Comparação entre os métodos administrativo e de monitoramento rápido da cobertura vacinal de rubéola em Minas Gerais

Abstract

Objective: To compare the rubella vaccination coverage estimated by the administrative and residential monitoring (RMC) methods in 28 Regional Health Management (RHM) of Minas Gerais State, Brazil. Methods: This is a cross-sectional population-based study developed with secondary data on the vaccination campaign and the residential monitoring of rubella vaccination coverage realized by Health Secretary of Minas Gerais State in 853 municipalities from October 2008 to December 2009. In total, 146,769 individuals of both sexes, aged between 12 to 39 years old, were interviewed. This sample was distributed among the 28 RHM. Data were analyzed with the Statistical Package for Social Science version 15.0. Vaccination coverage in 28 RHM were presented for each methods, administrative and RMC, through the relative frequencies according to sex (male and female) and ages (12 to 19 years, 20 to29 years, and 30 to 39 years). Furthermore, we calculated the differences between these rates following the same stratification pattern. The concordance between the methods were evaluated by kappa index, percentage of agreement and disagreement to reach the vaccination goal (>= 95%), according to sex (male and female) and ages (12 to 19 years, 20 to 29 years, and 30 to 39 years). We also estimated the sensitivity and specificity of the administrative methods in achieving the goal immunization with RMC as reference, following the same stratification pattern. Statistical differences were assessed at a level of 5% (p < 0.05). Results: There was poor concordance of vaccination coverage between administrative and RMC methods independently of sex and age; this condition worsened with age. The administrative method overestimated and underestimated the vaccination coverage. Furthermore, women had better vaccination coverage after RMC than men. Conclusion: The agreement between administrative and RMC methods for rubella vaccination coverage is poor, fact that should be taken into consideration by health managers to assess the immunization campaigns effectiveness.