일개 도농복합시 영유아 예방접종 수첩의 정확도 평가 Evaluation on the Accuracy of Vaccination Card for National Immunization Program in a 2005 Population-Based Survey in Nonsan, Korea원문보기
목적 : 이 연구는 국가예방접종률 산출 및 조사방법론 개발을 위한 기반을 조성하기 위하여 예방접종률 파악을 위한 자료원 중 영유아 예방접종 수첩기록의 정확도를 평가하기 위하여 수행되었다. 대상 및 방법 : 연구대상은 2005년 1월 31일을 기준으로 충청남도 논산시에 주민등록상 거주하는 생후 12-35개월 영유아 전체로 하였다. 연구대상자가 거주하는 가구를 2005년 2-4월까지 방문하여 보호자의 동의를 얻어 예방접종 수첩기록을 조사하였다. 예방접종 수첩기록의 정확도를 평가하기 위하여 2005년 5-7월까지 예방접종을 시행한 의료기관 및 보건소의 접종관련 기록을 확보하여 예방접종 접종 여부 및 접종 일자의 기록 일치 여부를 확인하였다. 비교 대상 예방접종은 결핵(BCG), B형간염, 디프테리아/파상풍/백일해 (DTaP), 홍역/유행성이하선염/풍진(MMR), 폴리오, 일본뇌염, 수두, 인플루엔자, B형 헤모필루스 인플루엔자뇌수막염(Hib), A형간염, 폐구균으로 총 11종을 대상으로 하였다. 결과 : 예방접종 수첩의 예방접종 여부 및 접종 일시 기록의 정확도는 BCG는 69.5% 및 80.1%였으며, B형 간염은 1차 41.3% 및 89.7%, 2차 76.6% 및 82.1%, 3차 79.7% 및 79.0%였으며, DTaP는 1차 79.9% 및 87.5%, 2차 80.8% 및 87.3%, 3차 82.5% 및 85.1%, 4차 79.9% 및 83.5%였으며, 폴리오는 1차 79.5% 및 88.1%, 2차 79.8% 및 86.2%, 3차 82.1% 및 84.8%였으며, MMR은 83.2% 및 84.0%였으며, 일본뇌염 1차는 80.7% 및 83.1%였으며, 수두는 74.9% 및 83.7%였으며, 인플루엔자는 74.1% 및 55.3%였으며, Hib 1차는 72.7% 및 90.7%였으며, A형 간염 1차는 79.5% 및 88.4%였으며, 폐렴구균 1차는 73.2% 및 90.3%로 나타났다. 결론 : 여러 가지 연구의 제한점에도 불구하고, 예방접종 수첩의 상당한 수준의 신뢰도를 확인하였으나 수첩의 예방접종력 정확도 및 타당도에 대한 추가 연구가 필요할 것으로 판단된다.
목적 : 이 연구는 국가예방접종률 산출 및 조사방법론 개발을 위한 기반을 조성하기 위하여 예방접종률 파악을 위한 자료원 중 영유아 예방접종 수첩기록의 정확도를 평가하기 위하여 수행되었다. 대상 및 방법 : 연구대상은 2005년 1월 31일을 기준으로 충청남도 논산시에 주민등록상 거주하는 생후 12-35개월 영유아 전체로 하였다. 연구대상자가 거주하는 가구를 2005년 2-4월까지 방문하여 보호자의 동의를 얻어 예방접종 수첩기록을 조사하였다. 예방접종 수첩기록의 정확도를 평가하기 위하여 2005년 5-7월까지 예방접종을 시행한 의료기관 및 보건소의 접종관련 기록을 확보하여 예방접종 접종 여부 및 접종 일자의 기록 일치 여부를 확인하였다. 비교 대상 예방접종은 결핵(BCG), B형간염, 디프테리아/파상풍/백일해 (DTaP), 홍역/유행성이하선염/풍진(MMR), 폴리오, 일본뇌염, 수두, 인플루엔자, B형 헤모필루스 인플루엔자 뇌수막염(Hib), A형간염, 폐구균으로 총 11종을 대상으로 하였다. 결과 : 예방접종 수첩의 예방접종 여부 및 접종 일시 기록의 정확도는 BCG는 69.5% 및 80.1%였으며, B형 간염은 1차 41.3% 및 89.7%, 2차 76.6% 및 82.1%, 3차 79.7% 및 79.0%였으며, DTaP는 1차 79.9% 및 87.5%, 2차 80.8% 및 87.3%, 3차 82.5% 및 85.1%, 4차 79.9% 및 83.5%였으며, 폴리오는 1차 79.5% 및 88.1%, 2차 79.8% 및 86.2%, 3차 82.1% 및 84.8%였으며, MMR은 83.2% 및 84.0%였으며, 일본뇌염 1차는 80.7% 및 83.1%였으며, 수두는 74.9% 및 83.7%였으며, 인플루엔자는 74.1% 및 55.3%였으며, Hib 1차는 72.7% 및 90.7%였으며, A형 간염 1차는 79.5% 및 88.4%였으며, 폐렴구균 1차는 73.2% 및 90.3%로 나타났다. 결론 : 여러 가지 연구의 제한점에도 불구하고, 예방접종 수첩의 상당한 수준의 신뢰도를 확인하였으나 수첩의 예방접종력 정확도 및 타당도에 대한 추가 연구가 필요할 것으로 판단된다.
The aims of this study were to survey, evaluate the accuracy of personal immunization record of vaccination card, and to establish the applicability of personal immunization record for presuming population based immunization rate and evaluation method. In 2005, a population-based survey of 12-35 mon...
The aims of this study were to survey, evaluate the accuracy of personal immunization record of vaccination card, and to establish the applicability of personal immunization record for presuming population based immunization rate and evaluation method. In 2005, a population-based survey of 12-35 months old children was carried out in Nonsan, Korea. We conducted household survey and provider check using questionnaire and checklist to obtain data on immunization status for children. Total 11 vaccinations were checked in vaccination card such as BCG, hepatitis b, polio, chickenpox vaccine. For estimating accuracy of immunization status and dates of immunization, we estimated correspondence rate between data from personal vaccination card and data from medical records and immunization registry data. Accuracy of the child's vaccination card by type of National Immunization Program vaccine in whole medical institutions were from 41.8% to 83.2%. Accuracy for the date of vaccination of vaccination card in National Immunization Programme vaccine were from 55.3% to 89.7%. In spite of this study limitations, this study verified the validity of vaccination record of vaccination card substantially, but suggests more efforts to reassure the validity of vaccination card.
The aims of this study were to survey, evaluate the accuracy of personal immunization record of vaccination card, and to establish the applicability of personal immunization record for presuming population based immunization rate and evaluation method. In 2005, a population-based survey of 12-35 months old children was carried out in Nonsan, Korea. We conducted household survey and provider check using questionnaire and checklist to obtain data on immunization status for children. Total 11 vaccinations were checked in vaccination card such as BCG, hepatitis b, polio, chickenpox vaccine. For estimating accuracy of immunization status and dates of immunization, we estimated correspondence rate between data from personal vaccination card and data from medical records and immunization registry data. Accuracy of the child's vaccination card by type of National Immunization Program vaccine in whole medical institutions were from 41.8% to 83.2%. Accuracy for the date of vaccination of vaccination card in National Immunization Programme vaccine were from 55.3% to 89.7%. In spite of this study limitations, this study verified the validity of vaccination record of vaccination card substantially, but suggests more efforts to reassure the validity of vaccination card.
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문제 정의
The aims of this study were to evaluate the accuracy of personal immunization record and to establish the applicability of personal immunization record for estimating population-based or national-wide immunization rates.
The aims of this study were to survey, evaluate the accuracy of personal immunization record of vaccination card, and to establish the applicability of personal immunization record for presuming population based immunization rate and evaluation method.
Our study was focused primarily on the accuracy of vaccination record, therefore, did not include related many other factors. The findings indicated that a vaccination card should be developed and implemented in order to improve the accuracy of immunization record of vaccination card. In spite of these limitations, this study verified the validity of vaccination record of vaccination card substantially, but suggests more efforts to reassure the validity of vaccination card.
제안 방법
The first program was distribution and management of child's vaccination card in the general public and general physicians.
대상 데이터
Study subjects were 1,544 infants and children from 12 to 35 months living in Nonsan, Chungcheongnamdo, as of January 31st, 2005. We conducted face-to-face interviews with subjects' guardians and check record of subject's vaccination card from February to April, 2005[6,7].
We conducted household survey and provider check using questionnaire and checklist to obtain data on immunization status for children. Total 11 vaccinations were checked in vaccination card such as BCG, hepatitis b, polio, chickenpox vaccine. For estimating accuracy of immunization status and dates of immunization, we estimated correspondence rate between data from personal vaccination card and data from medical records and immunization registry data.
성능/효과
Accuracy of date of immunization were as follow: 80.1% for BCG, 89.7% for first HBV, 82.1% for secondary HBV, 79.0% for third HBV, 87.5% for first DTaP, 87.3% for second DTaP, 85.1% for third DTaP, 83.5% for fourth DTaP, 88.1% for first Polio, 86.2% for second Polio, 84.8% for third Polio, 84.0% for MMR, 83.1% for JBE, 83.7% for Chickenpox, 55.3% for Influenza, 90.7% for first Hib, 88.4% for first HAV and 90.3% for first Pneumococcal(Table 2).
Accuracy of immunization status were as follow: 69.5% for BCG, 41.3% for first HBV, 76.6% for secondary HBV, 79.7% for third HBV, 79.9% for first DTaP, 80.8% for second DTaP, 82.5% for third DTaP, 79.9% for fourth DTaP, 79.5% for first Polio, 79.8% for second Polio, 82.1% for third Polio, 83.2% for MMR, 80.7% for JBE, 74.9% for Chickenpox, 74.1% for Influenza, 72.7% for first Hib, 79.5% for first HAV and 73.2% for first Pneumococcal(Table 2).
[15] estimated agreement between vaccination cards and medical records in up-to-date status data of DTaP, polio and MMR vaccine. Among total 175 subjects, agreement rate was 81.1% of DTaP, 81.7% of polio, and 90.1% of MMR. These results correspond with our result, suggesting that vaccination cards are able to be used as data source for estimating national immunization coverage rates.
Results of this study show that accuracy of immunization status range from 69.5% to 83.2% except accuracy of 41.3% for first HBV. Since 2002, the Ministry of Health and Welfare in Korea has started national program for controlling vertical transmission by hepatitis B virus and the first HBV injection was shot to infants born in women with positive HBsAg[11].
후속연구
The findings indicated that a vaccination card should be developed and implemented in order to improve the accuracy of immunization record of vaccination card. In spite of these limitations, this study verified the validity of vaccination record of vaccination card substantially, but suggests more efforts to reassure the validity of vaccination card.
In spite of this study limitations, this study verified the validity of vaccination record of vaccination card substantially, but suggests more efforts to reassure the validity of vaccination card.
참고문헌 (15)
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Centers for Disease Control and Prevention. Vaccination coverage levels among children aged 19-35 months--United States, April-June 1994. MMWR Morb Mortal Wkly Rep 1995;44(20):396-8
Bolton P, Holt E, Ross A, Hughart N, Guyer B. Estimating vaccination coverage using parental recall, vaccination cards, and medical records. Public Health Rep 1998;113(6):521-6.
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