2016—2018年上海市闵行区手足口病EV71疫苗免疫接种的卫生经济学评价  

Health and economic evaluation of entervirus 71 vaccine immunization on HFMD in Minhang District of Shanghai from 2016 to 2018

作　　者：徐智寅[1] 汪曦[1] 张莉萍[1] 吕静 李旭成 刘念 陆佳[1] 苏华林[1] 曾玫[2] 吴敏[1] XU Zhi-yin;WANG Xi;ZHANG Li-ping;Lü Jing;LI Xu-cheng;LIU Nian;LU Jia;SU Hua-lin;ZENG Mei;WU Min(Minghang Center for Disease Control and Prevention,Shanghai 201101,China;Pediatric Hospital of Fudan University,Shanghai 201101,China)

机构地区：[1]上海市闵行区疾病预防控制中心,上海201101 [2]复旦大学附属儿科医院,上海201102

出　　处：《上海预防医学》2021年第5期404-409,共6页Shanghai Journal of Preventive Medicine

基　　金：上海市闵行区自然科学基金课题(2018MHZ012)。

摘　　要：【目的】了解EV71疫苗对上海市闵行区手足口病(HFMD)的干预效果,评价免疫接种EV71疫苗的卫生经济效益,为制定HFMD疫苗免疫防控策略提供参考依据。【方法】采用描述性分析和成本效益法,比较EV71疫苗干预前后HFMD流行病学特征变化。结合HFMD发病资料、疾病负担和EV71疫苗接种情况进行成本效益评价。【结果】闵行区2017—2018年HFMD发病率为202.17/10万,较前6年下降43.8%(χ^(2)=395.49,P<0.05);重症发生率为0.06%,较前6年均值下降88.7%(χ^(2)=40.84,P<0.05)。2017—2018年门诊病例EV71型阳性率为2.56%(18/704),较前6年均值下降88.2%(χ^(2)=124.74,P<0.05);重症病例仍以EV71型感染为主(84.5%~100.0%)。EV71疫苗人均接种成本526元,是HFMD人均就诊费用的30.2%。2016—2018年闵行区EV71疫苗的接种率达40.12%,投入为1748.93万元,减少HFMD发病2491例、减少住院病例232例、减少重症病例54例,效益成本比为0.35∶1。【结论】EV71疫苗干预措施,不仅能降低HFMD发病率和重症死亡率,且能减轻患儿家庭就医负担。建议未来减免疫苗接种费用,提高疫苗接种覆盖率。[Objective]To investigate the prevention and control effect of hand,foot and mouth disease(HFMD)after entervirus(EV)71 vaccine immunization,evaluate economic benefit of EV71 vaccine immunization,and provide evidence for developing HFMD vaccine immunization strategies.[Methods]Descriptive analysis was performed on comparing epidemiological characteristics of HFMD before and after EV71 vaccine immunization.Cost-benefit analysis was conducted,in which disease burden of HFMD,coverage of EV71 vaccine immunization,and costs of EV71 vaccine immunization were collected to evaluate the benefit-cost ratio(BCR).[Results]The average incidence of HFMD was 202.17/10 million from 2017 to 2018,which decreased by 43.8%compared with the average of the previous six years(χ^(2)=395.49,P<0.05);the average proportion of severe case decreased by 88.7%(χ^(2)=40.84,P<0.05).The prevalence of EV71 in the outpatients from 2017 to 2018 were 2.56%(18/704),which decreased by 88.7%compared with the previous six years(χ^(2)=124.74,P<0.05).The severe and fatal cases were mainly caused by EV71(84.5%-100.0%).The average cost of EV 1 vaccine immunization was RMB 526,which was approximately 30.2%of the average cost of HFMD diagnosis and treatment.Coverage of EV71 vaccine was 40.12%from 2017 to 2018 in Minhang.The total costs of EV71 vaccination in Minghang from 2016 to 2018 was 174.89 million RMB.It was estimated that EV71 vaccination strategies had prevented 2491 outpatients,232 ordinary inpatients and 54 severe cases.The BCR was determined to be 0.35∶1.[Conclusion]EV71 vaccine may reduce the incidence of HFMD,the incidence of severe cases,and the disease burden.It is highly recommended to reduce the immunization costs to increase the immunization coverage.

关 键 词：手足口病 EV71疫苗 免疫接种 防控效果 经济效益 

分 类 号：R183[医药卫生—流行病学]