新生儿乙型肝炎疫苗接种状况调查及应对措施探讨

目的:调查六盘水市、安顺市乙型肝炎(乙肝)疫苗首针(HBV1)接种情况,探讨提高HBV1及时接种率措施。方法:分层随机抽样调查新生儿接种情况、孕妇/婴儿母亲及接生/接种医生乙肝免疫预防知识掌握情况。结果:HBV1及时率医院出生儿童远高于在家出生,县级以上医院高于乡镇卫生院。81.10%孕妇/婴儿母亲做过产前检查,53.79%通过产前检查、67.01%通过村医获得乙肝免疫预防知识,79.51%认为村医口头宣传对自己有效;仅82.30%接生/接种医生知道国家对新生儿HBV1实行"谁接生、谁接种"政策,35.88%知道低体重新生儿不是接种禁忌证,56.94%知道新生儿感染乙肝病毒后最易成为慢性携带者,69.86%知道乙肝的传播途径包括围产期传播。结论:出生地点是影响新生儿HBV1及时接种的重要因素,提高住院分娩率,做好在医院出生儿童HBV1及时接种,是提高HBV1及时率的主要措施,乡镇级卫生院是院内出生新生儿及时接种的薄弱环节。应加强产前检查医生及村级防保人员的新生儿HBV接种宣传工作,加强对接生/接种医生乙肝免疫预防知识的培训。

Investigation on the inoculation status of hepatitis B vaccine in neonates and discussion of the solutions

Objective:To investigate the first needle inoculation statuses of hepatitis B vaccine(HBV1) in Liupanshui city and Anshun city,explore the measures to improve the timely coverage rate of HBV1.Methods:A stratified random sampling method was used to investigate the inoculation status of neonates,the preventive knowledge of HBV immunization of the pregnant women,mothers of infants,midwives,and the doctors engaged in inoculation.Results:The timely coverage rate of HBV1 among the children born in hospitals was significantly higher than that among the children born at home,the timely coverage rate of HBV1 among the children born in hospitals at county level or above was higher than that among the children born in township hospitals.81.10% of the pregnant women and mothers of infants received prenatal examination,and 53.79% of them gained the preventive knowledge of HBV immunization during prenatal examination,while 67.01% of them gained the preventive knowledge of HBV immunization from village doctors,79.51% of them considered that oral publicity from village doctors was effective.Only 82.30% of the midwives and doctors engaged in inoculation knew the inoculation policy of HBV1 among the neonates,35.88% of them knew that the low birth weight infants were not the contraindication of inoculation,56.94% of them knew that the neonates after hepatitis B infection were easy to become to be chronic carriers,69.86% of them knew that the transmission routes of hepatitis B included perinatal transmission.Conclusion:The birth place is one of the important factors affecting timely inoculation of HBV1 among the neonates,increasing the delivery rate in hospital and ensuring timely inoculation of HBV1 among the birth population in hospital are the measures to improve the timely coverage rate of HBV1;township hospitals are weak links of timely inoculation of neonates born in hospitals.It is necessary to enhance the publicity of HBV inoculation of the neonates among the doctors engaged in prenatal examination and the medical workers at village level,and strengthen the training of preventive knowledge of hepatitis B immunization among the midwives and doctors engaged in inoculation.