2016年天津市儿童预防接种信息管理系统脱漏儿童现况调查

Cross-sectional investigation on missing children in Children Immunization Information Management System of Tianjin in 2016

目的掌握天津市儿童预防接种信息管理系统(CIIMS)脱漏儿童现状,为系统数据的深度利用打下基础。方法采用整群分层抽样的方法,对天津市18个地区的72个街/乡分4次共计调查14 400名1~6岁儿童的CIIMS管理情况,对数据结果进行统计分析。结果全年共发现脱漏儿童221人,脱漏率为1.53%;发现脱漏儿童最多的是东丽区为37人(4.63%),最低的是和平区为0人,不同地区的儿童脱漏率差异有统计学意义(P<0.05);第二季度发现的脱漏儿童最多71人(1.97%),第3季度最少41人(1.14%),不同季度的儿童脱漏率差异有统计学意义(P<0.05);1岁组儿童脱漏率最低(0.71%),6岁组儿童脱漏率最高(2.33%),不同年龄的儿童脱漏率差异有统计学意义(P<0.05);外来流动儿童脱漏率(2.30%)高于本地儿童(1.24%),不同户籍儿童脱漏率差异有统计学意义(P<0.05);脱漏主要原因为本地儿童脱管144人(65.16%),其次是外来儿童漏管59人(20.67%)。221名脱漏儿童中有63名存在各种程度的疫苗漏种,漏种率为28.51%;在漏种疫苗中百白破漏种人数最多17人(7.69%),甲型肝炎漏种人数最少8人(3.62%)。结论天津市CIIMS目标人群覆盖率较好,脱漏儿童分布受到地区、时间、年龄段、户籍等多种因素的影响,脱漏儿童疫苗漏种较为严重,未来应提高对这一人群的关注程度,制定有效措施尽量减少儿童脱漏数量,保障CIIMS的数据质量,提高系统利用程度。

[Objective]To analyze the situation of missing children in Children Immunization Information Management System（CIIMS） of Tianjin,lay the foundation for the deep use of system data.[Methods]Cluster stratified sampling was used to get the subjects from 72 townships/sub-districts in 18 areas of Tianjin. After four times of sampling,totally 14 400 children aged 1-6 years old were enrolled from CIIMS. And the data were statistically analyzed. [Results]221 children were missing in the year with the missing rate of 1.53%. The highest missing number was 37（4.63%） in Dongli District, and no missing child was found in Heping District. There was a statistically significant difference in the missing rate among different areas（P〈0.05）. The highest and lowest missing number was 71（1.97%） in the second quarter and 41（1.14%） in the third quarter respectively, and the difference in the missing rate was statistically significant among four quarters（P〈0.05）. The missing rate in 1 year-old age group was the lowest（0.71%） and that in 6 year-old age group was the highest（2.33%）, and the difference in the missing rate was statistically significant among different age groups（P〈0.05）. The missing rate in floating children（2.30%） was higher than that in local children（1.24%）, and the difference in the missing rate was statistically significant among children with different household register（P〈0.05）. The main missing causes were lost of 144 local children（65.16%） and missing of 59 floating children（20.67%）. Among 221 missing children,63 missed immunization of various vaccines, and the missing rate for vaccine was28.51%. In missing vaccines, the missing number of DPT was the highest（17 children, 7.69%） and that of hepatitis A vaccine was the lowest（8 children, 3.62%）.[Conclusion]There is a good coverage for targeted population in CIIMS of Tianjin, and the missing children distribution is affected by area, time, age and household register. The missing immunization is serious in missing children. In future, it is necessary to pay more attention to this population, develop effective measures to minimize the number of missing children, guarantee the data quality of CIIMS, and improve system utilization degree.