Socioeconomic inequalities and vaccination coverage: results of an immunisation coverage survey in 27 Brazilian capitals, 2007-2008
Carregando...
Citações na Scopus
86
Tipo de produção
article
Data de publicação
2012
Título da Revista
ISSN da Revista
Título do Volume
Editora
BMJ PUBLISHING GROUP
Autores
BARATA, Rita Barradas
RIBEIRO, Manoel Carlos Sampaio de Almeida
MORAES, Jose Cassio de
FLANNERY, Brendan
Citação
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, v.66, n.10, p.934-941, 2012
Resumo
Background Since 1988, Brazil's Unified Health System has sought to provide universal and equal access to immunisations. Inequalities in immunisation may be examined by contrasting vaccination coverage among children in the highest versus the lowest socioeconomic strata. The authors examined coverage with routine infant immunisations from a survey of Brazilian children according to socioeconomic stratum of residence census tract. Methods The authors conducted a household cluster survey in census tracts systematically selected from five socioeconomic strata, according to average household income and head of household education, in 26 Brazilian capitals and the federal district. The authors calculated coverage with recommended vaccinations among children until 18 months of age, according to socioeconomic quintile of residence census tract, and examined factors associated with incomplete vaccination. Results Among 17 295 children with immunisation cards, 14 538 (82.6%) had received all recommended vaccinations by 18 months of age. Among children residing in census tracts in the highest socioeconomic stratum, 77.2% were completely immunised by 18 months of age versus 81.2%-86.2% of children residing in the four census tract quintiles with lower socioeconomic indicators (p < 0.01). Census tracts in the highest socioeconomic quintile had significantly lower coverage for bacille Calmette-Guerin, oral polio and hepatitis B vaccines than those with lower socioeconomic indicators. In multivariable analysis, higher birth order and residing in the highest socioeconomic quintile were associated with incomplete vaccination. After adjusting for interaction between socioeconomic strata of residence census tract and household wealth index, only birth order remained significant. Conclusions Evidence from Brazilian capitals shows success in achieving high immunisation coverage among poorer children. Strategies are needed to reach children in wealthier areas.
Palavras-chave
Referências
- Agarwal S, 2005, INDIAN PEDIATR, V42, P653
- Atti MLC, 2004, VACCINE, V22, P4351, DOI 10.1016/j.vaccine.2004.04.026
- Barata RCB, 2000, REV PANAM SALUD PUBL, V8, P332, DOI 10.1590/S1020-49892000001000003
- Bardenheier B, 2004, ARCH PEDIAT ADOL MED, V158, P569, DOI 10.1001/archpedi.158.6.569
- Brazilian Institute of Geography and Statistics (IBGE), 2002, DAT INF CENS TRACT 2
- Brazilian Ministry of Health, 2008, BAS IMM CAL CHILDR
- Cortese MM, 2004, AM J PREV MED, V26, P29, DOI 10.1016/j.amepre.2003.09.021
- Darling N., 2008, Morbidity and Mortality Weekly Report, V57, P961
- Dayan GH, 2006, AM J EPIDEMIOL, V163, P561, DOI 10.1093/aje/kwj074
- Gwatkin D R., 2007, SOCIOECONOMIC DIFFER
- Gwatkin DR, 2001, IMMUNIZATION COVERAG
- HENDERSON RH, 1982, B WORLD HEALTH ORGAN, V60, P253
- Howe LD, 2009, J EPIDEMIOL COMMUN H, V63, P871, DOI 10.1136/jech.2009.088021
- Joyce T, 2005, PEDIATRICS, V115, pE526, DOI 10.1542/peds.2004-1533
- Luman ET, 2009, VACCINE, V27, P2534, DOI 10.1016/j.vaccine.2008.10.002
- Luman ET, 2005, JAMA-J AM MED ASSOC, V293, P1204, DOI 10.1001/jama.293.10.1204
- Luna EJA, 2009, VACCINE, V27, P5326, DOI 10.1016/j.vaccine.2009.06.096
- Marmot M, 2008, LANCET, V372, P1661, DOI 10.1016/S0140-6736(08)61690-6
- Matsumura T, 2005, BMC PUBLIC HEALTH, V5, DOI 10.1186/1471-2458-5-59
- Mello Maria Lúcia Rocha, 2010, Rev. bras. epidemiol., V13, P278, DOI 10.1590/S1415-790X2010000200010
- Ozcirpici B, 2006, PUBLIC HEALTH, V120, P145, DOI 10.1016/j.puhe.2005.04.008
- Pearce A, 2008, BMJ-BRIT MED J, V336, P754, DOI 10.1136/bmj.39489.590671.25
- Santoli JM, 2004, PEDIATRICS, V113, P1959
- Smith PJ, 2006, PEDIATRICS, V118, pE1287, DOI 10.1542/peds.2006-0923
- Stampi S, 2005, BMC PUBLIC HEALTH, V5, DOI 10.1186/1471-2458-5-42
- Temporão José Gomes, 2003, Hist. cienc. saude-Manguinhos, V10, P601, DOI 10.1590/S0104-59702003000500008
- Torun SD, 2006, BMC PUBLIC HEALTH, V6, DOI 10.1186/1471-2458-6-125
- United Nations Development Programme, 2008, 2007 2008 HUM DEV RE
- Victora CG, 1997, INT J EPIDEMIOL, V26, P224, DOI 10.1093/ije/26.1.224