儿童预防接种门诊疑似预防接种异常反应监测主动干预模式效果评价  

Evaluation on the effect of active intervention model for monitoring suspected abnormal vaccination response in children’s vaccination clinic

作　　者：刘世科[1] 王帆[1] 章海斌[1] 胡莉莉[1] 陈伟[1] 叶莉霞[2] LIU Shi-ke;WANG Fan;ZHANG Hai-bin;HU Li-li;CHEN Wei;YE Li-xia(Center for Disease Control and Prevention Ninghai County,Ninghai,Zhejiang 315600,China)

机构地区：[1]宁海县疾病预防控制中心,浙江315600 [2]宁波市疾病预防控制中心

出　　处：《现代预防医学》2021年第1期101-104,共4页Modern Preventive Medicine

基　　金：2017年宁海县社发类科技计划项目(200706);宁波市自然科学基金项目(2018A610407)。

摘　　要：目的探讨儿童预防接种门诊疑似预防接种异常反应(AEFI)监测工作主动干预措施干预效果,为制定提高AEFI监测质量工作模式提供科学依据。方法选择浙江省宁海县所有18家儿童预防接种门诊,在干预期(2016年9月至2018年8月)和非干预期(2018年9月至2019年8月)报告的肠道病毒71型(EV71)灭活疫苗(EV71灭活疫苗)引起的AEFI为研究对象。将研究对象随机分为干预组和对照组,在干预期AEFI监测过程中对干预组实施定期培训、业务指导、质量评价、质量考核、工作奖惩及对家长主动告知的主动干预措施。比较干预组及对照组在干预期和非干预期EV71灭活疫苗AEFI监测报告率差异,评价主动干预措施对EV71灭活疫苗AEFI监测工作报告率的影响效果,采用χ~2检验或χ~2连续校正进行统计学检验。结果干预期,干预组共主动观察EV71灭活疫苗1 753剂次,报告AEFI病例51例,报告率2 909.30/10万(51/1 753);对照组共主动观察1 126剂次,报告AEFI病例13例,报告率1 154.53/10万(13/1 126),主动监测AEFI报告率干预组高于对照组(χ~2=9.713,P=0.020)。干预组被动监测2 189剂次,报告AEFI病例12例,报告率548.20/10万(12/2 189);对照组被动监测1 485剂次,报告AEFI病例1例,报告率67.34/10万(1/1 485),被动监测AEFI报告率干预组高于对照组(χ~2=4.519,P=0.034)。干预期与非干预期被动监测结果比较,干预期AEFI被动监测共3 674剂次,报告AEFI病例数13例,AEFI报告率为353.84/10万(13/3 674);非干预期AEFI被动监测共观察11 287剂,报告AEFI病例数4例,AEFI报告率35.44/10万(4/11 287),被动监测AEFI报告率干预期高于非干预期(χ~2=22.032,P <0.001)。结论采取的主动干预工作模式可有效提高AEFI主动监测和被动监测报告的敏感性,提示对AEFI主动监测和被动监测工作实施主动干预措施十分必要。Objective To explore the intervention effect of active intervention measures in monitoring suspected abnormal vaccination response(AEFI)in children’s vaccination clinic,so as to provide scientific basis for the establishment of work mode to improve the quality of AEFI monitoring.Methods AEFI caused by EV71 inactivated vaccine reported in the intervention period(from September 2016 to August 2018)and the non-intervention period(from September 2018 to August 2019)was selected from all 18 children’s vaccination clinics in Ninghai County,Zhejiang Province.The subjects were randomly divided into intervention group and control group.In the process of AEFI monitoring,regular training,business guidance,quality evaluation,quality assessment,work rewards and punishments and active intervention measures were implemented for intervention group.The difference of AEFI monitoring report rate between intervention group and control group was compared,and the effect of active intervention on AEFI monitoring report rate of EV71 inactivated vaccine was evaluated.Results In the intervention group,a total of 1753 doses of EV71 inactivated vaccine were actively observed and 51 cases of AEFI were reported with a reporting rate of 2909.30/100000(51/1753).In the control group,1126 doses were actively observed and 13 cases of AEFI were reported with a reporting rate of 1154.53/100000(13/1126).The reporting rate of AEFIwith active observation in the intervention group was higher than that in the control group(χ2=9.713,P=0.020).In the intervention group,2189 doses of AEFI were monitored passively and 12 AEFI cases were reported with a reporting rate of 548.20/100000(12/2189).In the control group,1485 doses of AEFI were monitored passively and 1 AEFI case was reported with a reporting rate of 67.34/100000(1/1485).The reporting rate of AEFI with passive monitoring in the intervention group was higher than that in the control group(χ2=4.519,P=0.034).Comparing the results,there were 3674 times of AEFI passive monitoring during the interven

关 键 词：肠道病毒71型(EV71)灭活疫苗 疑似预防接种异常反应 主动干预模式 效果评价 

分 类 号：R186[医药卫生—流行病学]