健康人群乙型肝炎疫苗接种效果评估

目的 了解健康人群乙型肝炎(乙肝)疫苗接种情况,评价乙肝预防效果,为制定免疫策略提供依据.方法 按照两阶段抽样法,在马鞍山市三区一县抽取8个行政村1-59岁常住人口2038人,进行问卷调查,并采集静脉血,用ELISA法检测乙肝血清标志物.率的比较采用卡方检验.结果 乙肝疫苗调查接种率为50.54%,城市高于农村,低年龄组(98.14%)到高年龄组(0.95%)逐渐降低,男性高于女性.散居和托幼儿童接种率最高(96.58%和98.77%),学生次之(87.17%),农民最低(4.26%).1～59岁人群HBsAg阳性率从低年龄组到高年龄组逐渐增高(O%-10.48%),抗-HBs阳性率为14.58%-50.18%,15-岁组最低(14.58%).1990-2007年间乙肝报告发病率以1999年最高,为67.0660/10万,之后呈逐年下降趋势.2005-2007年平均乙肝报告发病率在≤14岁的人群中低于4.6731/10万,在≥15岁的人群中高于32.0789/10万.乙肝血源疫苗接种后HBsAg和抗-HBs阳性率分别为0.98%和39.54%,与基因工程疫苗接种后阳性率(0.49%和43.28%)的差异无统计学意义(x2=0.107,P=0.744;x2=1.004,P=0.316).结论 应继续开展新生儿乙肝疫苗接种,推广成年人接种,并将预防乙肝资源向农村倾斜.

Evaluation on the effect of Immunization with hepatitis B vaccine in healthy people

Objective To evaluate the effect of hepatitis B vaccination in healthy people and provide the basis for developing immunization strategy.Methods Two-stage sampling method was designed.A questionnaire survey was conducted among 2038 permanent residents aged 1-59 years old from 8 villages.Intravenous blood samples were taken and detected for hepatitis B virus serum markers by ELISA.Results The surveyed inoculation rate of hepatitis B vaccine was 50.54%,with the rate being higher in urban area than in rural area and being higher in men than in women.The vaccination rate decreased gradually from the youngest group(98.14%)to the oldest group(0.95%).The scattered and nursery children had the highest rate (96.58%and 98.77%),followed by students(87.17%),farmers had the lowest rate(4.26%).HBsAg positive rates increased gradually from the youngest group to the oldest one(0%-10.48%).Anti-HBs positive rates were between 14.58%-50.18%,with 15-year old group having the lowest rate(14.58%).The reported incidence rate of hepatitis B was the highest in 1999(67.0660/100 000)from 1990 to 2007,and showed a descending tendency since then.The average reported incidence rate wag lower than 4.673 1/100 000 among age groups 14 years and under and was higher than 32.0789/100 000 among age groups 15 years and above between 2005 and 2007.HBsAg and anti-HBs positive rates after vaccination with plasma-derived hepatitis B vaccine(0.98%and 39.54%)had no statistical difference from those vaccinated with genetically engineered vaccine(0.49%and 43.28%)(x2=0.107,P=0.744;x2=1.004,P=0.316).ConclusionsWe should continue hepatitis B vaccination for neonates,expand adult hepatitis B vaccination and allocate more resources of hepatitis B prevention to the rural.