利用儿童预防接种信息管理系统开展接种率监测报告的可行性研究  

Study on the Practicability of Immunization Coverage Surveillance by Using Child Immunization Information Management System

作　　者：卢莉[1] 马蕊[1] 苑新海[2] 王中战[3] 王海红[2] 王凤双[4] 富继业[5] 李晓梅[1] 潘静彬[1] 李娟[1] 刘维祥[1] 左树岩[6] 姚维 

机构地区：[1]北京市疾病预防控制中心,北京100013 [2]北京市昌平区疾病预防控制中心,北京102200 [3]北京市丰台区疾病预防控制中心,北京100071 [4]北京市顺义区疾病预防控制中心,北京101300 [5]北京市海淀区疾病预防控制中心,北京100037 [6]世界卫生组织驻华代表处,北京100600 [7]金卫信信息技术有限公司,广东深圳518038

出　　处：《中国疫苗和免疫》2014年第2期146-151,共6页Chinese Journal of Vaccines and Immunization

摘　　要：目的探讨利用儿童预防接种信息管理系统(Child Immunization Information Management System,CIIMS)常规免疫接种率报表替代手工报表,开展接种率监测的可行性。方法选择北京市4个预防接种门诊,利用CIIMS生成的某月接种率电子报表,对其中首剂含麻疹成份疫苗(First Dose of Measles-containing Vaccine,MCV1)的接种率、应种人数、实种人数,与CIIMS导出的儿童数据库通过编程统计的接种率、应种人数、实种人数进行比对,并通过儿童预防接种个案,核实比较电子报表中应种和实种儿童数差异的来源;通过电话联系电子报表中未接种儿童家长核实未接种原因;对其中2个预防接种门诊进行儿童MCV1抽样调查并与CIIMS核对,计算儿童建卡率。结果 CIIMS计算的接种率高于编程统计,其中实种儿童数一致,但电子报表的应种儿童数少20.7%,差异主要来源于CIIMS的设置,如"与上一剂间隔<14天"、"有优先补种的其他疫苗"等共计8种情况的儿童不计入应种对象;电子报表中的未接种儿童未接种原因包括客观因素,如"已迁出本地"、"禁忌证"等;真正漏种的占4.5%,原因为"家长没时间"等。2个预防接种门诊现场抽样调查儿童建卡率分别为98.1%和99.1%。结论 CIIMS生成的电子报表准确性较好,儿童建卡率较高,北京市CIIMS已具备替代手工接种率监测的基本条件。影响电子报表准确性的主要因素为儿童临时迁出,临时禁忌证,导致CIIMS不能将其从应种人数中剔除,以及流动儿童长期离开在CIIMS中变为死卡。可开展试点替代手工报表,探索制定迁出和临时禁忌证儿童在CIIMS中及时标识与管理的标准操作规范(Standard Operation Procedure,SOP),针对流动儿童迁入、迁出在信息化技术下电子预防接种卡清理的SOP。Objective To explore the feasibility of alternation manual immunization coverage reporting by using Beijing child immunization information management system （CIIMS）. Methods To compare the difference of the number of target children, immunized children, coverage of the first dose of measlescontaining vaccine （MCV1 ） between auto-generated coverage reporting form from CIIMS and calculated coverage by using exported data from CIIMS database in 4 selected immunization clinics by computer programming. To contact parents of dropped children to confirm the reasons of failed vaccination. Through field investigation to understand record rate of children in the CIIMS. Results The number of target children of MCV1 by auto-generate was higher （20. 7% ） than that by calculated from exporting data, and no difference in the number of vaccinated children between these two ways. The main reasons of differences of targeted children came from CIIMS settings such as： the child did not include in the target children who vaccinated vaccine less than 14 days interval with vaccinated vaccine previously. Main reasons of failed immunization of dropped out children were move out of the area,temporary contraindication, and no time to take children for immunization et al. In field investigation, the rate of children recorded in the CIIMS was 98.1% -99. 1%. Conclusions Practicability is good for alternate manual reporting system by using information system. Standard operation procedure （SOP） should be developed for marking children who are temporary moving out or temporary contraindications, and cleaning timely stagnate records in Beijing CIIMS.

关 键 词：接种率监测 儿童预防接种信息管理系统 可行性 

分 类 号：R186[医药卫生—流行病学]