婴儿出生后24小时内乙型肝炎疫苗低接种率的原因及居民教育

The Factors Affecting the Low Coverage Rate of Hepatitis B Vaccine at Birth and the Role of Health Education in Gansu Province,China

为防止乙型肝炎 (乙肝 )病毒 (HBV)母婴传播 ,婴儿出生后 2 4h内接种乙肝疫苗 (HepB)非常重要 ,但其接种率很低。为探讨接种率低的原因及其对策 ,在甘肃省访问了承担预防接种的工作人员 ,并对婴儿家长及乡村医生进行了小组访谈。调查结果显示 ,几乎所有婴儿家长对乙肝知识了解甚少或有错误。本次调查中 ,2 4h内接种HepB的婴儿全部在医院出生 ,2 4h内未接种的全部在家出生。即使及时接种的婴儿家长亦不知 2 4h内接种HepB的重要性 ,只不过是因为在医院出生才偶然做到了 2 4h内接种。另外 ,在家分娩且非乡村医生接生时 ,婴儿家长即使知道 2 4h内接种的重要性 ,但如不及时通知乡村医生 ,乡村医生也不能及时到家接种。因此 ,为提高婴儿出生后 2 4h内HepB接种率 ,对婴儿家长的宣传教育 ,特别是对孕妇和新婚夫妇的教育非常必要。

The first dose of hepatitis B vaccine within 24 hours after birth is very important to prevent vertical transmission of hepatitis B virus from mother to her child. To understand the reasons for low coverage rate of the first dose,the semi-structured face-to-face interviews with immunization managers,the focus group discussions with parents of the children and with village doctors were conducted. It was found that most of the parents had very limited knowledge about hepatitis B and its prevention. Although all children who were born at hospitals received the birth dose,their parents did not know about the necessity of the first dose within 24 hours before,which means if a mother could not go to a hospital for some reasons,her baby would most likely not to be vaccinated. It is often said that to improve the coverage rate it is necessary to promote the institutional delivery,however,the results of this study suggest that this is not enough. Parents should know about the hepatitis B vaccination at birth before a baby is born and this is critical if the baby is born at home assisted by other than village doctor. Therefore,health education,especially targeting parents,is the key to increase the coverage rate of the birth dose.