上海市青浦区民工子弟学校新生强化免疫前麻疹血清流行病学横断面调查

A cross-sectional study on measles serological epidemiology of freshmen in schools for children of migrant workers before the supplementary immunization in Qingpu District,Shanghai

目的掌握上海市青浦区民工子弟学校新生强化免疫前的麻疹免疫水平。方法采用多阶段抽样方法，抽取民工子弟学校新生606名，采用定量ELISA测定调查对象血清中的麻疹IgG抗体水平，同时调查就学史、麻疹相关疫苗接种史、麻疹患病史等情况。结果民工子弟学校新生强化免疫前麻疹IgG抗体几何平均浓度（geometric mean of concentration，GMC）为998．96mIU／mL（95％CI，912．93～1093．10），阳性率为94．88％。不同学校类别（幼托、小学、初中）对象的GMC差异无统计学意义（F=1．19，P=0．30），抗体阳性率差异无统计学意义（X^2=0．36，P=0．83）；不同就学史（此前无就学史、于户籍地就学、于上海其他学校就学）对象的GMC差异无统计学意义（F：1．22，P=0．30），抗体阳性率差异无统计学意义（X^2=3．46，P=0．18）；38。29％调查对象无预防接种证或已经丢失，麻疹相关疫苗接种≥2剂次者占37．95％，接种史不详者占48．18％，不同接种史对象的GMC差异无统计学意义（F=0．75，P=0．53）。结论上海市青浦区民工子弟学校新生强化免疫前麻疹抗体水平及抗体阳性率均处于较高水平，但不能提供明确麻疹疫苗接种史是其中一个突出问题，预防接种证的管理和入托／入园、入学接种证查验工作是外来民工子弟学校学生免疫规划工作的薄弱环节。

Objective To understand the measles immune state of freshmen in schools for children of migrant workers in Qingpu District before the supplementary immunization. Methods A sample of 606 freshmen from schools for children of migrant workers was recruited by multi-stage sampling. The measles IgG antibodies of serum samples were tested by quantitative ELISA. Meanwhile, the information was investigated such as education history, immunization, measles history, etc. Results The geometric mean of concentration （GMC） of measles IgG antibodies was 998.96 mlU/mL （95% CI, 912.93 - 1093. t 0）, with the positive rate of 94.88%. The GMC （F = 1.19, P = 0.30） and the positive rates （X2 = 0. 36, P = 0. 83） among kindergarten, primary school and junior middle school had no statistical significance. The difference of GMC （F = 1.22, P = 0.30） and positive rates （Z2 = 3.46, P = 0.18） between students with different educational histories （no educational history, educational history in place of domicile or Shanghai） had no statistical significance. Meanwhile,38.29% of freshmen didn＇t have or had lost their immunization record,37.95% of freshmen had been inoculated with at least 2 doses of measles vaccine,and 48.18% of freshmen couldnrt confirm their immunization history. There was no statistical significance to compare their GMC with different immunization history （F = 0.75,P = 0.53）. Conclusions The freshmen in schools for children of migrant workers in Qingpu District had a high measles immune level and positive rate before the supplementary immunization. Meanwhile, it was an outstanding problem that most of them couldn‘t provide a clear history of measles vaccination. The management of immunization record and the work of checking the immunization record before education were obviously weak links of the immunization work in schools for children of migrant workers.