Estratégias para aumentar a demanda para a imunização infantil em renda baixa e média: uma revisão sistemática e meta-análise
DOI:
https://doi.org/10.17533/udea.rfnsp.v34n2a13Palavras-chave:
vacinação, população infantil, país do terceiro mundoResumo
Objetivo: investigar quais as estratégias para aumentar a demanda para a vacinação é eficaz em aumentar a cobertura da vacinação infantil em renda baixa e média. Metodologia: Foram pesquisados os bancos de dados do MEDLINE, EMBASE, Cochrane Library, POPLINE, EconLit, CINAHL, LILACS, BDSP, Web of Science e Scopus foram feitas para encontrar estudos relevantes, publicadas em Alemão, Espanhol, Francês, Hindi, Inglês e Português até 25 de Março de 2014. estudos de intervenções que visam a aumentar a demanda para a vacinação infantil de rotina incluído. Os estudos foram considerados elegíveis se eles foram feitos em renda baixa e média utilizou um desenho randomizado controlado julgamento, sem estudo controlado randomizado, controlado antes e depois do estudo ou série temporal interrompida. um risco de viés foi estimado pelos efeitos aleatórios Cochrane Collaboration diretrizes e meta-análises foram realizadas. Resultados: 11 estudos abrangendo quatro ensaios clínicos randomizados, seis experimentos de aglomeração randômica controladas e controladas antes e depois de estudos publicados em Inglês, entre 1996 e 2013. Em geral identificados, os participantes foram pais de crianças pequenas expostas a uma intervenção elegíveis . Seis estudos mostraram um baixo risco de viés e cinco estudos mostraram um risco de viés moderado a elevado. Uma análise foi realizada tendo em conta conjunta dos 11 estudos com dados de 11.512 participantes. Intervenções focadas na demanda foram associados com significativamente maior recebimento de vacinas, o risco relativo (RR): 1,30 (intervalo de confiança, IC 95%: 1,17-1,44). O subgrupo análises também mostraram efeitos significativos de sete estudos de educação e tradução do conhecimento, RR 1,40 (IC 95%: 1,20 a 1,63) e quatro estudos utilizando incentivos, RR 1, (IC 95%: 1,12- 1,45) 28. Conclusão: intervenções focadas na procura vai gerar melhorias significativas na cobertura de imunização infantil em renda baixa e média. Além disso, as abordagens educacionais e usando incentivos foram estratégias eficazes.
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Referências
Decade of Vaccines Collaboration 2012. Global Vaccine Action Plan 2011-2020. Geneva: World Health Organization; 2013. Available from: http://www.who.int/iris/bitstream/10665/78141/1/9789241504980_eng.pdf?ua=1 [cited 2015 March 3].
Narrowing the gaps to meet the goals. New York: United Nations Children’s Fund; 2010. Available from: http://www.unicef.org/publications/files/Narrowing_the_Gaps_to_Meet_the_Goals_090310_2a.pdf [cited 2015 Mar 23].
Global immunization data. Geneva: World Health Organization; 2014. Available from: http://www.who.int/immunization/monitoring_surveillance/global_immunization_data.pdf [cited 2015 Mar 23].
Batt K, Fox-Rushby JA, Castillo-Riquelme M. The costs, effects and cost- effectiveness of strategies to increase coverage of routine immunizations in low- and middle-income countries: systematic review of the grey literature. Bull World Health Organ. 2004 Sep;82(9):689–96. PMID: 15628207
Pegurri E, Fox-Rushby JA, Damian W. The effects and costs of expanding the coverage of immunisation services in low- and middle-income countries: a systematic literature review. Vaccine. 2005 Feb 18;23(13):1624–35. doi: http://dx.doi.org/10.1016/j.vaccine.2004.02.029 PMID: 15694515
Haines A, Sanders D, Lehmann U, Rowe AK, Lawn JE, Jan S, et al. Achieving child survival goals: potential contribution of community health workers. Lancet. 2007 Jun 23;369(9579):2121–31. doi: http://dx.doi.org/10.1016/ S0140-6736(07)60325-0 PMID: 17586307
Ryman TK, Dietz V, Cairns KL. Too little but not too late: results of a literature review to improve routine immunization programs in low- and middle- income countries. BMC Health Serv Res. 2008;8(1):134. doi: http://dx.doi.org/10.1186/1472-6963-8-134 PMID: 18570677
Shea B, Andersson N, Henry D. Increasing the demand for childhood vaccination in low- and middle-income countries: a systematic review. BMC Int Health Hum Rights. 2009;9 Suppl 1:S5. doi: http://dx.doi.org/10.1186/1472-698X-9-S1-S5 PMID: 19828063
Oyo-Ita A, Nwachukwu CE, Oringanje C, Meremikwu MM. Interventions for improving coverage of child immunization in lowand middle-income countries. Cochrane Database Syst Rev. 2011; (7):CD008145. PMID: 21735423
Effective Practice and Organisation of Care (EPOC). What study designs should be included in an EPOC review and what should they be called? EPOC Resources for review authors. Oslo: Norwegian Knowledge Centre for the Health Services; 2015. Available from: http://epoc.cochrane.org/epoc-specific-resources-reviewauthors [cited 2015 Mar 23].
Country and lending groups. Data & statistics: country classification. Washington: The World Bank; 2013.
Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions. Oxford: The Cochrane Collaboration; 2011. Available from: http://handbook.cochrane.org/ [cited 2015 April 10].
Viechtbauer W. Conducting meta-analyses in R with the metafor package. J Stat Softw. 2010;36:1–48.
Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002 Jun 15;21(11):1539–58. doi: http://dx.doi.org/10.1002/sim.1186 PMID: 12111919
Owais A, Hanif B, Siddiqui AR, Agha A, Zaidi AK. Does improving maternal knowledge of vaccines impact infant immunization rates? A community- based randomized-controlled trial in Karachi, Pakistan. BMC Public Health. 2011;11(1):239. doi: http://dx.doi.org/10.1186/1471-2458-11-239 PMID: 21496343
Usman HR, Akhtar S, Habib F, Jehan I. Redesigned immunization card and center-based education to reduce childhood immunization dropouts in urban Pakistan: a randomized controlled trial. Vaccine. 2009 Jan 14;27(3):467–72. doi: http://dx.doi.org/10.1016/j.vaccine.2008.10.048 PMID: 18996423
Usman HR, Rahbar MH, Kristensen S, Vermund SH, Kirby RS, Habib F, et al. Randomized controlled trial to improve childhood immunization adherence in rural Pakistan: redesigned immunization card and maternal education. Trop Med Int Health. 2011 Mar;16(3):334–42. doi: http://dx.doi.org/10.1111/j.1365-3156.2010.02698.x PMID: 21159080
Banerjee AV, Duflo E, Glennerster R, Kothari D. Improving immunisation coverage in rural India: clustered randomised controlled evaluation of immunisation campaigns with and without incentives. BMJ. 2010 May 17;340(1):c2220. doi: http://dx.doi.org/10.1136/bmj.c2220 PMID: 20478960
Andersson N, Cockcroft A, Ansari NM, Omer K, Baloch M, Ho Foster A, et al. Evidence-based discussion increases childhood vaccination uptake: a randomised cluster controlled trial of knowledge translation in Pakistan. BMC Int Health Hum Rights. 2009;9 Suppl 1:S8. doi: http://dx.doi.org/10.1186/1472-698X-9- S1-S8 PMID: 19828066
Pandey P, Sehgal AR, Riboud M, Levine D, Goyal M. Informing resource- poor populations and the delivery of entitled health and social services in rural India: a cluster randomized controlled trial. JAMA. 2007 Oct 24;298(16):1867–75. doi: http://dx.doi.org/10.1001/jama.298.16.1867 PMID: 17954538
Morris SS, Flores R, Olinto P, Medina JM. Monetary incentives in primary health care and effects on use and coverage of preventive health care interventions in rural Honduras: cluster randomised trial. Lancet. 2004 Dec 4-10;364(9450):2030–7. doi: http://dx.doi.org/10.1016/S0140-6736(04)17515-6 PMID: 15582060
Brugha RF, Kevany JP. Maximizing immunization coverage through home visits: a controlled trial in an urban area of Ghana. Bull World Health Organ. 1996;74(5):517–24. PMID: 9002332
Roy SK, Bilkes F, Islam K, Ara G, Tanner P, Wosk I, et al. Impact of pilot project of Rural Maintenance Programme (RMP) on destitute women: CARE, Bangladesh. Food Nutr Bull. 2008 Mar;29(1):67–75. PMID: 18510207
Robertson L, Mushati P, Eaton JW, Dumba L, Mavise G, Makoni J, et al. Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: a cluster-randomised trial. Lancet. 2013 Apr 13;381(9874):1283–92. doi: http://dx.doi.org/10.1016/S0140- 6736(12)62168-0 PMID: 23453283
Briere EC, Ryman TK, Cartwright E, Russo ET, Wannemuehler KA, Nygren BL, et al. Impact of integration of hygiene kit distribution with routine immunizations on infant vaccine coverage and water treatment and handwashing practices of Kenyan mothers. J Infect Dis. 2012 Mar;205 Suppl 1:S56–64. doi: http://dx.doi.org/10.1093/infdis/jir779 PMID: 22315387
Bassani DG, Arora P, Wazny K, Gaffey MF, Lenters L, Bhutta ZA. Financial incentives and coverage of child health interventions: a systematic review and meta-analysis. BMC Public Health. 2013;13 Suppl 3:S30. doi: http://dx.doi.org/10.1186/1471-2458- 13-S3-S30 PMID: 24564520
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