Performance of small cluster surveys and the clustered LQAS design to estimate local-level vaccination coverage in Mali 英文参考文献.docVIP

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Performance of small cluster surveys and the clustered LQAS design to estimate local-level vaccination coverage in Mali 英文参考文献.doc

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Performance of small cluster surveys and the clustered LQAS design to estimate local-level vaccination coverage in Mali 英文参考文献

Minettietal.EmergingThemesinEpidemiology2012,9:6 /content/9/1/6 EMERGINGTHEMES IN EPIDEMIOLOGY ANALYTIC PERSPECTIVE OpenAccess Performanceofsmallclustersurveysandthe clusteredLQASdesigntoestimatelocal-level vaccinationcoverageinMali AndreaMinetti1*,MargaritaRiera-Montes1,FabienneNackers1,ThomasRoederer1,MarieHortenseKoudika2, JohanneSekkenes2,AuroreTaconet3,FlorenceFermon3,AlbouharyTouré4,RebeccaFGrais1 andFrancescoChecchi1 Abstract Background:Estimationofvaccinationcoverageatthelocallevelisessentialtoidentifycommunitiesthatmay requireadditionalsupport.Clustersurveyscanbeusedinresource-poorsettings,whenpopulationfiguresare inaccurate.Tobefeasible,clustersamplesneedtobesmall,withoutlosingrobustnessofresults.Theclustered LQAS(CLQAS)approachhasbeenproposedasanalternative,assmallersamplesizesarerequired. Methods:Weexplored(i)theefficiencyofclustersurveysofdecreasingsamplesizethroughbootstrappinganalysis and(ii)theperformanceofCLQASunderthreealternativesamplingplanstoclassifylocalVC,usingdatafroma surveycarriedoutinMaliaftermassvaccinationagainstmeningococcalmeningitisgroupA. Results:VCestimatesprovidedbya10×15clustersurveydesignwerereasonablyrobust.Weusedthemto classifyhealthareasinthreecategoriesandguidemop-upactivities:i)healthareasnotrequiringsupplemental activities;ii)healthareasrequiringadditionalvaccination;iii)healthareasrequiringfurtherevaluation.Assamplesize decreased(from10×15to10×3),standarderrorofVCandICCestimateswereincreasinglyunstable.Resultsof CLQASsimulationswerenotaccurateformosthealthareas,withanoverallriskofmisclassificationgreaterthan0.25 inonehealthareaoutofthree.Itwasgreaterthan0.50inonehealthareaoutoftwoundertwoofthethree samplingplans. Conclusions:Smallsampleclustersurveys(10×15)areacceptablyrobustforclassificationofVCatlocallevel.We donotrecommendtheCLQASmethodascurrentlyformulatedforevaluatingvaccinationprogrammes. Keywords:Vaccinationcoverage,Mali,Meningitis,Lotqualityassurancesampling,LQAS,Clustersampling,Survey Introduction A specific ch