Measuring the Performance of Vaccination Programs Using Cross-Sectional Surveys A Likelihood Framework and Retrospective Analysis 英文参考文献.docVIP

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Measuring the Performance of Vaccination Programs Using Cross-Sectional Surveys A Likelihood Framework and Retrospective Analysis 英文参考文献.doc

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Measuring the Performance of Vaccination Programs Using Cross-Sectional Surveys A Likelihood Framework and Retrospective Analysis 英文参考文献

MeasuringthePerformanceofVaccinationPrograms UsingCross-SectionalSurveys:ALikelihoodFramework andRetrospectiveAnalysis JustinLessler1*,C.JessicaE.Metcalf2,RebeccaF.Grais3,4,FranciscoJ.Luquero3,DerekA.T.Cummings1, BryanT.Grenfell5,6 1DepartmentofEpidemiology,JohnsHopkinsBloombergSchoolofPublicHealth,Baltimore,Maryland,UnitedStatesofAmerica,2DepartmentofZoology,Universityof Oxford,Oxford,UnitedKingdom,3Epicentre,Paris,France,4HarvardHumanitarianInitiative,HarvardUniversity,Cambridge,Massachusetts,UnitedStatesofAmerica, 5Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, United States of America, 6Forgarty International Center, National InstituteofHealth,Maryland,UnitedStatesofAmerica Abstract Background: The performance of routine and supplemental immunization activities is usually measured by the administrativemethod:dividingthenumberofdosesdistributedbythesizeofthetargetpopulation.Thismethodleadsto coverageestimatesthataresometimesimpossible(e.g.,vaccinationof102%ofthetargetpopulation),andaregenerally inconsistentwiththeproportionfoundtobevaccinatedinDemographicandHealthSurveys(DHS).Wedescribeamethod thatestimatesthefractionofthepopulationaccessibletovaccinationactivities,aswellaswithin-campaigninefficiencies, thusprovidingaconsistentestimateofvaccinationcoverage. Methods and Findings: We developed a likelihood framework for estimating the effective coverage of vaccination programsusingcross-sectionalsurveysofvaccinecoveragecombinedwithadministrativedata.Weappliedourmethodto measlesvaccinationinthreeAfricancountries:Ghana,Madagascar,andSierraLeone,usingdatafromeachcountry’smost recentDHSsurveyandadministrativecoveragedatareportedtotheWorldHealthOrganization.Weestimatethat93%(95% CI: 91, 94) of the population in Ghana was ever covered by any measles vaccination activity, 77% (95% CI: 78, 81) in Madagascar,and69%(95%CI:67,70)inSierraLeone.‘‘Within-activity’’inefficiencieswereestimatedtobelowinGhana, andhigherinSierraLeonean