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目的评价浙江省不同时期麻疹减毒活疫苗(Measles Attenuated Live Vaccine,MV)接种的效果与效益。方法通过自回归移动平均模型测算麻疹的发病与死亡人数,结合8个县现场调查数据和特尔斐(Delphi)法专家咨询结果,计算工作成本与疾病负担,并分冷链前期(1978～1984年)、冷链时期(1985～1998年)和免疫规划时期(1999～2007年),对浙江省MV接种进行成本效果分析(Cost Effectiveness,CE)分析、成本效益(Cost Benefit,CB)分析和成本效用(Cost Utility,CU)分析。结果 1978～2007年,浙江省MV使用成本共计1.59亿元,通过实施MV接种,减少麻疹发病3947390例,减少死亡112780例,减少经济损失98.18亿元,减少伤残标化寿命年(Disability-adjusted Life Year,DALY)损失372.23亿。CE为每40元投入便能减少1例麻疹发病,每1410元投入便能减少1例因麻疹死亡。合计CB比为1∶61.75,CU比为1∶234.10DALY。结论浙江省实施MV接种的CE、CB和CU均十分显著,应继续加强冷链配置和规范化预防接种门诊建设,提高预防接种质量,确保MV及时、有效接种。
Objective To evaluate the efficacy and benefits of Measles Attenuated Live Vaccine (MV) vaccination in different periods in Zhejiang Province. Methods The incidence and death toll of measles were estimated by the autoregressive moving average model. The cost of work and the burden of disease were calculated according to the field survey data of 8 counties and the consultancy results of Delphi method. Year), cold chain period (from 1985 to 1998) and immune planning period (from 1999 to 2007), the cost effectiveness (CE) analysis and cost benefit (CB) analysis of MV vaccination in Zhejiang Province were carried out Cost Utility (CU) analysis. Results From 1978 to 2007, MV use cost in Zhejiang Province totaled 159 million yuan. By MV vaccination, 3947390 cases of measles were reduced, 112,780 cases of death were reduced, the economic loss was reduced to 9,818 million yuan, and the Disability-adjusted life span was reduced Life Year, DALY) lost 37.223 billion. CE for each 40 yuan investment will be able to reduce the incidence of 1 case of measles, every 1,410 yuan investment can reduce 1 case of death due to measles. The total CB ratio was 1:61.75, and the CU ratio was 1: 234.10 DALY. Conclusion CE, CB and CU of MV vaccination in Zhejiang Province are all very significant. We should continue to strengthen the configuration of cold chain and standardize vaccination clinics so as to improve vaccination quality and ensure timely and effective MV vaccination.