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首页> 外文期刊>PLoS Medicine >Measuring Coverage in MNCH: Design, Implementation, and Interpretation Challenges Associated with Tracking Vaccination Coverage Using Household Surveys
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Measuring Coverage in MNCH: Design, Implementation, and Interpretation Challenges Associated with Tracking Vaccination Coverage Using Household Surveys

机译：在MNCH中测量覆盖率：与使用家庭调查跟踪疫苗接种率相关的设计，实施和解释挑战

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Vaccination coverage is an important public health indicator that is measured using administrative reports and/or surveys. The measurement of vaccination coverage in low- and middle-income countries using surveys is susceptible to numerous challenges. These challenges include selection bias and information bias, which cannot be solved by increasing the sample size, and the precision of the coverage estimate, which is determined by the survey sample size and sampling method. Selection bias can result from an inaccurate sampling frame or inappropriate field procedures and, since populations likely to be missed in a vaccination coverage survey are also likely to be missed by vaccination teams, most often inflates coverage estimates. Importantly, the large multi-purpose household surveys that are often used to measure vaccination coverage have invested substantial effort to reduce selection bias. Information bias occurs when a child's vaccination status is misclassified due to mistakes on his or her vaccination record, in data transcription, in the way survey questions are presented, or in the guardian's recall of vaccination for children without a written record. There has been substantial reliance on the guardian's recall in recent surveys, and, worryingly, information bias may become more likely in the future as immunization schedules become more complex and variable. Finally, some surveys assess immunity directly using serological assays. Sero-surveys are important for assessing public health risk, but currently are unable to validate coverage estimates directly. To improve vaccination coverage estimates based on surveys, we recommend that recording tools and practices should be improved and that surveys should incorporate best practices for design, implementation, and analysis.
机译：疫苗接种率是一项重要的公共卫生指标，可以通过行政报告和/或调查来衡量。使用调查来衡量中低收入国家的疫苗接种覆盖率容易受到诸多挑战。这些挑战包括选择偏差和信息偏差（无法通过增加样本数量来解决），以及覆盖范围估计的精度（由调查样本大小和抽样方法确定）。选择偏差可能是由不正确的抽样框架或不适当的现场程序造成的，并且由于疫苗接种覆盖率调查中可能会遗漏的人群也可能被疫苗接种团队遗漏，因此通常会夸大覆盖率估计值。重要的是，经常用于衡量疫苗接种覆盖率的大型多功能家庭调查已经投入了巨大的精力来减少选择偏见。当由于疫苗接种记录上的错误，数据转录，呈现调查问题的方式或监护人对没有书面记录的儿童进行疫苗接种的回忆而导致儿童的疫苗接种状态分类错误时，就会出现信息偏差。在最近的调查中，很大程度上依赖于监护人的召回，而且令人担忧的是，随着免疫计划的日趋复杂和多变，信息偏见在将来可能会更大。最后，一些调查直接使用血清学分析评估免疫力。血清调查对于评估公共健康风险很重要，但是目前无法直接验证覆盖率估计。为了提高基于调查的疫苗接种覆盖率估计值，我们建议应改进记录工具和做法，并且调查应纳入设计，实施和分析的最佳做法。

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