影响边远地区新生儿乙肝疫苗首针及时接种的原因及对策  

Factors Affecting First Hepatitis B Vaccine Inoculation Injection in Remote Area Neonates and Strategy for qmprovement of This Condition

作　　者：夏伟[1] 陈长[1] 李放军[1] 李俊华[1] 谢超[1] 胡瑚[1] 张淑君[1] 黄铭华[1] 

机构地区：[1]湖南省疾病预防控制中心,湖南长沙410005

出　　处：《实用预防医学》2006年第6期1421-1424,共4页Practical Preventive Medicine

基　　金：北京生物制品研究所国际合作项目(编号:GAT.770-790-01535-COT)

摘　　要：目的分析、评价影响边远农村地区新生儿乙肝疫苗首针及时接种的主要原因及对策。方法在湖南省20个国贫县中随机抽4个县,其中3个为项目县,1个为对照县,所有距离县城40km以上的乡作为项目乡和对照乡,将项目乡随机分3个组,分别实施不同的免疫策略,对照乡为对照组。项目实施前、后对目标儿童展开接种率调查,调查采用标准的世界卫生组织30组群接种率调查方法的改进方法—40组群接种率调查法,进行调查。资料分析使用Excel和SPSS软件。结果不同地点出生的新生儿其乙肝疫苗的首针及时接种率的差异有统计学意义,在家出生的新生儿的首针及时接种率最低(47．6%),其次是乡级医院(79．2%)和县级医院(86．5%)；不同接种人员对新生儿乙肝疫苗首针及时接种的贡献不同,由乡以上医生实现的首针及时接种率最高为46．6%；大多数不及时接种的原因是“儿童家长不知道儿童出生后24h之内要接种乙肝疫苗第一针”。项目的实施能提高边远地区新生儿乙肝疫苗首针及时接种率,特别是在家出生的新生儿,其首针及时接种率由项目实施前的2．0%提高到实施后的47．6%。结论在家出生和监护人缺乏相关知识是目前制约边远地区新生儿乙肝疫苗首针及时接种的重要因素之一,项目的实施能改善这种状况,大大提高新生儿乙肝疫苗首针及时接种率。实施的关键在于村级卫生工作者参与新生儿乙肝疫苗的首针接种工作。Objective To evaluate the major factors affecting the first HB vaccine injection at birth in remote rural areas and the strategies for improving this condition.Methods Four counties were randomly selected from 20 national grade economic,poor counties in Hunan Province.The rural counties distanced more than 40 km from the county town were defined to serve as the project and/or control county areas.The project counties were randomly assigned into three groups to perform different inoculation strategies;and the county assigned as control served as the control.Before and after the conduction of the project,the coverage rates of hepatitis B vaccine first injections in all neonates were surveyed by the 40 - group method,a modified method for WHO standard 30 - group method;and the data were analyzed by Excel and SPSS accordingly.Results In different delivery places the neonate first injection rate showed significant differences:The first hepatitis B vaccine injec- tion rates of delivery in home,in country and in county hospitals were 47.6 %,79.2 %,and 86.5 % respectively (P＜0.05). The different health providers had different contribution to the first injection,and the country level above practitioners had the major contribution of 46.6 %.The significant reason of missed first injection was due to the parents did not have the knowledge of HB vaccine inoculation should receive within 24 hours after delivery.The project implementation improved the HB vaccine first injection rate from the previous 2.0 % to the current 47.6 %.Conclusions It is suggested that the missed first injection is mainly due to lack of knowledge of the parents.The implementation of this project is greatly improved HB vaccine first in- jection rate among the neonates in remote areas,and the most important factor is the village health providers including mid- wives should engage in this project.

关 键 词：乙肝疫苗 首针 接种 对策 

分 类 号：R186[医药卫生—流行病学]