Serviços de vacinação e cobertura vacinal incompleta em crianças: uma análise espacial comparativa das coortes BRISA, São Luís (Maranhão) e Ribeirão Preto (São Paulo), Brasil

Correspondence
R. C. C. S. Queiroz Universidade Federal do Maranhão. Av. dos Portugueses 1996, São Luís, MA 65080-805, Brasil. rafaelle_cristina@globomail.com

Contributors

R. C. C. S. Queiroz contributed to the study conception, data interpretation, and writing of the article. R. C. S. Queiroz contributed to the study design, data acquisition and interpretation, writing, and revision of the text. T. A. H. Rocha contributed to the writing and revision of the text. F. S. Silva contributed to data analysis and interpretation, writing, and revision of the text. I. G. Santos and I. P. Silva contributed to spatial analysis of the data and revision of the text. N. C. Silva contributed to the writing of the article. M. A. Barbieri, M. C. P. Saraiva and A. A. M. Silva contributed to data acquisition, interpretation of the results, writing, and revision of the text.

Additional informations

ORICD: Rafaelle Cristina Cruz da Silva Queiroz (0000-0001-7137-805X); Rejane Christine de Sousa Queiroz (0000-0003-4019-2011); Thiago Augusto Hernandes Rocha (0000-0002-6262-3276); Francelena de Sousa Silva (0000-0003-3053-0494); Izani Gonçalves dos Santos (0000-0003-0809-3902); Isaias Pereira da Silva (0000-0002-3506-0738); Núbia Cristina da Silva (0000-0002-0809-2152); Marco Antônio Barbieri (0000-0001-8060-1428); Maria da Conceição Pereira Saraiva (0000-0001-6858-7029); Antônio Augusto Moura da Silva (0000-0003-4968-5138).

Characteristics	Ribeirão Preto (n = 3,325 *)		São Luís (n = 2,744 *)		p-value **
Characteristics	n	%	n	%	p-value **
Sociodemographic characteristics ***
Mother’s age (years)					0.675
> 20	2,944	86.70	2,262	82.40
≤ 19	381	13.30	482	17.60
Mother’s schooling level (years)					0.043
≥ 12	724	23.40	263	14.80
9-11	2,100	60.40	2.016	69.50
5-8	382	13.60	269	12.70
0-4	74	2.60	65	3.00
Economic class ^#					0.734
A-B	1,542	48.70	496	20.00
C	1,548	42.00	1.595	54.10
D-E	235	9.30	653	25.90
Nubmer of siblings of the child residing in the household					0.593
0	1,756	53.40	1.357	49.40
1	1,029	30.20	889	32.00
2-3	474	14.40	430	15.90
> 3	66	2.00	68	2.70
Maternal characteristics
Planned pregnancy ***					0.418
Yes	1,570	47.10	866	31.60
No	1,746	52.90	1.875	68.40
New pregnancy during the first year after the birth of the child under study ^##					0.966
No	3,031	92.60	2.497	91.50
Yes	235	7.30	225	8.50
Low birth weight ^##					0.447
Yes	334	10.05	196	7.15
No	2,991	89.95	2.542	92.65
Preterm birth ^##					0.927
Yes	463	13.92	298	11.00
No	2,420	72.78	2,102	77.00
Use of a health service
Trimester when started ***					0.188
1st	2,664	83.80	1.850	69.50
2nd	462	15.00	763	28.70
3rd	38	1.20	50	1.80
Prenatal visits ***					0.993
≥ 6	2,792	93.30	1.271	68.80
< 6	194	6.70	567	31.20
Did the child obtain a visit, hospitalization or a vaccine ^##					0.216
Yes	3,020	90.80	1.958	71.00
Did not obtain a visit /hospitalization	303	9.10	368	13.60
Did not obtain vaccination due to lack of vaccines	2	0.10	418	15.40
Site of vaccination ^##					0.369
Health center	3,246	97.60	2.701	98.40
Private clinic	73	2.40	41	1.60
Incomplete vaccine coverage ^##
BCG	66	2.10	14	0.50	0.581
Poliomyelitis	91	2.80	119	4.40	0.203
Hepatitis B	95	2.90	156	5.70	0.443
Tetravalent	145	4.40	222	8.20	0.260
Yellow fever	122	3.70	275	10.30	0.007
Triple viral	147	4.60	301	10.90	0.221
Human rotavirus	215	6.70	537	19.90	0.499
Child vaccination schedule	405	12.40	938	34.60	0.726

Characteristics	Ribeirão Preto		São Luís
Demographic and socioeconomic
Gini coefficient (0 to 1)	0.54			0.61
MHDI (0 to 1)	0.800			0.768
Proportion of children younger than 5 years (%)	6.5			7.4
GDP (in Brazilian Real)	44,463.80			20,242.70
Demographic density (inhabitants/km²)	927.65			1,215.70
Coverage of policies and services of support for vaccination
FFP coverage (%)	72.8			35.7
TCHA coverage (%)	31.4			46.3
FHS coverage (%)	14.1			32.5
Basic care coverage (%)	39.1			43.5
Ratio of UBS with vaccination service per inhabitants	1/14,404			1/19,171
Number of facilities that perform childbirths	9			11
Vaccination services in the UBS	Sample (n = 41)		Sample (n = 50)
Vaccination services in the UBS	n	%	n	%
Organizational characteristics
Offer of human resources
Presence of at least 1 nurse in the UBS	41	100.0	49	98.0
Hours open
UBS open in 2 shifts, 5 days/week	36	87.8	46	92.0
Structural characteristics
Environment
At least 1 vaccination room in the UBS	26	63.4	48	96.0
Equipment
At least 1 air conditioner	23	56.1	41	82.0
At least 1 refrigerator exclusively for the vaccines	27	65.8	41	82.0
Material (always available)
Thermal vaccine box	27	65.8	47	94.0
Maximum and minimum thermometer	8	19.5	36	72.0
Disposable syringes	40	97.6	47	94.0
Disposable needles	40	97.6	48	96.0
Disposable container for sharp objects	39	95.1	46	92.0
Immunobiological agents for 2010 (always available)
BCG	26	63.4	46	92.0
Hepatitis B	27	65.8	45	90.0
Rotavirus	27	65.8	46	92.0
Poliomyelitis	27	65.8	45	90.0
Tetravalent	23	56.1	33	66.0
Yellow fever	26	63.4	41	82.0
Triple viral	27	65.8	28	56.0

[1] Correspondence
R. C. C. S. Queiroz Universidade Federal do Maranhão. Av. dos Portugueses 1996, São Luís, MA 65080-805, Brasil. rafaelle_cristina@globomail.com