix will be explored in order to better understand and contextualize studies. We will express the result of each study as a risk ratio with its corresponding 95% confidence intervals for dichotomous data, or mean difference with its standard deviation for continuous data. We will conduct meta-analysis for the same type of participants, interventions, study designs, and outcome measures where homogeneity of data allows. Use of harvest plots may be explored as an alternative. Heterogeneity will be assessed using the χ2 test of heterogeneity, and quantified using the I2 statistic. This protocol has not been registered with PROSPERO. Discussion This review will allow us to document evidence across a broad range of intervention types for improving routine immunization coverage in children and also distinguish between those that are well supported by evidence (to direct policy recommendations) and those that are not well supported (to direct research agenda).
机译：背景几乎所有低收入和中等收入国家都依赖世界卫生组织的“扩大免疫计划”向儿童提供疫苗。扩大的免疫计划免费提供来自医疗机构的常规免疫服务。了解提高免疫接种覆盖率的干预措施仍然是实现儿童普遍免疫的关键。方法我们将进行系统的评估，旨在评估各种潜在干预措施的有效性，以提高中低收入国家儿童的常规免疫覆盖率。我们将包括干预研究以及观察性研究。我们将搜索Cochrane系统评价数据库（CDSR），Cochrane对照试验中央注册系统（CENTRAL），MEDLINE，EMBASE，截至2013年8月31日发布的符合条件的研究的电子数据库。至少两名作者将独立筛选搜索结果，选择研究。 ，提取数据并评估偏见的风险（使用干预和观察研究的单独标准）;通过讨论和共识解决任何分歧。将探索逻辑模型和Cochrane复杂度矩阵的使用，以更好地理解研究并使其具有背景性。对于二分类数据，我们将每个研究的结果表示为风险比率及其相应的95％置信区间，对于连续数据，我们将其平均值表示为其标准差。在数据均一性允许的情况下，我们将对相同类型的参与者，干预措施，研究设计和结果测量进行荟萃分析。可以选择使用收割地作为替代。异质性将通过异质性的χ 2 检验进行评估，并使用I 2 统计进行量化。该协议尚未在PROSPERO中注册。讨论这项审查将使我们能够记录各种干预措施的证据，以改善儿童的常规免疫覆盖率，并区分得到证据充分支持（指导政策建议）的证据和未得到充分证据支持（指导政策建议）的证据。研究议程）。

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