云南省保山市农村学生麻疹免疫现状分析及强化免疫效果评价  

Analysis on measles immunization status of rural students and estimation of effect of the supplementary immunization activities on measles vaccine in Baoshan of Yunnan Province

作　　者：张腾[1] 郑维斌[1] 李园园[1] 段生朝[1] 林冬梅[1] 马崇会[1] 马占钦[1] 李洪[2] 陆林[2] 

机构地区：[1]保山市疾病预防控制中心免疫规划科,云南保山678000 [2]云南省疾病预防控制中心,云南昆明650022

出　　处：《中华疾病控制杂志》2011年第7期586-589,共4页Chinese Journal of Disease Control & Prevention

摘　　要：目的调查农村小学生麻疹免疫现状,同时进行麻疹强化免疫并对其效果进行评价,提高农村学生麻疹免疫水平,探讨控制和消除麻疹的可行性。方法多阶段随机抽样,抽取2个县的2所农村完小(1～6年级都有的小学),再按年级分层抽样抽取302名小学生,对其进行接种证、卡的查验;并在强化免疫前后采集302名学生静脉血5 ml,检测免疫前后麻疹IgG抗体水平。结果强化免疫前,302名学生麻疹疫苗第1针接种率为85.8%,第2针接种率为74.8%,2针均完成占74.8%;麻疹IgG抗体阳性率、抗体保护率分别为88.7%、51.0%,麻疹抗体几何平均滴度(GMT)为1∶551;此外免疫针次直接影响抗体的水平。通过强化免疫,302名学生抗体阳性率为100%,抗体保护率为76.9%,较强化免疫前的抗体阳性率88.7%、保护率51.0%分别上升了11.3个百分点(P<0.001)、25.9个百分点(P<0.001);GMT由强化前的1∶551升至1∶746(P<0.05)。结论强化免疫前,保山市农村学生中仍然存在一部分麻疹免疫空白人群,同时相当一部分学生的免疫水平较低,未达麻疹IgG抗体保护水平。因而在做好农村地区学生麻疹血清学监测的基础上,适时开展强化免疫是消除麻疹有力的措施。Objective To investigate the measles immunization status in rural students, evaluate the effect of sup- plementary immunization activities （SIAs）, and to explore the feasibility of measles control and elimination. Methods Multi-stage random sampling was used to sample two primary schools of two towns from two counties, from which 302 students were sampled by stratified random sampling. Finally the measles immunization status and the effect of SIAs were determined by laboratory test and field survey. Results The vaccination rate of the first dose was 85.8 % , the vaccina- tion rate of the second dose was 74.8 % , and the vaccination rate of the two doses was 74.8 %. And measles IgG antibody positive rate was 88.7 % , protection rate was 51.0 % , geometric mean titer （GMT） was 1：551. Through the SIAs, the positive rate was greatly improved from 88.7 % to 100%; the antibody protection rate was improved from 51.0% to 76.9 % ; the two rate was improved by 11.3 percentage points （ P 〈 0. 001 ） and 25.9 percentage points （ P 〈 0.001 ） re- spectively. The GMT was improved from 1 ： 551 to 1 ： 746 （P 〈 0.05）. Conclusions Before the SIAs, the immunization level of students＇ measles antibody was weak. After the SIAs, the whole immunization level of students＇ measles antibody was significantly improved. So the proper SIAs implementation was necessary for elimination of measles on the basis of serological surveillance.

关 键 词：学生 麻疹 免疫接种 加强 

分 类 号：R181.1[医药卫生—流行病学] R272.22[医药卫生—公共卫生与预防医学]