云南省红河州河口县边远山区儿童乙肝疫苗接种率及抗体水平调查分析

目的了解云南省红河州河口县边远山区儿童乙型病毒性肝炎(乙肝)疫苗免疫接种率及乙肝表面抗体水平,为进一步完善河口县乙型病毒性肝炎(乙肝)的防治策略提供参考依据。方法抽取3个边远乡镇(桥头乡、瑶山乡、莲花滩乡),按整群抽样原则抽取9个行政村为监测点,分4个年龄组(8~月龄、18~月龄、2~岁、4~5岁),每个年龄组至少调查5~6人,每个监测点至少调查20~24人,对所有调查对象进行接种率调查并采集静脉血3 ml,使用酶联免疫吸附试验(ELISA)对血标本进行乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)检测。结果共调查205名儿童,乙肝疫苗首针及时率为60.00%、全程接种率89.76%,合格接种率83.90%,各年龄组之间全程接种率、合格接种率差异无统计学意义(χ2=7.01,P0.05;χ2=2.11,P0.05);首针及时接种率差异有统计学意义(χ2=13.50,P0.01)。HBsAg阳性率1.46%,抗-HBs阳性率69.76%,各年龄组之间HBsAg阳性率差异无统计学意义,而抗-HBs阳性率差异有统计学意义(χ2=31.96,P0.01)。结论 2013年河口县边远山区乙肝疫苗全程接种率和合格接种率均达到80%以上,抗-HBs阳性率随着年龄增大逐渐下降。认真落实儿童乙肝疫苗免疫规划,做好新生儿乙肝疫苗接种,提高乙肝首针及时接种率和全程接种率,提高儿童乙肝抗体的阳性率,对降低和消除乙肝发病很有必要。

Hepatitis B vaccination coverage and antibody level to hepatitis B virus in children living in remote mountain area in Hekou,Yunnan

Objective To understand the hepatitis B vaccination coverage and surface antibody level to hepatitis B in children living in remote mountain area in Hekou county, Yunnan province and provide evidence for the improvement of local hepatitis B prevention and control. Methods Cluster random sampling was conducted to select children aged 8 - 17 months, 18 - 23 months, 2 - 3 years and 4 - 5 years in 9 villages of 3 townships in remote mountain area in Hekou. Blood samples were taken from the children selected to detect HBsAg and anti-HBs with ELISA. Results A total of 205 children were surveyed. The timely vaccination rate of the first dose hepatitis B vaccine was 60.00%, the completed vaccination rate was 89. 76% and the qualified vaccination rate was 83.90%. The differences in age specific completed vaccination rate and qualified vaccination rate had no statistical significance （χ2 = 7.01, P 〉 P 〉 0. 05 ; χ2 = 2. 11, P〉0.05）, but the difference in age specific timely 1st vaccination rate had statistical significance （χ2= 13.50, P〈0.01）. The overall HBsAg positive rate was 1.46% and the overall anti-HBs positive rate was 69.76%. The difference in age specific HBsAg positive rate had no statistical significance, but the difference in age specific anti-HBs positive rate had statistical significance （χ2 = 31.96, P 〈 0. 01 ）. Conclusion In 2013, the completed vaccination rate and qualified vaccination rate of hepatitis B vaccine in children in remote mountain area in Hekou were all above 80%. Anti-HBs level decreased with age. It is necessary to improve the newborns hepatitis B vaccination, increase the first dose vaccination rate and completed vaccination rate to increase the positive rate of antibody to hepatitis B virus in children for the purpose of reducing the incidence of hepatitis B.