国家计划免疫综合审评县2004年农村儿童白喉免疫水平与白百破疫苗接种率调查  

Study on the immunity of diphtheria in children at county level with different 4-vaccine coverage rates based on the results from ＂National Immunization Program Review＂ in 2004

作　　者：王华庆[1] 郭欣[1] 陈丽娟[2] 杨洁[2] 和京果[2] 罗明[2] 贺雄[2] 周玉清[1] 曹玲生[3] 卢永[4] 殷大鹏[1] 陈园生[1] 夏伟[1] 梁晓峰[1] 

机构地区：[1]中国疾病预防控制中心免疫规划中心,北京100050 [2]北京市疾病预防控制中心 [3]安徽省安庆市疾病预防控制中心 [4]陕西省疾病预防控制中心

出　　处：《中华流行病学杂志》2007年第5期433-436,共4页Chinese Journal of Epidemiology

摘　　要：目的 掌握2004年国家免疫规划综合审评“四苗覆盖率”县儿童的白喉免疫水平。方法 根据全国2004年综合审评县“四苗覆盖率”不同分为3层,每层随机抽取2个县,每县随机调查10个村,每村随机调查1992-2003年出生儿童42名;检测方法用ELISA定量法检测白喉抗毒素IgG抗体。结果 （1）被调查县儿童白喉抗毒素抗体总阳性率仅为49．6%,最高的县阳性率为78．1%,最低的县阳性率仅为33．0%;阳性率随着年龄的增长,呈明显的下降趋势,阳性率最高的年龄是2003年出生的儿童为61．2%,阳性率最低的年龄是1992-1995年出生的儿童为37．6%。（2）几何平均浓度（GMCs）仅为0．48 IU/ml,随着年龄的增长,GMCs呈明显的下降趋势,在应加强免疫的年龄没有出现白喉抗毒素抗体GMCs预计的高峰。（3）2001-2003年出生儿童的白百破疫苗调查基础免疫接种率均高于90%,而相应年龄抗体的阳性率却均低于62%。（4）白百破疫苗基础免疫接种率合格与不合格儿童的抗体阳性率分别为58．1%和59．6%,没有明显差别。结论 调查县（除个别县外）儿童白喉的保护水平较低,儿童白百破疫苗的接种率不能客观反映儿童白喉的免疫状况，如何提高儿童白喉的免疫水平，是免疫规划近期亟待解决的问题。Objective To investigate the immunity level of diphtheria antibody among children living in the areas where different coverage rates of 4-vaccines stratified by results of national immunization program （NIP） reviewed in 2004. Methods According to data from 4-vaccine coverage rates of NIP reviewed in 2004,3 levels could be set. We randomly selected 2 counties at each level and then 10 villages from each county with 42 children involved who were born between 1992 and 2003. ELISA quantitative method was used to test IgG of diphtheria antitoxin. Results （ 1 ） The positive rate of diphtheria antitoxin was only 49.6 % with the highest as 78.1% and lowest as 33.0 %. There was a significant decreasing trend of this positive rate with the increase of age. The highest（61.2 % ） fell in the group that were born in 2003 and the lowest（37.6 % ） was seen among children born in 1992 to 1995. （2）Geometric mean concentrations（GMCs） was only 0.48 IU/ml with a trend of decrease when age was increasing. There was no GMCs peak seen in children who were at the age of boosting, as expected. （3） Positive rates of children born between 2001 and 2003 were lower than 62 % while the diphtheria-pertussis-tetanus （DPT） vaccine coverage rates were all higher than 90%. （4）There was no significant difference of diphtheria antitoxin positive rates between children with eligible routine immunization （ 58.1% ） and those were ineligible （59.6 % ）. Conclusion Other than some specific ones, children from most of the investigated counties had a low level of antibody against diphtheria. The coverage rate of DPT vaccine did not necessarily reflect the immunity against diphtheria, suggesting the increase of immunity against diphtheria an urgent task to be taken care of.

关 键 词：白喉 疫苗 接种率 儿童 

分 类 号：R686[医药卫生—骨科学]