江苏省农村地区儿童乙型肝炎疫苗免疫效果及其影响因素研究

目的探讨江苏省农村地区儿童接种乙型肝炎(乙肝)疫苗后免疫效果及其影响因素。方法采用多阶段分层随机整群抽样方法,抽取江苏省农村地区在实施乙肝疫苗计划免疫后出生的农村儿童为研究对象,检测HBsAg、抗-HBs标志,对抗-HBs阴转儿童进行不同种类疫苗的加强免疫,并分析HBsAg阳性儿童乙肝病毒(HBV)感染的危险因素。结果2522名1～7岁儿童中HBsAg阳性率在0．28%～1．28%之间,抗-HBs随年龄增加而逐渐下降,由1岁时的76．7%降至7岁时的45．5%;出生时未及时接种乙肝疫苗的儿童的HBV感染率显著高于及时接种儿童(1．4%:0．5%, P=0．031);应用不同剂量疫苗加强免疫后,抗-HBs阳转率均为90%以上。结论江苏省农村地区计划免疫适龄儿童人群的HBsAg阳性率为0．28%～1．28%,平均为0．8%,儿童中HBV感染主要为母婴传播,并与未及时接种乙肝疫苗有关。

Study on the efficacy of hepatitis B viruse vaccination and its influencing factors among children in rural area of Jiangsu province

Objective Toevaluate the efficacy of hepatitis B viruse(HBV) vaccination and its influencing factors among children in rural area of Jiangsu province.Methods Twenty-five hundred and twenty-two children born after 1998 in rural area were selected as the study population using multistage cluster sampling method.HBsAg and anti-HBs were detected by enzyme linked immunoassay(ELISA) and radio-immunoassay(RIA),respectively.Anti-HBs negative children were boosted using different hepatitis B vaccines and the efficacy was compared.Factors causing HBV infection in HBsAg positive children were also investigated.Results HBsAg positive rates in 1-7 year olds were 0.28%-1.28%,and the anti-HBs positive rates decreased from 76.7% to 45.5%.The HBsAg positive rate in children not timely vaccinated was significantly higher than those with HBV vaccine injection within 24 hours after birth(1.4% vs. 0.5%,P=0.031).More than 90% of the anti-HBs negative children had protective level of anti-FIBs after boosted with HBV vaccine.Conclusion HBsAg positive rate in children born after 1998 in rural area of Jiangsu province decreased significantly,with an average of 0.8%.The reason for HBsAg carriage in children might be attributed to mother-to-infant transmission or not timely HBV vaccination.