提高贫困地区新生儿乙肝疫苗首针及时接种率服务模式研究  

Study on results of immunization service model of improving the timeliness coverage of the first dose of hepatitis B vaccine among newborns in the poor area

作　　者：孙莲英[1] 曾昭长[1] 符振旺[1] 莫永强[2] 蔡开宁 李文师 邓海英[1] 曾雪霞[1] 

机构地区：[1]海南省疾病预防控制中心,海南海口570203 [2]定安县疾病预防控制中心,海南定安571200 [3]白沙县卫生防疫站,海南白沙572800 [4]保亭县疾病预防控制中心,海南保亭572300

出　　处：《中国热带医学》2007年第10期1740-1742,共3页China Tropical Medicine

基　　金：海南省自然科学基金课题

摘　　要：目的探讨提高贫困地区新生儿首针乙肝疫苗及时接种率的免疫服务模式。方法采用不同的免疫服务模式,分别由不同的接种人员采用不同的方式为不同的接种对象提供首针乙肝疫苗接种服务,分析比较不同服务模式对提高贫困地区新生儿首针乙肝疫苗及时接种率的效果。结果项目实施后,预充疫苗组和常规疫苗组乙肝疫苗首针及时率较项目前均有了较大幅度的提高,前者明显高于后者(χ2=16.03,P<0.01);在家分娩新生儿由村医接种者及时接种率高于乡级防保员接种者,使用预充疫苗者高于常规疫苗者(χ2=20.09,P<0.01;χ2=16.03;P<0.01);筛查阳性孕妇分娩新生儿乙肝疫苗首针及时接种率为94.4%,远高于未筛查组(χ2=26.51,P<0.01)。结论采用自毁型预充式乙肝疫苗,并且在冷链外存放,由村医负责首针乙肝疫苗接种是提高在家分娩新生儿乙肝疫苗首针及时接种率的最佳服务模式。开展孕妇筛查对阳性母亲所生新生儿及时接种乙肝疫苗,能阻断母婴传播和减少接种后发生异常反应的风险,是值得进一步探讨的课题。Objective To evaluate the results of immunization service model and look for a new model to improve timeliness coverage of the first dose within 24 hours after birth in the poor area. Methods The efficacy of different immunity service model carried out by different injector for different targets in poor area were compared. Results The timeliness coverage of the first - dose of hepatitis B vaccine increased obviously since the implementation of the research prject , the timeliness coverage of the UnijectTM hepatitis B vaccine group was higher than that of the routine hepatitis B vaccine group, the village doctor group was higher than the other group among the non- hospital delivering newborns, the screening group higher than the non - screening group, showing significant difference（x^2= 16.03, P 〈0.01;x^2=20.09, P 〈0.01;x^2=26.51, P 〈0.01）, respectively. Conclusion The newborns delivered at home and immunized with UnijectTM hepatitis B vaccine stored outside cold chain by the village dootor is the optimal model; the strategy of screening pregnant women and immunization of children born by HBsAg positive mothers with Hepatitis B vaccine can interrupt the vertical transmission of hepatitis B and reduce the risk of abnormal reactions after vaccination.

关 键 词：乙肝疫苗 服务模式 及时接种率 新生儿 贫困地区 

分 类 号：R373.2[医药卫生—病原生物学]