深圳和郑州市急性呼吸道感染及流感认知调查

目的 了解甲型H1N1流感大流行不同阶段中国深圳和郑州两城市人群的急性呼吸道感染两周罹患率及流感相关知识、态度和行为.方法 运用分阶段按容量比例概率抽样法对两城市分阶段进行6次电话调查.其中深圳市调查1 217人,郑州市调查1 214人.结果 深圳市受访人出现急性呼吸道感染症状者占10.1%,6次调查受访家庭成员罹患率6.1%;郑州市分别是5.6%、3.0%.深圳市季节性流感疫苗接种率10.9%,甲型H1N1流感疫苗接种率9.2%;郑州市分别是6.0%、7.5%.深圳甲型H1N1流感疫苗免费接种知晓率是62.2%;郑州为67.5%.结论 急性呼吸道感染罹患率、甲型H1N1疫苗接种率深圳均高于郑州.两市人群流感相关知识掌握尚不全面,需要针对性地加强健康宣传教育.     

深圳市宝安区托幼机构人员甲型H1N1流感疫苗接种率及其影响因素

目的 了解深圳市宝安区托幼机构人员甲型H1N1流行性感冒(甲流)疫苗接种率及其影响因素.方法 随机抽取深圳市宝安区100家托幼机构530人作为面访匿名问卷调查对象.采用描述性分析、秩和检验、x 2检验和Logistic回归分析分别对疫苗接种率的影响因素进行单因素和多因素分析.结果 深圳市宝安区托幼机构人员甲型H1N1流感疫苗接种率为39.96％,未接种的主要原因是怕出现疫苗不良副反应,占39.10％.性别为男性[男性:比值比(Odds Ratio,OR)=3.193,95％可信区间(Confidence Interval,CI)=1.285～7.936];工作岗位为保健医生和保育人员(保健医:OR=12.583,95％ CI=2.825 ～56.082;保育员:OR =7.581,95％ CI=1.881～30.554)、工作年限为11～ 15年(11 ～ 15年:OR=6.299,95％CI=1.169～33.945)和近3年接种过季节性流感疫苗(接种过:OR=8.856,95％CI=4.139～ 18.703;不清楚:OR =4.322,95％CI=1.588～ 11.766)对疫苗接种率有影响.结论 深圳市宝安区托幼人员甲流疫苗接种率较高,应加强甲流疫苗有效性和安全性的宣传,特别要针对女性、教师、工作年限小于11年、大于15年和近3年无季节性流感疫苗接种史等人群.     

武汉市部分中学生甲型H_1N_1流感KAP及疫苗接种现况调查

目的为掌握武汉地区中学生对甲型H1N1流感的KAP及接种甲型H1N1流感疫苗的意愿、效果,制定适宜的防控措施。方法采用问卷调查的方法,整群随机抽取190位中学生进行甲型H1N1流感有关知识、信念、卫生习惯改变和接种甲型H1N1流感疫苗的意愿和效果。结果中学生采取多项预防措施应对甲型H1N1流感,对甲型H1N1流感的担忧、恐慌程度较2009年5月明显降低(P0.05),67.4%的被调查中学生愿意并接种了甲型H1N1流感疫苗;甲型H1N1流感疫苗近似保护率为70.9%。结论疫情流行期间,通过大力宣传预防措施和学校健康教育,可以引导中学生养成良好的卫生习惯;本次甲型H1N1流感疫苗接种安全有效。     

无锡市甲型H1N1流感及季节性流感疫苗接种效果分析

目的调查流感样病例(ILI)和无锡市一般人群中甲型H1N1流感疫苗及季节性流感疫苗的接种情况,评估疫苗接种后对人群的保护效果。方法以无锡市2家哨点医院为基础,采集流感样病例病毒核酸检测阳性的病例作为病例组,共1 529人,同时按照"病例"的电话信息,随机产生电话号码选择、年龄匹配的一般人群作为对照组,共380人。结果病例组甲型H1N1流感疫苗接种率为6.1%(94/1 529),对照组甲型H1N1流感疫苗接种率为12.1%(46/380),两组比较,差异有统计学意义(P0.01);甲型H1N1流感病例中接种甲型H1N1流感疫苗的比例为12.5%(3/24),门诊检测阴性的ILI病例接种甲型H1N1流感疫苗的比例为6.1%(78/1 273),"接种甲型H1N1流感疫苗"因素的OR值为0.457(P=0.201);以电话调查一般人群(330例)作为对照组,接种甲型H1N1流感疫苗的比例为13.3%(44/330),OR值为1.077(P=0.908)。结论该次调查说明接种甲型H1N1流感疫苗对预防流感样病例有一定效果,但由于样本量较少,24种方法病例对照分析均未得出差异有统计学意义。     

社区医护人员甲型H1N1流感院内感染防控知信行调查

目的了解社区医疗机构医护人员防控甲型H1N1流感院内感染的知信行现状及影响因素。方法通过多阶段抽样方法确定调查对象,采用集中自填统一调查问卷,调查其防控甲型H1N1流感医院感染知识态度和行为,运用F值或t值及χt2rend进行检验,采用二项分类logistic回归分析影响接种流感疫苗的因素。结果共调查247名医护人员,不同工作年限的医护人员知识得分差异有统计学意义(P0.01),随着知识得分下降,所占人数增加,且差异有统计学意义(P0.05);25.1%的医护人员认为自己有可能在医院感染甲型H1N1流感;43.32%医护人员懂得对佩戴医用防护口罩进行密合性检查;21.05%医护人员接种过季节性流感疫苗;Logistic回归分析表明,单位负责接种季节性流感疫苗费用是提高疫苗接种率的有力促进因素(OR=4.56,P0.01)。结论社区医疗机构防控甲型H1N1流感医院感染,宜加强相关知识培训,完善软硬件建设和资金投入,提高流感疫苗接种率。     

北京市普通人群甲型H1N1流感病毒血清抗体阳性影响因素的病例对照研究

目的探讨影响北京市普通人群血清甲型H1N1流感病毒抗体阳性的因素。方法按1∶1配对的病例对照研究设计,采用问卷调查方法,收集65例血清甲型H1N1流感病毒抗体阳性病例和65例阴性对照者的人口统计学特征、疫苗接种史,卫生习惯等信息。结果单因素分析显示,疫苗接种史、旅游史、调查前曾出现流感样症状、周围有确诊的甲型H1N1流感患者、调查前曾去医院发热门诊、勤洗手习惯等与血清甲型H1N1流感病毒抗体阳性有关。多因素条件Logistic回归分析结果表明,甲型H1N1流感病毒疫苗接种史（OR=4.82,95%CI：1.23-19.91）、调查前1月内曾出现过流感样症状（OR=2.53,95%CI：1.01-6.25）,勤洗手习惯（OR=0.21,95%CI：0.06-0.74）等3个因素与血清甲型H1N1流感病毒抗体阳性有关。结论甲型H1N1流感疫苗接种史、旅游史、曾出现流感样症状、曾与确诊的甲型H1N1流感患者接触、勤洗手习惯等与血清甲型H1N1流感病毒抗体阳性有关。提示应当继续推行甲型H1N1流感疫苗的接种,加强手卫生等一般措施是预防甲型H1N1流感的重要手段。     

2009年华容县健康人群甲型H1N1流感疫苗免疫效果分析

目的了解健康人群接种甲型H1N1流感疫苗后的免疫效果及抗体水平。方法观察接种甲型H1N1流感疫苗人群中不良反应的发生情况;按照不同的年龄组随机抽取350人,采用描叙性流行病学方法,对疫苗的安全性和有效性进行评价;微量血凝抑制试验检测接种者甲型H1N1流感病毒抗体,SPSS16.0统计学软件对接种30 d后甲型H1N1流感与普通流感的发病率、就诊率及HI抗体阳转率进行比较。结果接种组接种甲型H1N1流感疫苗30 d后甲型H1N1流感与普通流感的发病率与就诊率均低于对照组,差异有统计学意义（P〈0.05）;接种甲型H1N1流感疫苗人群中共出现不良反应1 891例,总不良反应率为4.35%;接种组总体HI抗体阳转率显著高于对照组（χ2=4.27,P〈0.05）,达到欧盟药品评价委员会的标准,各年龄组间HI抗体阳转率差异无统计学意义。结论国产甲型H1N1流感疫苗具有较高的安全性与较好的免疫原性,适合在健康人群中普遍接种。     

东莞市中小学生、工人和居民甲型H1N1流感防治知信行现况调查

目的了解东莞市中小学生、工人和居民甲型H1N1流感防治知识、态度及行为现况,为下一步防控工作提供科学依据。方法选择东莞市小学、初中、工厂各1间,居民社区1个,其中小学和初中每个年级选择两个班进行整群抽样,社区和工厂采取随机抽样方法选取对象,采用自填式问卷调查甲型H1N1流感防治知识的认知水平、日常行为习惯及对待甲型H1N1流感的态度等。结果调查对象对甲型H1N1流感总体知晓率为69.63%,其中中小学生为75.32%,工人为64.10%,居民为52.46%,三者知晓率之间差异有统计学意义(χ2=45.98,P0.05);中小学生不带病上课、打喷嚏或咳嗽时捂嘴、每天洗手次数、洗手时点和洗手方式等卫生习惯方面均优于工人及居民,差异有统计学意义;有27.24%的调查对象认为甲型H1N1流感可怕,认为可怕的原因主要是甲型H1N1流感难以预防(52.68%)、该病易病死(46.34%)和没有特效药(41.22%);在未接种过甲型H1N1流感疫苗的调查对象中,仅58.10%表示愿意接种免费的甲型H1N1流感疫苗,不愿意接种的原因主要是担心疫苗的安全性。结论东莞市中小学生在甲型H1N1流感防治知识、态度及行为等方面均优于工人及居民,应在特定人群中有针对性地开展甲型H1N1流感可防可治、疫苗安全有效、不带病工作及正确洗手方法等关键知识点的宣传教育。     

医务人员接种和推荐接种流感疫苗意愿调查

目的了解宁波市医疗机构医务人员接种及向患者推荐接种流感疫苗的意愿。方法在宁波市20家社区卫生服务中心、20家县级及以上医院、11家疾病预防控制中心抽取1 311名医务人员作为调查对象,采用微信问卷调查方式,收集调查对象流感疫苗接种和向患者推荐该疫苗意愿情况,采用多因素Logistic回归模型分析流感疫苗接种和推荐意愿的影响因素。结果调查对象流感疫苗接种率为14.49%,25.78%有意愿接种流感疫苗,79.86%有意愿向患者推荐流感疫苗。多因素Logistic回归分析结果显示,既往有流感疫苗接种史(接种:OR=4.889,95%CI:3.783~6.317;推荐:OR=2.176,95%CI:1.553~3.050)、参加过慢性病与流感疫苗知识培训(接种:OR=1.448,95%CI:1.073~1.953;推荐:OR=2.078,95%CI:1.518~2.846)与接种意愿和推荐意愿均呈正相关;与社区卫生服务中心比较,县级及以上医院医务人员(接种:OR=0.515,95%CI:0.390~0.680;推荐:OR=0.624,95%CI:0.445~0.876)更不愿意接种和向患者推荐流感疫苗。正确知晓流感疫苗的医保报销范围(OR=1.751,95%CI:1.280~2.396)、知晓流感疫苗接种季节(OR=1.926,95%CI:1.302~2.851)、认为疫苗是安全的(OR=1.917,95%CI:1.368~2.685)医务人员更倾向于向患者推荐流感疫苗,而对疫苗不良反应的担忧(OR=0.601,95%CI:0.401~0.901)会降低向患者推荐的意愿。结论流感疫苗接种相关知识知晓率影响医务人员接种和推荐接种意愿,应加强流感疫苗相关知识培训,提高医务人员流感疫苗接种率和推荐意愿率。     

电话12320对南京市居民甲型H1N1流感疫苗接种意愿的调查

甲型H1N1流感在墨西哥暴发后迅速蔓延至全球,各个国家迅速开展对该病毒的研究,争取尽早研制出疫苗。中国在全球率先研制出甲型H1N1流感疫苗。为了解南京市民对该疫苗的认知以及接种意愿,为以后的疫苗接种政策的制定提出指导性意见,借助本市12320公共卫生公益电话平台开展了电话调查,     

深圳市宝安区重点人群甲型H1N1流感疫苗接种率及其影响因素

目的了解深圳市宝安区医务人员和中小学生两类重点人群甲型H1N1流感（简称甲流）疫苗接种率及其影响因素。方法在宝安区所辖的中小学校和医疗机构中随机抽取1 549名学生和770名医务人员作为调查对象进行匿名问卷调查。采用卡方检验分别对疫苗接种率的影响因素进行单因素分析。结果宝安区中小学生甲流疫苗的接种率为30.39%,医务人员接种率为55.03%;两类人群未接种的主要原因是怕出现疫苗不良反应,分别占36.81%、39.10%;不同学生在年龄、监护人职业、是否知道甲型流疫苗接种时间、是否认为甲流疫苗能预防甲流和近3年是否接种过季节性流感疫苗方面,接种率差异存在统计学意义（P〈0.05）,医务人员不同文化程度、医疗岗位、工作年限、是否知道甲流疫苗接种时间和近3年是否接种过季节性流感疫苗间差异有统计学意义（P〈0.05）。结论应加强对医务人员和中小学生两类重点人群甲流疫苗有效性、安全性和接种相关知识宣传,医疗机构应利用各种渠道及时对公众传达准确的信息。     

深圳市宝安区中小学生甲型H1N1流感疫苗接种率调查及影响因素分析

目的调查深圳市宝安区中小学生甲型H1N1流感疫苗接种率及影响因素。方法在全部中小学中随机抽取1 405名学生进行问卷调查,对一般情况采用描述性分析,组间构成比比较采用χ2检验,探讨多变量影响因素采用多因素Logistic回归分析。结果宝安区中小学生的甲型H1N1流感疫苗调查接种率为30.4%;甲流疫苗知识的总体知晓率为39.5%;未接种甲流疫苗最主要原因是怕出现疫苗不良副反应,占38.7%;男性学生、年龄增加、近三年接种过季节性流感疫苗的学生更倾向于接种疫苗。结论宝安区中小学生甲流疫苗知晓率偏低,应加强对学生甲流和甲流疫苗的相关知识宣传,同时加强季节性流感知识的健康教育,疾控部门应利用各种渠道及时对公众传达准确的信息。     

江苏省新甲型H1N1流感疫苗免疫后抗体水平变化趋势研究

目的了解新甲型H1N1流感疫苗免疫前后人群抗体水平动态变化情况。方法随机选取部分疫苗接种人群为受试者,微量半加敏血凝抑制实验检测免疫前、免疫后1个月与免疫后3个月的血清抗体水平,计算抗体阳性率与抗体几何平均滴度(GMT),并进行统计学分析。结果免疫前、免疫后1个月与3个月抗体阳性率分别为13.64%(9.58%~18.61%)、83.63%(78.15%~88.20%)、77.06%(71.09%~82.32%),GMT分别为9.36(8.30~10.56)、122.53(100.29~149.70)、96.07(77.85~118.54)。免疫前与免疫后1个月、3个月后相比,抗体阳性率与GMT差异均有统计学意义。免疫后1个月与免疫后3个月两者差异均无统计学意义。结论本研究所用甲型H1N1流感病毒裂解疫苗免疫后抗体水平明显升高,且维持时间较长。     

Seasonal influenza vaccination predicts pandemic H1N1 vaccination uptake among healthcare workers in three countries

The aim of this study was to identify the common barriers and facilitators for acceptance of pandemic influenza vaccination across different countries. This study utilized a standardized, anonymous, self-completed questionnaire-based survey recording the demographics and professional practice, previous experience and perceived risk and severity of influenza, infection control practices, information of H1N1 vaccination, acceptance of the H1N1 vaccination and reasons of their choices and opinions on mandatory vaccination. Hospital-based doctors, nurses and allied healthcare workers in Hong Kong (HK), Singapore (SG) and Leicester, United Kingdom (UK) were recruited. A total of 6318 (HK: 5743, SG: 300, UK: 275) questionnaires were distributed, with response rates of 27.1% (HK), 94.7% (SG) and 94.5% (UK). The uptake rates for monovalent 2009 pandemic H1N1 vaccine were 13.5% (HK), 36.2% (SG) and 41.3% (UK). The single common factor associated with vaccine acceptance across all sites was having seasonal influenza vaccination in 2009. In UK and HK, overestimation of side effect reduced vaccination acceptance; and fear of side effect was a significant barrier in all sites. In HK, healthcare workers with more patient contact were more reluctant to accept vaccination. Drivers for vaccination in UK and HK were concern about catching the infection and following advice from health authority. Only a small proportion of respondents agreed with mandatory pandemic influenza vaccination (HK: 25% and UK: 42%), except in Singapore where 75.3% were in agreement. Few respondents (<5%) chose scientific publications as their primary source of information, but this group was more likely to receive vaccination.The acceptance of pandemic vaccine among healthcare workers was poor (13-41% of respondents). Breaking barriers to accept seasonal influenza vaccination should be part of the influenza pandemic preparedness plan. Mandatory vaccination even during pandemic is likely to arouse substantial discontent.     

Correlates of 2009 H1N1 influenza vaccine acceptability among parents and their adolescent children

School-aged children were a priority group for receipt of the pandemic (2009) H1N1 influenza vaccine. Both parental and adolescent attitudes likely influence vaccination behaviors. Data were collected from surveys distributed to middle- and high-school students and their parents in two counties in rural Georgia. Multivariable logistic regression analyses were conducted to assess correlates of parental acceptance of H1N1 influenza vaccination for their children and adolescents' acceptance of vaccination for themselves. Concordance analyses were conducted to assess agreement between parent-adolescent dyads regarding H1N1 influenza vaccine acceptance. Parental acceptance of H1N1 influenza vaccination for their children was associated with acceptance of the vaccine for themselves and feeling motivated by the H1N1 influenza pandemic to get a seasonal influenza vaccine for their child. Adolescents' acceptance was associated with receipt of a seasonal influenza vaccine in the past year, fear of getting H1N1 influenza, feeling comfortable getting the vaccine and parental acceptance of H1N1 influenza vaccine. Half (50%) of parent-adolescent pairs included both a parent and child who expressed H1N1 influenza vaccine acceptance, and 19% of pairs would not accept the vaccine. This research highlights the need for interventions that target factors associated with H1N1 influenza vaccine acceptance among both parents and adolescents.     

Willingness of healthcare workers to accept voluntary stockpiled H5N1 vaccine in advance of pandemic activity

Healthcare workers may be at risk during the next influenza pandemic. Priming with stockpiled vaccine may protect staff and reduce nosocomial transmission. Despite campaigns to increase seasonal influenza vaccine coverage, uptake among healthcare workers is generally low; creating uncertainty whether they would participate in pre-pandemic vaccine programmes. We conducted a cross-sectional questionnaire survey of healthcare workers in a UK hospital during, and 6 months after, a period of media reporting of an H5N1 outbreak at a commercial UK poultry farm. A total of 520 questionnaires were returned, representing 20% of frontline workforce. More respondents indicated willingness to accept stockpiled H5N1 vaccine during the period of media attention than after (166/262, 63.4% vs. 134/258, 51.9%; p = 0.009). Following multivariate analysis, factors associated with willingness to accept H5N1 vaccine included: previous seasonal vaccine (OR 6.2, 95% CI 3.0–12.8, p < 0.0001), awareness of occupational seasonal vaccine campaigns (OR 2.2, 95% CI 1.4–3.5, p = 0.001), belief that seasonal vaccine benefits themselves (OR 2.5, 95% CI 1.6–4.0, p < 0.0001) or the hospital (OR 3.6, 95% CI 2.3–5.8, p < 0.0001), belief that pandemic risk is high/moderate (OR 14.1, 95% CI 7.6–26.1, p < 0.0001) and would threaten healthcare workers (OR 2.9, 95% CI 1.8–4.5, p < 0.0001). Those who would not accept vaccine (220 respondents, 42.7%) if offered before the pandemic do not perceive pandemic influenza as a serious threat, and have concerns regarding vaccine safety. A majority of healthcare workers are amenable to accept stockpiled H5N1 vaccine if offered in advance of pandemic activity.     

Factors influencing the uptake of 2009 H1N1 influenza vaccine in a multiethnic Asian population

The study aimed to determine factors influencing the uptake of 2009 H1N1 influenza vaccine in a multiethnic Asian population. Population-based, cross-sectional survey was conducted between October and December 2009. Approximately 70% of overall participants indicated willingness to be vaccinated against the 2009 H1N1 influenza. Participants who indicated positive intention to vaccinate against 2009 H1N1 influenza were more likely to have favorable attitudes toward the 2009 H1N1 vaccine. A halal (acceptable to Muslims) vaccine was the main factor that determined Malay participants’ decision to accept vaccination, whereas safety of the vaccine was the main factor that influenced vaccination decision for Chinese and Indian participants. The study highlights the challenges in promoting the 2009 H1N1 vaccine. Ethnic-sensitive efforts are needed to maximize acceptance of H1N1 vaccines in countries with diverse ethnic communities and religious practices.     

深圳居民甲型H1N1流感抗体水平影响因素的研究

目的通过检测深圳居民血清中甲型H1N1流感抗体水平,了解相关的影响因素,为有效预防和控制甲型H1N1流感疫情提供有效科学依据。方法随机选取480位深圳居民作为观察对象,采用血凝抑制方法进行甲型H1N1流感抗体水平检测。并进行问卷调查,用SPSS16.0软件对血清抗体水平与不同流行病学指标之间进行相关因素分析。结果通过研究发现,年龄和甲流疫苗接种史与血清中甲型H1N1流感抗体水平显著性相关。6~15岁人群与已接种甲流疫苗人群血清中的甲型H1N1流感抗体阳性率显著性高于其它人群,阳性率分别是34.1%和48.1%。所有调查对象中,甲型H1N1流感疫苗接种率较低,仅为11.25%,6~15岁人群的疫苗接种率最高,为41.76%。结论青少年为甲型H1N1流感高危人群,加强对该人群的免疫接种,可对甲型H1N1流感的疫情控制起到显著成效。     

北京市顺义区健康人群甲型H1N1流感抗体水平及其疫苗免疫效果

目的了解北京市顺义区健康人群甲型H1N1流感抗体水平,评价甲型H1N1流感疫苗免疫效果,为卫生部门制定预防控制措施和策略提供依据。方法随机选取顺义区12个乡街的5岁以上健康人群(202名)采集免疫前静脉血检测抗体,评估健康人群抗体水平;接种甲型H1N1流感疫苗后,各年龄组随机选取部分人群做免疫后抗体水平检测,评估疫苗免疫效果。结果 202份血清标本中甲型H1N1流感抗体水平阳性率46.53%(94/202),与北京市人群甲型H1N1流感抗体水平检测结果差异有统计学意义。抗体几何平均滴度倒数(GMRT)为32.78。不同性别人群之间甲型H1N1流感抗体阳性率差异无统计学意义,不同年龄组之间抗体水平阳性率差异有统计学意义,25~29岁、10~14岁组抗体水平阳性率高。50名评估对象免疫前抗体阳性率50%(25/50),免疫后抗体阳性率94%(47/50),甲型H1N1流感抗体阳转率80%(30/50)。免疫前阴性和阳性评估对象之间抗体阳转率差异有统计学意义。评估对象总体抗体滴度呈6倍增高,各年龄组免疫前、后抗体GMRT的变化之间差异有统计学意义,25~29岁、60岁以上组滴度升高倍数最低。结论顺义区甲型H1N1流感实际感染数高于北京市甲型H1N1流感平均感染水平。疫苗接种使目标人群达到了形成该样本人群免疫屏障的要求,提示在甲型H1N1流感大流行之际接种疫苗是控制疫情的必要手段。免疫前抗体水平、年龄是甲型H1N1流感抗体阳转率的影响因素。