Mapping diphtheria-pertussis-tetanus vaccine coverage in Africa, 2000–2016: a spatial and temporal modelling study

作者：Jonathan F Mosser, William Gagne‐Maynard, Puja C Rao, Aaron Osgood‐Zimmerman, Nancy Fullman, Nicholas Graetz, Roy Burstein, Rachel L Updike, Patrick Y Liu, Sarah E. Ray, Lucas Earl, Aniruddha Deshpande, Daniel Casey, Laura Dwyer‐Lindgren, Elizabeth A. Cromwell, David M. Pigott, Freya M. Shearer, Heidi J. Larson, Daniel J. Weiss, Samir Bhatt, Peter W. Gething, Christopher J L Murray, Stephen S Lim, Robert C. Reiner, Simon I Hay · 发表于：The Lancet · 年份：2019 · DOI：10.1016/s0140-6736(19)30226-0 · 被引用次数：174 · 研究领域：Vaccine Coverage and Hesitancy、Bacterial Infections and Vaccines、Immune responses and vaccinations

BACKGROUND: Routine childhood vaccination is among the most cost-effective, successful public health interventions available. Amid substantial investments to expand vaccine delivery throughout Africa and strengthen administrative reporting systems, most countries still require robust measures of local routine vaccine coverage and changes in geographical inequalities over time. METHODS: This analysis drew from 183 surveys done between 2000 and 2016, including data from 881 268 children in 49 African countries. We used a Bayesian geostatistical model calibrated to results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017, to produce annual estimates with high-spatial resolution (5 × 5 km) of diphtheria-pertussis-tetanus (DPT) vaccine coverage and dropout for children aged 12-23 months in 52 African countries from 2000 to 2016. FINDINGS: Estimated third-dose (DPT3) coverage increased in 72·3% (95% uncertainty interval [UI] 64·6-80·3) of second-level administrative units in Africa from 2000 to 2016, but substantial geographical inequalities in DPT coverage remained across and within African countries. In 2016, DPT3 coverage at the second administrative (ie, district) level varied by more than 25% in 29 of 52 countries, with only two (Morocco and Rwanda) of 52 countries meeting the Global Vaccine Action Plan target of 80% DPT3 coverage or higher in all second-level administrative units with high confidence (posterior probability ≥95%). Large areas of low DP...