2013年至2020年大理白族自治州8月龄至14岁儿童乙型肝炎血清流行病学调查  

Seroepidemiological survey of hepatitis B among children aged eight months to 14 years in Dali Bai Autonomous Prefecture, 2013-2020

作　　者：刘彦君 赵红梅 杨晓炜 谢潇潇 管芳 Liu Yanjun;Zhao Hongmei;Yang Xiaowei;Xie Xiaoxiao;Guan Fang(Immunization Program Department,Dali Bai Autonomous Prefecture Center for Disease Control and Prevention,Dali 671000,Yunnan Province,China)

机构地区：[1]大理白族自治州疾病预防控制中心免疫规划科,大理671000

出　　处：《中华传染病杂志》2023年第12期768-772,共5页Chinese Journal of Infectious Diseases

摘　　要：目的分析大理白族自治州8月龄至14岁儿童的乙型肝炎疫苗(HepB)接种情况和免疫水平,以评价免疫预防控制效果。方法采用分层整群抽样方法对2013年至2020年4个年龄组(8~17月龄、18~35月龄、3~6岁、7~14岁)的17236名来自大理白族自治州所辖12个县(市)的儿童开展问卷调查和血清采集,以酶联免疫吸附测定(ELISA)法检测血清乙型肝炎表面抗原(HBsAg)和乙型肝炎表面抗体(抗-HBs)。统计学方法采用Spearman秩相关分析和χ2检验。结果纳入儿童的HepB接种率、及时接种率、全程接种率分别为98.78%(17025/17236)、84.13%(14500/17236)、97.69%(16838/17236),HBsAg和抗-HBs阳性率分别为0.28%(49/17236)和70.57%(12164/17236)。2013年至2020年,HepB接种率、及时接种率和全程接种率呈逐年上升趋势。8~17月龄组的及时接种率[88.64%(3989/4500)]和抗-HBs阳性率[92.78%(4175/4500)]最高,年龄与抗-HBs阳性率呈负相关(rs=-0.427,P<0.001)。男童HepB接种率、全程接种率、HBsAg阳性率均高于女童,农村儿童HepB接种率、及时接种率、全程接种率均高于城镇儿童,少数民族儿童HepB接种率、全程接种率和抗-HBs阳性率均高于汉族儿童,差异均有统计学意义(χ2=4.41、6.05、0.92,51.75、4.81、33.20,29.44、11.83、5.04,均P<0.05)。有HepB免疫史、及时接种和全程接种HepB儿童的抗-HBs阳性率均高于无HepB免疫史、未及时接种和未全程接种儿童,差异均有统计学意义(χ2=64.67、65.46、13.39,均P<0.001)。结论大理白族自治州大年龄组儿童的抗-HBs阳性率下降。应在做好常规免疫工作的同时,加强监测、强化查漏补种,并探索大龄儿童的HepB接种,以巩固免疫屏障。Objective To analyze the hepatitis B vaccine(HepB)vaccination rate and immune level among children aged eight months to 14 years in Dali Bai Autonomous Prefecture,and to evaluate the effect of immune prevention and control.Methods A stratified and cluster sampling was designed to survey and collect serum samples of the 17236 cases from 12 counties(cities)in Dali Bai Autonomous Prefecture.The cases were divided into four age groups(eight to 17 months,18 to 35 months,three to six years,seven to 14 years).Serum levels of hepatitis B surface antigen(HBsAg)and hepatitis B surface antibody(anti-HBs)were detected by enzyme linked immunosorbent assay(ELISA).Statistical analysis was conducted by Spearman rank correlation analysis and chi-square test.Results The overall HepB vaccination rate,timely vaccination rate,and full course vaccination rate among 17236 children were 98.78%(17025/17236),84.13%(14500/17236)and 97.69%(16838/17236),respectively.The positive rates of HBsAg and anti-HBs were 0.28%(49/17236)and 70.57%(12164/17236),respectively.From 2013 to 2020,the trend of the vaccination rate,timely vaccination rate,and full vaccination rate of HepB increased year by year.The timely vaccination rate(88.64%(3989/4500))and the positive rate of anti-HBs(92.78%(4175/4500))were the highest at the age of eight to 17 months.Age was negatively correlated with the positive rate of anti-HBs(rs=-0.427,P<0.001).The vaccination rate,full course vaccination rate,and positive rate of HBsAg in males were higher than those in females(χ2=4.41,6.05 and 0.92,respectively,all P<0.05),while the vaccination rate,timely vaccination rate and full course vaccination rate in rural areas were higher than those in urban areas(χ2=51.75,4.81 and 33.20,respectively,all P<0.05).The vaccination rate,full course vaccination rate and the positive rate of anti-HBs in minority nationality were higher than those in Han nationality(χ2=29.44,11.83 and 5.04,respectively,all P<0.05).The differences were all statistically significant.The positive rates of anti-

关 键 词：乙型肝炎 乙型肝炎表面抗原 乙型肝炎抗体 乙型肝炎疫苗 

分 类 号：R512.62[医药卫生—内科学]