TRUONG D�I HQC Y HA N()I

GIAO TRINH THUC

,,., . HANH
DICH
• TE HOC
•
 D!CHT.tHOC

BA.I 8. TIEM CHUNG MO R()NG

MVC TIEU HQC T.i).P

Sau khi h9c xong bai nay, sinh vien c6 kha niing:
1. Trinh bay aU(J'C Itch sir phat tridn cua chucmg trinh tiem chung m&
r(}ng (TCMR) & Viit Nam
2. Trinh bay ilu(J'c mJJ,c tieu, hoc;zt a(Jng cua chuang trinh TCMR a
Vi¢t Nam
3. Trinh bay ilu(J'c cac loc;zi vacxin, each sir d1µ1,g, Zich TCMR & Vi¢t Nam
4. Trinh bay QU(J'C cac bu&c th11c hanh tiem chung an toan

1. Lich sir phat tri�n chtrong trinh tiem chung mO' rQng
(TCMR)

Chu<Yilg trinh Tiem chung mo r('mg (ten ti€ng Anh la Expanded

Programme on Immunization - EPI), b�t d§u duqc tri€n khai o Vi�t
Nam tir nam 1981 do B◊ Y ti khoi xu6ng v6i S\I h6 trq cua T6 chirc
Y ti The gi&i - WHO va Quy Nhi df>ng Lien hqp quf>c - UNICEF.
Chu<Yilg trinh c6 m1,1c tieu ban d§u la cung c�p dich V\l tiem chung
mi6n phi cho tre em du6i 1 tu6i, bao v� tre kh6i mAc 6 lo�i b�nh
truyen nhi€m ph6 bi€n va gay tt'r vong cao. Sau m9t thoi gian thi
di€m, Chu<Yilg trinh tung bu&c duqc mo r9ng d§n cave dia banva dbi
tuQ'Ilg tiem chung, d€ tu nam 1985 t6i nay toan h◊ tre em du6i 1 tufii
la d6i tuQ'Ilg cua Chuang trinh tren toan qu6c da co co h9i duqc ti€p
c�nv&i Chuang trinh TCMR. Bin nam 2010, da c6 11 vie xin phong
b�nh truy6n nhi€m ph6 bi6n, nguy hi€m cho tre em duqc dua vao
Chu<Yilg trinh.
1.1.Giai ilofl,n thf ttiim (1981-1984)
Trong giai do� thi di€m Chu<Yilg trinh chu y€u su dl,lllg hinh thirc
tiem chung chi€n dich (tiem chung hang lo�t) tren m◊t sf> dja ban c6

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Bai 8. Ttem chimg ma r9ng

- Truy8n thong cho vi�c tri8n khai chi€n djch tiem chung v�c xin
Sm - Rubella va mµc tieu Lol;li trir b�nh Soi
3. 7. Tri€n khai viic xin mui (Rubella) trong TCMR
- Xay d1JI1g van ki�n va phe duy�t d\I an tri€n khai v�c xin Sm­
Rubella cho tre 9 thang-14 tu6i trong toan qu6c.
- Xay d1JI1g tai li�u �P huful tri€n khai v�c xin mm trong TCMR,
in va phan b6 tai li�u t�p huful.
- Xay d\IIlg tai li�u truyen thong ve v�c xin m6'i
- T6 chirc h9i nghi tri€n khai tuy€n Qu6c gia va 4 khu V\JC.
- D\I ki€n tri6n khai thi di6m tl;li 1 s6 tinh/TP cho d6i tuqng 11-14
tu6i tren quy mo tinh
3.8.H{IJJ tac quac ti
- WHO: H6 trggiam sat cac b�nh, giam sat PVSTC, bao v� thanh
qua thanh toan bl;li li�t.
- UNICEF: H6 trgduy tri LTUVSS, h6 trgtang cuong chftt luqng
djch V\l TC tl;li vung kh6 khan, cung ung v�c xin.
- Chinh phu Luxembourg: V� d9ng h6 trg cho giai dol;lfl t6'i
nhfun duy tri bao duong h� thfing day chuy8n 1/;lllh cac tuy€n.
- GAVI: H6 trg vie xin DPT-VGB-Hib, BKT, HAT; nang cao
chftt luqng djch V\l TC; chi€n djch tiem VX Soi - Rubella cho
tre tit 9 thang - 14 tu6i tren toan qu6c. H6 trg �p huful cho can
be) TCMR, can be) b�nh vi�n va h9c sinh tnrong Trung h9c y t8
41i cac tinh d\I an HSS.
- AMP: D\I an ''Nang cao nang 11.Ic quan ly TCMR tuy€n TV & thi
di€m dao tl;lo tit xa tl;li tinh T.Binh, H.Binh, TT.Hu€, TP.HCM".

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4.5.Biin chfit va ctic dpng wic xin sir d(lng trong Tiem chiing mu rpng

Bang 8.5. Tom tdt ban chdt va cac dgng vdc xin SU dtmg
trong Tiem chung ma r(Jng

D�mgvic
Ten Ban chit
, , xin SU' Ltruy
vac xin vac xin
dt_mg
Vile xin phai pha h6i chin h
v6i dung lo�i dung moi
Vi khu§n lao B◊t dong
Lao t.. • ., duqc cAp eung v6i vile xin
songg1am kho, kem
(BCG) d()c hJc theo dung cua cung CCY SO' san xuAt.
Vile xin da pha h6i chinh d6
moi
hong b&i nhi�t d9, chi duqc
dung trong vong
-- - - -- ..
4 giO'.
Vi rut b� li�t
B�i li�t s6ng pain doc
Dun g dieh
·
Vile xin d€ bi hong b&i nhi�t
(OPV) 1\regom 3 typ d9 cao
I, 2, 3.
ADNcuavi
Viemgan , Vile xin d6 bi hong khi dong
A

ru1 �1emgan B Dung d"1ch

•A

B bang
tai to hqp
B�eh hlu Giai doc t6 vi
- �oga - khu§n b�ch
uon van hiu, u6n van
-viem va vi khufui
Vile xin d€ bi hong khi dong
gan hoga eh8t, Dung djch
bang
B-Hib khang nguyen
(DPT- vi rut VGB va
VGB- khang nguyen
Hib) Hib.
Vile xin phai pha h6i chinh
v&i dung lo�i dung moi
B◊t dong
Vi rut soi duqc eAp cung v6i vile xin
kho, kem
Sm songgiam
theo dung
eua cung ea s& san xuAt.
d(>c 1\rc Vile xin da pha h6i ehinh d€
moi
hong b&i n hi�t d9, chi duqc
dung trong vong 6 gia.

177