卡普兰-迈耶(Kaplan-Meier)法在首剂含麻疹成分疫苗接种率评估中的应用

Application of Kaplan-Meier in Evaluation of the Coverage of First Dose Measles-containing Vaccine

目的应用卡普兰-迈耶（Kaplan—Meier）法，快速评估首剂含麻疹成分疫苗（First Dose Measles-containing Vaccine，MCV．）的接种率。方法在A、B两省8个县（区、市，下同），每个调查县随机抽取5个乡（镇、街道，下同），备份各乡辖区内预防接种单位客户端数据库，利用预防接种单位客户端督导工具“数据质量模块”，对客户端数据质量进行评价，采用Kaplan-Meier法对预防接种单位MCV．接种数据进行分析。结果共对比了1674剂MCV。预防接种记录，预防接种单位客户端中MCV1接种信息与现场调查MCV1接种信息一致率为97．7％，一致率〉95％的乡有34个，占85．0％。A、B省8月龄儿童MCV1及时接种率分别为46．7％、39．9％，12月龄时点累积接种率分别为87．1％[95％可信区间（Confidence Interval，CI）：86．8％～87．4％]与73．5％（95％CI：73．2％-73．8％）。2个省儿童MCV1时点累积接种率在8—10月龄呈现较快增长，而在上述时点后增长速率缓慢。经对数秩检验，不同预防接种服务周期乡的儿童，MCV1接种率的差异有统计学意义（x2=175．848，P〈0．0001）。结论Kaplan—Meier法直观地展现MCV1接种率随时间变化的整个过程，可用于快速评估预防接种单位MCV1接种率。

Objective To Rapidly evaluate first dose measles-containing vaccine（ MCV1 ） coverage with the method of Kaplan-Meier. Method 5 township immunization sites from each county, 8 counties from 2 provinces were selected by random sampling method. Before analysis, the immunization data of MCV1 from immunization unit clients, we evaluated the accuracy of the immunization unit client data. Result 1674 records of MCV1 was examined, in which the agreement rate was 97.7%. Of all the 40 townships, the agreement rate of 34 townships （85.0%） was 〉 950/o. The timely coverage rate of MCV1 was 46.7% in A province and 39.9% in B province. Cumulative coverage of 12 months children was 87.1% [95% Confidence Interval（CI） ： 86. 8% -87.4% ] in A province and 73.5% （95% CI：73.2%-73.8% ） in B province. Cumulative coverage had rapid growth among the children aged 8-10 months and slow growth after that point. Immunization coverage of different vaccization period has statistically significant difference （x2 = 175. 848, P 〈 0. 0001）. Conclusion With the methods of Kaplan-Meier, the whole process of immunization coverage of MCV1 can be intuitive displayed to us. It＇s helpful in rapid evaluating the immunization coverage of different age group.