ABSTRACT
Objective@#To investigate the level and timeliness of CD4+T lymphocyte cell (CD4 cell) counts at first measurement among newly reported HIV/AIDS cases in Taizhou City, Zhejiang Province from 2012 to 2021, so as to provide insights into improving the management of HIV/AIDS cases. @*Methods@#Demographic data and first measurement of CD4 cell counts of newly reported HIV/AIDS cases in Taizhou City from 2012 to 2021 were collected from the HIV/AIDS Comprehensive Control System of Chinese Disease Prevention and Control Information System. The level and time of CD4 cell counts at first measurement were descriptively analyzed, and factors affecting CD4 cell counts at first measurement were identified using a multivariable logistic regression model. @*Results@#A total of 4 834 newly reported HIV/AIDS cases were recorded in Taizhou City from 2012 to 2021, including 3 889 men (80.45%), 2 005 cases at ages of 20 to 39 years (41.48%), and 2 130 farmers (44.06%). There were 1 664 cases (34.42%) with CD4 cell counts of <200/mm3 at first detection, 2 576 (53.29%) with CD4 cell counts of 200/mm3 to 499/mm3, and 594 (12.29%) with CD4 cell counts of ≥500/mm3. The proportion of CD4 cell counts of <200/mm3 showed a tendency towards a rise from 2012 to 2021 (χ2trend =4.250, P<0.001). There were 3 465 cases (71.68%) that had an interval of ≤14 days between the first detection of CD4 cell counts and confirmatory HIV test, 740 (15.31%) that had an interval of >14 to 30 days, 315 (6.52%) that had an interval of >30 to 90 days, 135 (2.79%) that had an interval of >90 to 180 days, and 179 (3.70%) that had an interval of >180 days. The proportion of an interval of ≤14 days appeared a tendency towards a rise from 2012 to 2021 (χ2trend=6.874, P<0.001). Multivariable logistic regression analysis identified women (OR=0.630, 95%CI: 0.529-0.751), age of ≥20 years (OR: 1.958 to 3.218, 95%CI: 1.216-5.412), other or unknown routes of HIV infection (OR=1.785, 95%CI: 1.100-2.896), and identification by medical institutions (OR=1.779, 95%CI: 1.497-2.114) as factors affecting CD4 cell counts of <200/mm3 at first measurement. @*Conclusions@#The timely detection of CD4 cell counts at first measurement gradually increased with year among newly reported HIV/AIDS cases in Taizhou City from 2012 to 2021; however, there were still 34.42% of cases with CD4 cell counts of <200/mm3. Gender, age, route of HIV infection, and sample source were factors affecting CD4 cell counts of <200/mm3 at first measurement.
ABSTRACT
Objective To analyze the timeline of occupational disease online reporting and reviewing in Guangdong Province from 2014 to 2022. Methods Data and review information from the Occupational Diseases and Hazards Monitoring Information System under China Disease Prevention and Control Information System were collected to analyze the reporting timeline, review status, and timeline of review of "Occupational Disease Report Cards" for the years 2014 to 2022 in enterprises located in Guangdong Province. Results A total of 9 929 occupational disease report cards were recorded in Guangdong Province from 2014 to 2022, and the timely reporting rate of occupational diseases was 84.10%, with an overall upward trend. There was a statistically significant difference in the reporting time among different years (P<0.05), and the reporting time showed a downward trend. In 2022, the timely reporting rate of all cities reached over 80.00%. The final review rate of occupational disease report cards was 85.02%, and the review rate and timely review rate at the county level showed an increasing trend. The occupational disease report card audit timeliness rate from high to low was provincial, district county and city level (61.26% vs 43.87% vs 36.72%, all P<0.05). Conclusion The timeline of occupational disease reporting in Guangdong Province is relatively high, and the review at all levels is generally good. However, further improvement is needed for timely review at the municipal and county levels.
ABSTRACT
ObjectiveTo analyze the timeliness of health science popularization during the outbreak of coronavirus disease 2019 （COVID-19） and its correlation with the epidemic situation and policies. MethodsThe original reports of health science popularization by 26 major media in Shanghai during the COVID19 outbreak between January 19 and March 25 of 2020 were retrieved， and the timeliness of the number of reports， media sources and categories， and contents were analyzed. ResultsDuring the epidemic of COVID-19， public media reported timely. Online media accounted for 63.35%， and text-based reports accounted for 85.90%. There was a correlation between the trend of the number of reports and the development of COVID-19 and the prevention and control policy issued by the government. After the change in the epidemic or the release of policy， the number of reports increased. The top four topics were personal protection， disease treatment， healthy lifestyle and psychological health， accounting for 18.62%， 18.54%， 12.96% and 11.74%， respectively. Reports focused on different aspects at different stages of COVID-19 epidemic， and the number of reports tended to increase one week after the occurrence of major events. ConclusionDuring the COVID-19 epidemic， the coverage of health science on media is timely and targeted. For future similar public health emergencies， it is suggested to respond quickly to major events according to the trend， to carry out publicity timely， to innovate the report forms， and thus make it easy for the public to accept and implement.
ABSTRACT
ObjectiveTo analyze the timeliness of health science popularization during the outbreak of coronavirus disease 2019 （COVID-19） and its correlation with the epidemic situation and policies. MethodsThe original reports of health science popularization by 26 major media in Shanghai during the COVID19 outbreak between January 19 and March 25 of 2020 were retrieved， and the timeliness of the number of reports， media sources and categories， and contents were analyzed. ResultsDuring the epidemic of COVID-19， public media reported timely. Online media accounted for 63.35%， and text-based reports accounted for 85.90%. There was a correlation between the trend of the number of reports and the development of COVID-19 and the prevention and control policy issued by the government. After the change in the epidemic or the release of policy， the number of reports increased. The top four topics were personal protection， disease treatment， healthy lifestyle and psychological health， accounting for 18.62%， 18.54%， 12.96% and 11.74%， respectively. Reports focused on different aspects at different stages of COVID-19 epidemic， and the number of reports tended to increase one week after the occurrence of major events. ConclusionDuring the COVID-19 epidemic， the coverage of health science on media is timely and targeted. For future similar public health emergencies， it is suggested to respond quickly to major events according to the trend， to carry out publicity timely， to innovate the report forms， and thus make it easy for the public to accept and implement.
ABSTRACT
As an important part of clinical medication, the main function of processing of traditional Chinese medicine (TCM) is to reduce toxicity and increase efficiency. The key to the best clinical efficacy of TCM after processing lies in three aspects of moderation, adaptation and timeliness, namely " three suitability" theory. In recent years, scholars have done a lot of research under the guide of " three suitability" theory, fully explaining the scientific connotation of the theory, which greatly promoted the inheritance and innovation of TCM processing. In this paper, the basic connotation of " three suitability" theory was summarized, combining with a large number of modern research reports, the pharmacodynamics and composition changes of processed drugs were analyzed and discussed under the guide of " three suitability" theory. At the end of the paper, the authors proposed that we should not only systematize the traditional processing theories, but also use modern advanced technologies to explain the essence of traditional processing theories, and to innovate and develop new processing theories, promote the development of TCM processing discipline and the progress of TCM processing industry.
ABSTRACT
Background: Immunization is the cost-effective public health intervention that prevents and protects against vaccine preventable diseases. The objective was to estimate the timeliness in receiving age appropriate vaccines and to study selected factors influencing the timeliness of age appropriate vaccines as per national immunization schedule among children aged 0 to 23 months in a rural area of Pondicherry. Methods: A retrospective study was done at a Community Health Centre, Karikalampakkam, Pondicherry using data from immunization registers of children aged 0 to 23 months, who were born between July 01, 2013 to July 31, 2015. If the child was vaccinated within 7 days of the scheduled time, it was considered as timely vaccination. Results: Out of 679 children, 52% were males and 48% were females. The median days of delay in vaccination were ranged from 1-171 days. The proportion and the median days of delay were increased progressively as the age of the child increased. The place of delivery was significantly associated with birth doses of OPV, Hepatitis B and BCG vaccination. There was a significant difference in timeliness of vaccination across the birth order of the children for the first, second and third doses of OPV and Pentavalent vaccines (p=0.02). Birth weight of the children was not statistically associated with vaccination delay. Conclusions: Delay in vaccination in varying frequency was observed for the vaccines administered under the national immunisation schedule. Hence, the age-appropriate vaccinations should be given up-to-date as well as on time.
ABSTRACT
Consultation system is one of the eighteen core systems. Excellent consultation supervision can assist clinical departments to maximize cooperation efficiency. This article, concentrating on timeliness, built an individual-group-organization model based on the organizational behavior theory and actual conditions, and took management actions from three aspects, including changing personal behavior attitude, adjusting organizational performance plan and establishing task-based groups. Timeliness data in October and November 2018 were selected retrospectively one month before and one month after the new actions. The timely rate of consultation increased from 76.69% to 82.62% with a significant difference(P=0.000 2).
ABSTRACT
Objective To evaluate the timeliness of the three sets of influenza surveillance data (influenza reported cases from Nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS), influenza-like illness consultation rate (ILI%) and influenza virus positive rate from Chinese Influenza Surveillance Information System) in mainland China. Methods The three sets of influenza surveillance data of North and South China from 2017 to 2018 were compared using peak comparison, cross correlation and Early Aberration Reporting System C3 method. Results The influenza epidemic trends reflected by the three sets of influenza surveillance weekly data from 2017 to 2018 were generally consistent and significantly correlated. However, the three sets of data had different timeliness. From 2017 to 2018, ILI% in the North was not timely at alarming the first epidemic peak, which was 6 weeks and 9 weeks later than influenza cases from NIDRIS and positive rate of influenza virus respectively. While in the South, ILI% was the most sensitive indicator, which was 4 weeks and 7 weeks earlier than influenza cases from NIDRIS and positive rate of influenza virus respectively. However, the three sets of data had little difference in the timeliness of the second epidemic peak both in the North and South. Conclusions The three sets of influenza surveillance data in mainland China could all roughly reflected the epidemic trend of influenza. After comparing the timeliness, a combination of influenza reported cases from NIDRIS together with ILI% and influenza virus positive rate could improve timeliness and accuracy for early warning of influenza.
ABSTRACT
Objective To analyze the status of information release and the ability to identify public needs for hypertension prevention and control information in Shanxi and Hebei areas. Methods A systematic data collection method was used to obtain various information about hypertension prevention and control published in Shanxi and Hebei provinces. Based on the Delphi method, sensitive and evaluation indicators for the tertiary prevention of hypertension were determined. To evaluate the degree to which public needs were met in the two areas, the authority, timeliness, continuity, systematicness, and credibility of identifying public needs were calculated. Results The release of information on hypertension prevention and control in Shanxi and Hebei lagged behind that in World Health Organization (WHO) for 2 and 27 years, respectively, and this was mainly carried out by research institutes, with no response from professional associations and government agencies. Information on primary and secondary prevention was first released in 1980 in Shanxi province, while primary prevention information was first released in 2005 in Hebei province. Regarding hypertension prevention and treatment, Shanxi province could meet 6.11% of the public need, and Hebei province could meet 3.57% of it. The five dimensions of authority, timeliness, continuity, systematicness, and credibility of identifying the public need were 11.34%, 25.29%, 0, 50.31%, and 0 in Shanxi province, and 6.86%, 14.54%, 0, 50.00%, and 0 in Hebei province, respectively. Conclusions The ability to identify the public need for information on hypertension prevention and control in Shanxi and Hebei provinces is relatively low. Relevant departments should take measures to enhance the two‐way communication of information and improve the public's knowledge and participation.
ABSTRACT
OBJECTIVE: To analyze and compare the age of data in contemporary research articles published in representative general radiology journals. MATERIALS AND METHODS: We searched for articles reporting original research studies analyzing patient data that were published in the print issues of the Korean Journal of Radiology (KJR), European Radiology (ER), and Radiology in 2017. Eligible articles were reviewed to extract data collection period (time from first patient recruitment to last patient follow-up) and age of data (time between data collection end and publication). The journals were compared in terms of the proportion of articles reporting the data collection period to the level of calendar month and regarding the age of data. RESULTS: There were 50, 492, and 254 eligible articles in KJR, ER, and Radiology, respectively. Of these, 44 (88%; 95% confidence interval [CI]: 75.8–94.8%), 359 (73%; 95% CI: 68.9–76.7%), and 211 (83.1%; 95% CI: 78–87.2%) articles, respectively, provided enough details of data collection period, revealing a significant difference between ER and Radiology (p = 0.002). The age of data was significantly greater in KJR (median age: 826 days; range: 299–2843 days) than in ER (median age: 570 days; range: 56–4742 days; p < 0.001) and Radiology (median age: 618; range: 75–4271 days; p < 0.001). CONCLUSION: Korean Journal of Radiology did not fall behind ER or Radiology in reporting of data collection period, but showed a significantly greater age of data than ER and Radiology, suggesting that KJR should take measures to improve the timeliness of its data.
Subject(s)
Humans , Data Collection , Patient Selection , PublicationsABSTRACT
PURPOSE: This study was conducted to identify the effect of crowding and nurse staffing on time to antibiotic administration for pneumonia patients in an emergency department (ED). METHODS: The sample included pneumonia patients visiting an ED from November 1, 2014 to February 28, 2015. Crowding was measured using ED occupancy rate, nurse staffing was measured as total length of stay per nurse and number of patients per nurse and the time duration was measured for the following processes: from patient arrival to prescription, from prescription to blood culture and antibiotic administration, and from blood culture to antibiotic administration. Data collected from the electronic medical records were analyzed using multivariate analyses. RESULTS: The mean times from arrival to antibiotics administration, from prescription to antibiotic administration, and from blood culture to antibiotic administration were 128.31, 47.29, and 15.60 minutes, respectively. Crowding, nurse staffing, work experience of the nurse and severity of the patient influenced the time duration of each process from patient arrival to antibiotic administration. CONCLUSION: The results reveal that crowding and nurse staffing affect length of time to antibiotic administration in pneumonia patients. Guidelines for safe nurse staffing in ED are required to improve patient outcomes.
Subject(s)
Humans , Anti-Bacterial Agents , Crowding , Electronic Health Records , Emergencies , Emergency Nursing , Emergency Service, Hospital , Length of Stay , Multivariate Analysis , Pneumonia , PrescriptionsABSTRACT
Objective@#To evaluate the quality of Pneumoconiosis Network Direct Report in Sichuan Province in 2006-2016.@*Methods@#download all the pneumoconiosis report cards from the Network Direct Report system. Screen out cards based on the diagnosis time that is between January 1st 2006 and December 31st 2016. Using R 3.4.0 software to analysis the number of missing or repeated cards, time-logical error rates, timeliness, reporting year, reporting intervals to evaluate the quality of Pneumoconiosis Network Direct Report and location distribution.@*Results@#there are 38 855 pieces of Pneumoconiosis report card in total in 2006-2016. 352 pieces of cards were reported twice. 224 cards were missing. 229 cards have time-logical error. The rate of timely reporting for 2006-2016 years was 66.41% (2 5453/38 326) , 67.14% (24 658/36 726) for new cases, 58.87% (783/1 330) for promoting cases and 4.44% (12/270) for deaths. 87.38% (33 490/38 326) patients was reported in the same year. 10 days was needed to finish one report, confirming-filling cost much more time than filling-report (9.865/49.019) .@*Conclusion@#the records of pneumoconiosis report cards are much more complete, logical errors are less, and the timeliness was a little bit higher than the average level in China. But it also should be improved. The death cases are difficult to report. It takes longer to diagnose and fill in cards. Improving the timeliness rate can significantly improve the quality of network direct reporting.
ABSTRACT
Objective: To compare the timeliness of catheter in interval and screw-type catheters for enteral nutrition of patients with severe craniocerebral injury. Methods: 120 patients with severe craniocerebral injury were divided into observation group and control group as different catheter method. Patients of observation group received catheter in interval and that of control group received screw-type catheter. The success rate of catheterization, complication and beginning time of enteral nutrition between the two groups were compared. Results: The waiting time of observation group was significantly lower than that of control group (x2=94.925, P<0.05). During intubation, the difference of incidence of mild bleeding of nasal mucosa between the two groups was no significant. The respiratory tract ectopic or digestive tract perforation and other complications didn't appear in the two groups. Besides, the success rate of catheterization in 48h of observation group was significantly higher than that of control group (x2=40.752, P<0.05). Conclusion: The new method has higher timeliness for implementing enteral nutrition of patients with severe craniocerebral injury. And it is safe and effective.
ABSTRACT
Objective To investigate the effect of optimizing rescue time for patients with acute st-elevation myocardial infarction (STEMI) in the hospital. Methods A retrospective analysis of the clinical data of 133 patients with ST-elevation myocardial infarction who were hospitalized in the first affiliated hospital of university of science and technology of china during July,2016 to June,2017 was performed. Timeline in the rescue, the result of coronary reperfusion and satisfaction degree of patients were analyzed. Results The rapid evaluation time (F=2.609, P=0.046),emergency handling time(F=7.581, P=0.032), login and logout time (F=5.667, P=0.017)and visit-ballon time (F=8.942, P=0.007) were shortened quarter by quarter . The average time of each project in the four quarters showed a statistically significant difference. The difference of TIMI classification of coronary flow reperfusion among the four quarters was statistically significant (H=8.402, P=0.038). The satisfaction degree of each quarter showed a statistically significant difference (the third quarter of 2016:94.68±2.38, the fourth quarter of 2016:96.72± 5.10, the first quarter of 2017:97.23 ± 7.64,the second quarter of 2017:98.36 ± 4.86;F=7.891,P=0.048). Conclusions Enhancing timeliness of emergency care can remarkably shorten rescue time, improve satisfaction degree of patients and help to improve the success rate of emergency treatment for patients with STEMI.
ABSTRACT
OBJECTIVE:To improve the timeliness of finished product infusion distribution in pharmacy intravenous admixture service(PIVAS)of our hospital,and promote timely and rational drug use of patients. METHODS:The factors affecting the timeli-ness of finished product infusion distribution were analyzed in terms of personnel,software/hardware,and relevant measures were developed. The distribution of long-term medical orders'planning execution time and actual execution time in Jan.-Jun. 2015 (be-fore improvement) and Jan.-Jun. 2016 (after improvement) were summed up,as well as the average time in each link of PIVAS packing-delivery/infusion sending-clinical reception-actual execution time,and the effects were evaluated. RESULTS:For the per-sonnel,software/hardware and other aspects of the factors,measures were developed and implemented,including strengthening the communication of clinicians(issued medical orders)and nurses(performed medical orders)in related information,improving pro-fessional level and ability of pharmacists that reviewing medical orders in PIVAS,optimizing information system functions and im-proving related systems in PIVAS. Compared with the same period in 2015,peak time distribution was dispersed in medical orders' planning execution time and actual execution time in 2016. The average time of delivery/infusion sending-clinical reception de-creased by 10.13 min,and the time of each link in 2016 showed a slight downward trend month by month. CONCLUSIONS:The management improvement measures in PIVAS of our hospital have improved the timeliness of finished product infusion distribu-tion,and provided a guarantee for the timely treatment of clinical patients.
ABSTRACT
Objective To explore the effect of timeliness motivation theory-based continuing care on the self-care ability and healthy behavior in elderly patients with type 2 diabetes. Methods A total of 202 elderly patients with type 2 diabetes in our hospital were selected,and were randomly divided into observation group and control group according to the random number table, with 101 cases in each group. The control group were given healthy related education during hospitalization , and post-discharge telephone follow-up every month, lasting 10~15min each time.The observation group were additionally given timeliness motivation theory-based continuing care by telephone follow-up each month , including emotional arousal , need motivation , examples stimulating and benefit motivation, lasting 6 months. Their self-care ability and healthy behavior in the two groups were compared. Result The self-care ability in the observation group was significantly significantly better than that of the control group (P<0.001), and had significantly much more healthy behaviors than the latter (P < 0.001). Conclusion Timeliness motivation theory-based continuing care can improve the self-care ability and healthy behavior in elderly patients with type 2 diabetes.
ABSTRACT
Objective To apply quality control circle (QCC) to reducing non-timely maintenance rate of medical equipment.Methods QCC was established,and some measures were taken to observe its effect in decreasing non-timely maintenance rate of medical equipment.Results The non-timely maintenance rate fell from 12.1％ to 4.5％,and 0.3 million Yuan was saved for the manpower cost.Conclusion QCC decreases the non-timely maintenance rate of medical equipment,increases the efficiency of the maintainer,shortens the downtime of the fault medical equipment,enhances hospital economic benefit and patient satisfaction and provides references for other hospitals.
ABSTRACT
Introduction: Adherence towards childhood immunization (completeness and timeliness), with consideration of age-dependent-seroconversion, is the basis for children protection. Despite high global and national immunization coverage, vaccine preventable diseases’ are rising. This study aimed to determine adherence (completeness and timeliness) towards different vaccines of childhood immunization and associated factors among mothers of under five children. Methods: Cross-sectional study design was conducted at a health clinic in Seremban. Total of 320 mothers of under five children attending child health clinic selected via systematic random sampling. Data collection was via validated self-administered questionnaires and proforma, analysed using SPSS version 22. Associations between categorical variables determined by chi-square tests. Results: Consented respondents were 314; resulting in response rate of 98.1%. Adherence (completeness) was 98.09% but only 56.5% - 97.1% of respondents adhered in terms of timeliness. Types of transportation was significantly associated with adherence (completeness), p=0.041. Employment status was significantly associated with adherence (timeliness) towards BCG (p=0.008), Hepatitis B dose one (p=0.018) and dose two (p=0.040) vaccines. Education level was significantly associated with adherence (timeliness) towards DTaP/IPV/HiB dose four (p=0.019). Maternal age and usage of government clinic were significantly associated with adherence (timeliness) of MMR dose one, p=0.030 and p=0.017 respectively. Conclusion: Adherence (completeness) was high but varying adherence towards vaccine timeliness. Transportation types associated with completeness. Employment status associated with BCG, first and second doses of Hepatitis B vaccines’ timeliness. Education level associated with fourth dose of DTaP/IPV/HiB. Maternal age and usage of government clinic associated with timeliness of first dose MMR.
ABSTRACT
Background: In 2012, reported pertussis reached the highest number of cases (48,277) in the United States since 1955. Objectives: Estimate the prevalence of children who missed the fourth dose of DTaP (Diphtheria and Tetanus toxoids and acellular Pertussis vaccine) by parents’ confidences in vaccines and influences from providers, the timeliness of the first through the third dose of DTaP, and selected socio-demographic characteristics; identify the significant risk factors for non-receipt of the fourth dose of DTaP; and evaluate the unadjusted and adjusted risk ratios for missing the fourth dose of DTaP. Methods: Data from 16,919 children 19–35 months living in the United States included in the 2011 National Immunization Survey were analyzed. Weighted categorical data analysis and multivariable regression in the context of complex sample survey were applied to assess the prevalence and to determine the independent risk factors. Results: Overall, 14.7% of children missed the fourth dose of DTaP. Children who were late in receiving the third dose of DTaP had significantly higher risk of missing the fourth dose of DTaP than children who were on-time in receiving the third dose of DTaP (adjusted risk ratio (RR) 2.48; 95%CI (1.92, 3.20)). The risk of missing the fourth dose of DTaP was 62% higher among children whose parents reported they didn’t have a good relationship with their child’s health-care providers than children whose parents reported having good relationship. Compared with the risk of missing the fourth dose of DTaP among children whose parents were confident in the value of vaccines, the risk was significantly higher for the children whose parents lacked confidence (adjusted RR 1.41; 95%CI (1.05, 1.89)). Conclusions: Timeliness in receiving the first through the third dose of DTaP, influences from providers, and parents’ confidence in the value of vaccines are the five significant risk factors for missing the fourth dose of DTaP vaccination. They are all modifiable. Future interventions to improve parental relationships with providers and attitudes toward vaccines could help improve pertussis vaccination coverage.
ABSTRACT
Aims: The aim of this study is to investigate the timeliness and out-of-sequence vaccination among children aged less than five years through the data of a local Health and Demographic Surveillance System (HDSS) in Burkina Faso. Study Design: Cross-sectional study nested into an existing HDSS. Place and Duration of Study: Nouna Health District in north-western Burkina Faso, over the period of September 2008 to December 2009. Methodology: We used data of 7,644 children born between September 2003 and March 2009. Vaccination data were provided on the basis of events recorded on vaccination cards. We assessed vaccination timeliness and the frequency of out-of-sequence vaccination. Results: The highest rates of timely administration were observed with vaccines recommended at birth (e.g. 68% for BCG) while the lowest rates were observed with vaccines given in late infancy (e.g. 33% for measles). The frequency of out-of-sequence vaccination between BCG and DTP/Penta 1 or between DTP/Penta 3 and measles were respectively around 5% and 4%. Out-of-sequence vaccination in early infancy occurred significantly more frequent in rural compared to urban areas contrary to out-of-sequence vaccination in late infancy. Both, timely and correct sequencing of vaccination have significantly improved in recent years in the study area. Conclusions: This study supports that significant vaccination delay occurs in SSA communities with high vaccination coverage and that the frequency of out-of-sequence vaccinations varies substantially between countries.