贵州省少数民族地区新生儿乙型肝炎疫苗首针及时接种率及影响因素调查

目的了解影响贵州省少数民族地区新生儿乙型肝炎(乙肝)疫苗首针(HepB1)及时接种的因素,探索提高少数民族地区新生儿HepB1及时接种率的方法。方法设计统一调查表,通过查阅资料、入户调查等方式收集有关资料及信息。结果560名2006年出生的新生儿HepB1调查及时接种率为37.14%,其中在医院出生新生儿HepB1及时接种率为60.14%,在家出生新生儿HepB1及时接种率为11.36%。在医院出生新生儿HepB1未及时接种原因主要是低体重儿或早产儿医生不予接种,占20.45%;在家出生新生儿未及时接种原因主要是家长不知道要接种,占57.10%。结论贵州省少数民族地区新生儿HepB1及时接种率较低。提高住院分娩率,合理掌握HepB接种禁忌症,安排责任接种人确保在家出生新生儿HepB1及时接种,提高家长接种HepB1的主动性,是提高少数民族地区新生儿HepB1及时接种率的可行措施。     

定西市2005年出生儿童乙型肝炎疫苗首针及时接种率及影响因素调查

[目的]寻找影响定西市新生儿乙型肝炎(乙肝)疫苗首针(HepB1)及时接种的因素,探索提高贫困山区新生儿HepB1及时接种率的方法。[方法]通过查阅资料、入户调查、问卷调查等方式收集相关资料。[结果]共调查2005年出生新生儿840名,住院分娩率48.93%,HepB1及时接种率61.31%,其中住院分娩新生儿HepB1及时接种率88.56%,在家分娩新生儿HepB1及时接种率35.20%。未住院分娩的原因主要是住院费用太高、离医院太远和认为住院分娩没有必要(占87.18%)。村级接种工作仍以入户接种(占82.16%)为主,从所在村到乡镇卫生院领取疫苗和入户接种主要通过步行(分别占43.11%和68.58%)完成。[结论]定西市2005年新生儿HepB1及时接种率处于较低水平。主要影响因素是经济文化落后、新生儿住院分娩率较低、免疫规划宣传不够、对辖区内的孕产妇和新生儿摸底不清等。今后要通过加大宣传教育力度、开展孕产妇和新生儿入户调查摸底、加强与妇幼机构和妇检机构的合作等措施,进一步提高新生儿HepB1及时接种率。     

黄南藏族自治州提高新生儿乙型肝炎疫苗首针及时接种率策略研究

目的调查影响边远贫困农牧区新生儿乙型肝炎(乙肝)疫苗首针(HepB1)及时接种的主要因素,探索提高新生儿HepB1及时接种率的有效手段和模式。方法在黄南藏族自治州开展基线调查,制定针对性策略并实施。包括开展多途径、多渠道的健康教育及宣传活动;加强对医院相关人员的培训,确保在医院出生新生儿得到及时接种;加强疾病预防控制机构与妇幼保健机构、村医与接生员之间的沟通与合作,做好孕妇产前登记和随访工作,确保在家出生新生儿得到及时接种;加强督导和技术支持,定期监测、分析相关指标,不断完善相关策略。结果项目实施前、后全州HepB1及时接种率由2004年的42.61%上升到2005年的75.02%。结论通过项目的实施,显著提高了农牧区新生儿HepB1及时接种率。     

中国中西部地区新生儿乙型肝炎疫苗首针及时接种状况调查

目的了解中国中西部地区新生儿乙型肝炎(乙肝)疫苗首针(HepB1)及时接种现况,探讨提高新生儿HepB1及时接种率的方法。方法按照卫生部/全球疫苗免疫联盟合作项目办公室的统一要求,2004年对22个项目省(自治区、直辖市,下同)27 459名2003年出生儿童,2005年对5个项目省10 843名2004年出生儿童、1 116名2005年出生儿童的HepB1及时接种情况开展现场调查。结果中西部地区新生儿HepB1及时接种率是:2004年出生儿童(81.55%)高于2003年出生儿童(74.01%);医院出生儿童(85.36%)高于在家出生儿童(19.00%);县级及以上医院出生儿童(88.27%)高于乡镇卫生院(71.74%)。结论中西部地区新生儿HepB1及时接种率正在逐年提高,同时也揭示提高在家出生、在乡镇卫生院出生儿童的HepB1及时接种率,是今后工作的重点。     

甘肃省<15岁儿童乙肝疫苗免疫现状调查

目的了解乙肝疫苗(HepB)纳入免疫规划12年后,甘肃省15岁儿童HepB接种情况,为制订乙肝预防控制策略提供参考。方法 2014年采用分层二阶段整群随机抽样方法首针,调查甘肃省1~14岁常住人口HepB接种情况以及基本情况。结果在调查的1 592名1~14岁儿童中,HepB1首针接种率、HepB1首针及时接种率和HepB全程接种率分别为96.36%、88.57%和95.85%,接种率均随年龄减小而明显升高(P0.001)。不同性别、民族儿童HepB1接种率、HepB1及时接种率和HepB全程接种率均无明显差异(P0.05)。城市儿童HepB1接种率、HepB1及时接种率和HepB全程接种率均明显高于农村儿童(P0.001)。在调查的儿童中,住院分娩率为93.53%;其中57.29%的儿童出生在县级医院,分娩地点在市级以上医院、乡级医院、在家和不详的分别占17.96%、18.28%、4.33%和2.14%。市级以上医院出生儿童HepB1接种率和HepB1及时接种率最高,分别为99.30%和95.45%;在家分娩或出生地点不详儿童HepB1接种率和HepB1及时接种率最低,分别为83.50%和59.22%。不同地点出生儿童HepB1接种率(χ2=56.173,P0.001)和HepB1及时接种率(χ2=1.053,P0.001)差异均有统计学意义。结论甘肃省HepB纳入免疫规划后15岁儿童HepB全程接种率和首针及时接种率明显提高,并保持在较高水平。提高住院分娩率是提高儿童HepB1及时接种率的关键。     

黄南藏族自治州提高新生儿乙型肝炎疫苗首针及时接种率项目可持续发展评价

目的 评价黄南藏族自治州提高新生儿乙型肝炎疫苗(Hepatitis B Vaccine,HepB)首针(HepB1)及时接种率项目的 可持续发展状况.方法 比较项目结束后和项目执行期间,新生儿HepB1及时接种率的变化状况;评价项目执行期间所采取的各项措施的继续执行情况.结果 项目结束后的18个月中,全州新生儿HepB1及时接种率均高于项目执行期间;各地仍在执行已制定的提高新生儿HepB1及时接种率的策略.结论 黄南藏族自治州提高新生儿HepB1及时接种率项目有较好的可持续发展性.     

山东省2004～2008年产妇乙肝病毒检测及新生儿首针乙肝疫苗接种监测结果分析

[目的]了解住院分娩产妇乙肝病毒(Hepatitis B virus)感染检测及新生儿首针乙肝疫苗(First dose of hepatitis B vaccine,HepB1)接种情况,为进一步完善新生儿乙肝免疫预防策略提供参考.[方法]对2004～2008年山东省各级医疗机构产科每月上报的产妇HBV感染检测和新生儿HepB1接种资料进行分析.[结果]山东省2004～2008年住院分娩产妇HBV感染检测率逐年升高,2008年达到85.22%;产妇HBsAg阳性率保持在较低水平,平均为3.32%.医院出生新生儿HepB1及时接种率平均为96.76%,未及时接种的主要原因为早产和/或低出生体重(占48.15%)以及患病(占35.01%).[结论]山东省新生儿HepB1及时接种率已达到较高水平.提高产妇HBV感染检测率,科学制订不同HBV感染状态产妇所生新生儿免疫方案对提高HBV母婴阻断率有重要意义.     

中国不同地区产妇住院分娩率与新生儿乙型肝炎疫苗接种率分析

目的分析新生儿乙型肝炎(乙肝)疫苗(HepB)接种率与产妇住院分娩率之间的关系,指导HepB预防接种工作。方法将2003年国家卫生服务调查的产妇住院分娩数据与2005年全国常规免疫接种报告的新生儿HepB接种数据进行配比分析。结果城市产妇住院分娩率高于农村,城市新生儿HepB接种率高于农村。在农村,产妇住院分娩率越高,新生儿HepB接种率越高,新生儿HepB接种率和产妇住院分娩率关系密切。结论为了提高新生儿HepB接种率,必须大力提倡产妇住院分娩,保证在医院出生的新生儿及时接种HepB;对在家出生的新生儿应采取特殊策略,保证及时接种HepB。     

北京市外来人口聚集地儿童乙型肝炎疫苗接种率调查

目的了解北京市外来人口聚集地儿童乙型肝炎(乙肝)疫苗(HepB)接种现状。方法2004年对6个区(县)12个乡(镇)外来人口聚集地采用整群分层抽样方法,调查133名适龄儿童HepB接种情况。结果外来儿童HepB全程接种率96.24%,HepB1及时接种率82.71%,HepB全程及时接种率81.95%结论外来儿童HepB全程接种率较高,但HepB全程及时接种率不理想。这是由于HepB1接种不及时造成的,原因是产妇在家分娩,预防保健人员不能及时掌握外来儿童在家出生情况并为其接种HepB。因此,由经过培训的接生人员接种HepB1,会收到事半功倍的效果。     

医院出生新生儿乙型肝炎疫苗首针未及时接种原因调查分析

目的 了解影响医院出生新生儿乙型肝炎(乙肝)疫苗首针(Hepatitis B Vaecune,HepB1)及时接种的因素.方法 收集2006～2007年在北京妇产医院出生的24 651名新生儿HepB1接种登记资料,对1169名未接种者的原因进行分析.结果 新生儿HepB1及时接种率为95.26%,未及时接种的原因主要是早产儿、低出生体重儿、窒息、呻吟待查、患有其它疾病等,分别占未及时接种者的74.42%、11.21%、5.48%、3.76%、5.13%.结论 在北京市住院分娩的新生儿HepB1及时接种率已达到较高水平,影响HepB1及时接种的主要原因在于对HepB1接种禁忌证把握过度严格.需加强医院内预防接种人员相关知识的培训.     

克拉玛依市在医院出生的新生儿首剂乙型肝炎疫苗未及时接种原因分析

目的分析克拉玛依市在医院出生的新生儿首剂乙型肝炎疫苗（First Dose Hepatitis B Vaccine,HepB．）未及时接种的原因,为提高新生儿HepB,及时接种率提供参考。方法采取回顾性调查分析方法,系统收集克拉玛依市2004～2010年所有在医院出生的新生儿的HepB,接种资料,对未及时接种HepB,的原因进行分析。结果克拉玛依市2004～2010年在医院出生的新生儿共20159人,HepB,及时接种率95．19％;不同年份HepB,及时接种率的差异有统计学意义（z。=289．29,P〈0．01）;不同地区在医院出生新生儿HepB,及时接种率的差异无统计学意义（X^2=2．84,P〉0．05）;在不同医院出生的新生儿HepB,及时接种率的差异有统计学意义（X^2=121．54,P〈0．01）。在医院出生的新生儿未及时接种HepB．的主要原因是新生儿疾病,占34．98％;其次为早产占26．73％,低体重占20．23％,窒息占13．31％,监护人拒绝接种和自动离院占4．75％。结论影响克拉玛依市在医院出生的新生儿HepB。未及时接种的主要原因是接种人员对HepB,接种禁忌证的把握过度严格,应加强对接种人员相关知识的培训,提高在医院出生新生儿的HepB,及时接种率。     

新生儿乙型肝炎疫苗首针及时接种的Logistic回归分析

目的分析新生儿出生后24h内乙型肝炎疫苗（Hepatitis B Vaccine,HepB）首针（HepB1）及时接种的影响因素,为提高HepB1及时接种率提供依据。方法以调查地类型、住院分娩、监护人职业、文化程度、民族、是否知道接种疫苗、是否主动带孩子接种疫苗等指标建立Logistic回归方程,分析影响HepB1及时接种的因素。结果852名调查儿童中,HepB1及时接种234名,及时接种率27．46％。其中在县级及以上医院出生的儿童HepB1及时接种率54．05％,在乡级卫生院出生的儿童HepB1及时接种率46．86％,在家中出生的儿童HepB1及时接种率6．71％。多因素分析显示,住院分娩、儿童监护人的文化程度是影响HepB1及时接种的因素,调查地类型、监护人职业、民族、是否知道接种疫苗、是否主动带孩子接种疫苗等虽与HepB1及时接种有关联,但并不是影响因素。结论提高住院分娩率,加大素质教育的投入,是提高HepB1及时接种率的主要措施。     

Progress in hepatitis B prevention through universal infant vaccination--China, 1997-2006

Hepatitis B virus (HBV) infection is a leading cause of illness and death in China. Approximately 60% of the population has a history of HBV infection, and 9.8% of persons in China are chronically infected with HBV and at risk for premature death from liver disease. Each year, an estimated 263,000 persons in China die from HBV-related liver cancer or cirrhosis, accounting for 37%-50% of HBV-related deaths worldwide. Because most HBV infections occur during infancy or early childhood, when HBV infection is most likely to become chronic, vaccination of infants beginning at birth is the key strategy for preventing chronic HBV infection. This report describes China's progress in increasing coverage among infants with hepatitis B vaccine (HepB) and timely administration of the HepB birth dose (i.e., within 24 hours of birth). Infant vaccination coverage with both the timely birth dose and the complete vaccine series was substantially higher among children born during 2003 than among those born during 1997; timely birth-dose coverage increased from 29.1% to 75.8%, and HepB series completion increased from 70.7% to 89.8%. Furthermore, in economically disadvantaged populations in western and middle provinces targeted by the China-Global Alliance for Vaccines and Immunization (China-GAVI) project, reported coverage with timely HepB birth dose increased from 64% in 2004 to 81% in 2006, and coverage with the complete HepB series increased from 52% in 2001 to 92% in 2006. China has established a goal to reduce chronic HBV infection among children aged <5 years to <1% by 2010. Achieving this goal will require continued commitment to increasing vaccination coverage in impoverished regions and ensuring that infants born at home are vaccinated within 24 hours of birth.     

Hepatitis B vaccination of newborn infants in rural China: evaluation of a village-based, out-of-cold-chain delivery strategy

OBJECTIVE: To prevent perinatal transmission of hepatitis B virus (HBV), WHO recommends that the first dose of hepatitis B (HepB) vaccine be given within 24 hours after birth. This presents a challenge in remote areas with limited cold-chain infrastructure and where many children are born at home. METHODS: Rural townships in three counties in China's Hunan Province were randomized into three groups with different strategies for delivery of the first dose of HepB vaccine. In group 1, vaccine was stored within the cold chain and administered in township hospitals. In group 2, vaccine was stored out of the cold chain in villages and administered by village-based health workers to infants at home. Group 3 used the same strategy as group 2, but vaccine was packaged in a prefilled injection device. Training of immunization providers and public communication conveying the importance of the birth dose was performed for all groups. FINDINGS: Among children born at home, timely administration (within 24 hours after birth) of the first dose of HepB vaccine increased in all groups after the study: group 1, from 2.4% to 25.2%; group 2, from 2.6% to 51.8%; and group 3, from 0.6% to 66.7%; P < 0.001 in each case. No significant difference in antibody response to vaccine was observed between the groups. CONCLUSION: Timely administration of the first dose of HepB vaccine was improved by communication and training activities, and by out-of-cold-chain storage of vaccine and administration at the village level, especially among children born at home.     

四川省实施卫生部/全球疫苗免疫联盟乙型肝炎疫苗合作项目评价

目的评价四川省实施卫生部/全球疫苗免疫联盟乙型肝炎(乙肝)疫苗(HepB)合作项目(GAVI项目)情况。方法从全省20个市(州,下同)随机抽取20个县(区,下同)、40个乡(镇,下同)开展HepB纳入免疫规划工作调查,抽取324份<3岁儿童血标本进行乙肝病毒(HBV)血清标志物检测。结果四川省自2003年开始实施GAVI项目以来,新生儿HepB全程(HepB3)接种率、首针(HepB1)及时接种率不断提高,分别为90.82%、74.73%;<3岁儿童乙肝病毒表面抗原(HBsAg)携带率为0.63%,比GAVI项目实施前的2002年下降了79.74%;县、乡两级医院住院分娩儿童HepB1及时接种率≥95%;通过项目的实施,提高了乡村医生和儿童监护人对乙肝预防知识的认知度,促进了预防接种安全注射的开展。结论四川省GAVI项目效果显著,以省为单位新生儿HepB3接种率、HepB1及时接种率和<3岁儿童HBsAg携带率已达到项目既定目标。今后的重点应在少数民族地区和边远山区,加强培训和宣传教育,提高住院和在家分娩儿童HepB1及时接种率。     

福建省2004年儿童计划免疫接种率调查

目的为了解福建省当前的计划免疫工作现状和存在问题。方法采取两阶段按容量比例概率抽样方法,抽取2001年1月~2003年9月出生的儿童,调查计划免疫接种率。结果共调查7个县4 032名适龄儿童,建证率99.45%,建卡率97.99%;卡介苗、口服脊髓类质炎疫苗全程、百白破联合疫苗(DPT)全程、麻疹疫苗及“四苗”全程免疫覆盖率分别为99.33%、96.16%、95.54%、95.19%和90.05%;乙型肝炎(乙肝)疫苗(HepB)全程接种率为94.67%,HepB首针及时接种率为83.03%;DPT加强免疫接种率为66.44%。本地儿童接种率明显高于非本地儿童,在医院出生儿童接种率高于在家中出生儿童。造成未接种的原因主要为不知道要接种、收费太贵。结论福建省儿童计划免疫“四苗”接种率保持在较高的水平,HepB纳入儿童计划免疫进展顺利,流动儿童预防接种的难点愈加突出,边远贫困村庄的预防接种工作开展有一定难度。     

Implementing the birth dose of hepatitis B vaccine in rural Indonesia

Reaching mothers and their newborn infants around the time of birth with adequate health services has long been a difficult problem in developing countries. In parallel, similar problems have arisen in attempting to deliver hepatitis B (HepB) vaccine to infants born at home in many countries where mother-to-infant transmission is common. It is logical, and supported by experience in Indonesia, to find a combined solution for both problems. The World Health Organization (WHO) recommends that a timely birth dose of HepB vaccine be given, particularly in areas of high vertical transmission of hepatitis B virus (HBV). This can be achieved relatively easily in situations where almost all births occur in health facilities. But where a significant proportion of births occur at home and without birth attendants able to give injections, this is much more difficult. Barriers to the timely administration of the birth dose of HepB vaccine include weakness in policy development and implementation, difficulties in reliably supplying potent vaccine to community level, limited transport, poor communication, limited cold chain capacity, lack of effective training, and lack of a clear delineation of responsibility between health care professionals. Demonstration projects, such as those in Indonesia, suggest that there are significant opportunities to improve the timely delivery of HepB vaccine birth dose in existing maternal and child health programmes where health workers are trained to provide home delivery care.     

Hepatitis B surface antigen seroprevalence among children in the Philippines, 2018

The World Health Organization Western Pacific Region (WPR) set a hepatitis B virus (HBV) control target to achieve HBV surface antigen (HBsAg) prevalence of <1% among children aged 5 years by 2017. The estimated HBsAg prevalence in the Philippines among adults was 16.7% during the pre-vaccine era. We estimated the HBsAg seroprevalence among children aged 5–7 years to measure the impact of vaccination.We conducted a household serosurvey, using a three-stage cluster survey methodology (provinces, clusters, and households). We estimated HBsAg prevalence using a rapid, point-of-care HBsAg test and calculated vaccination coverage by reviewing vaccination records or by caregiver recall. A questionnaire was administered to assess demographic variables for the child and family. We assessed the association between chronic HBV infection, vaccination coverage, and demographic variables, accounting for the complex survey design.Of the 2178 children tested, HBsAg was detected in 15 children [0.8%, 95% confidence interval (CI): 0.4, 1.7]. Only two of the HBsAg-positive children had been fully vaccinated against HBV. Based on documented vaccination or caregiver recall for the survey population, hepatitis B vaccine birth dose (HepB-BD) coverage was 53%, and the third dose hepatitis B vaccination (HepB3) coverage was 73 percent. Among the 1362 children with documented HepB-BD, timely HepB-BD coverage (given within 24 h of birth) was 43%; children born outside a health facility were less likely to receive a timely HepB-BD than those born in a health facility (adjusted odds ratio 0.10, 95% CI: 0.04, 0.23).HBsAg prevalence among children in the Philippines has decreased compared to the prevalence among adults in the pre-vaccination era. Strategies to further reduce HBsAg prevalence include ensuring that all children, whether born in health facilities or at home, receive a timely HepB-BD, and increasing HepB-BD and HepB3 coverage to reach the WPR goals of ≥95% coverage.     

中国西部地区不同出生地点新生儿乙型肝炎疫苗首针及时接种情况分析

目的分析和评价中国西部地区不同出生地点新生儿乙型肝炎(乙肝)疫苗首针(HepB1)及时接种情况,改善HepB1及时接种的薄弱环节。方法从西部11个省(自治区、直辖市,下同,未包括西藏自治区)、设区的市(地区、州、盟,下同)、县(市、旗,下同)、乡(镇、苏木,下同)级各抽取1所省级医院,2所市级医院,2所县级医院,4所乡级医院,分析各级医院出生新生儿HepB1接种情况,同时与在家中出生新生儿接种情况进行对比。结果中国西部地区在医院出生新生儿HepB1接种率平均>90%,在家出生新生儿HepB1接种率约为50%。结论随着产妇住院分娩率的提高,在医院出生新生儿的HepB1及时接种率达到了很高的覆盖率,今后应制定对策,提高在家出生新生儿的HepB1接种率。