选择性普种Vi疫苗控制伤寒地方性流行效果  

Analysis of effectiveness of selective mass vaccination with Typhoid Vi vaccine in the control of endemic typhoid

作　　者：房天喜 杨宏徽[2] 马小磊 唐昌新 寇玉秀 杨进[2] 

机构地区：[1]全州县卫生防疫站,广西全州541500 [2]广西壮族自治区疾病预防控制中心,广西南宁530021

出　　处：《中国热带医学》2009年第5期792-793,864,共3页China Tropical Medicine

摘　　要：目的评估全州县选择性群体预防接种对伤寒的影响。方法以全州县整个人群为基础。用被动监测法获得的血培养细菌阳性的伤寒病例为研究对象，并以细菌阳性的甲型副伤寒病例作对照，以控制除伤寒Vi预防接种以外的其他混杂因子的干扰，分析使用Vi疫苗后对伤寒发病率的影响。结果1995-1999年全州县学生接种覆盖率为42．2％时，观察到在学生及其他人群中伤寒的发病率均有下降。2000～2004年学生累积接种率为80.3％时，伤寒发病率急剧下降，学生的伤寒发病率比1995～1999年平均下降了97％（P〈0．001），其他人群也下降了84％。从2001年后。全县无伤寒爆发疫情，同时也观察到副伤寒甲病例明显上升。结论选择性对高危人群进行大规模免疫的方案表明伤寒Vi预防接种有高效率，而且能产生明显的群体免疫和群体保护效应。Objective To assess the effectiveness of selective mass vaccination with Vi vaccine in the control of endemic typhoid in Southwest China in a ten-year period. Methods Population-based studies in Quanzhou County with more than 760,000 residents using passive surveillance of confirmation by blood culture of typhoid cases were carried out with confirmed paratyphoid A cases as reference aimed at getting rid of the interfering factors. The influence of typhoid incidence after Vi vaccination was also analyzed. Results The vaccination coverage in students in Quanzhou in 1995- 1999 was 42.2%. A decline in disease rates was observed. When the Vi vaccination coverage reached to 80.3% in 2000- 2004. A drop of typhoid incidence of by 97% in student was observed as compared to that in 1995-1999. The incidence also decreased by 84% in other population. At the same period the paratyphoid A incidence had increased. Conclusion This selective mass immunization program in students in Quanzhou demonstrates that effectiveness of Vi vaccination can be achieved and also marked herd protection in other population can also be atained.

关 键 词：伤寒Vi疫苗 伤寒 副伤寒甲 选择性普种 群体保护力 

分 类 号：R576.3[医药卫生—消化系统]