2004年全国计划免疫审评不同免疫覆盖率县的儿童麻疹抗体水平调查

Investigation on Immunity of Measles in Children In Counties With Different 4 Vaccine Coverage Rates-National Immunization Programme Review in 2004

目的掌握2004年全国计划免疫审评不同免疫覆盖率县的儿童麻疹抗体水平。方法根据2004年全国计划免疫审评四种疫苗免疫覆盖率不同的县分为3层，每层随机抽取2个县，每个县随机调查10个村，每村随机调查1992-2003年出生儿童42名。酶联免疫吸附试验（ELISA）定量法检测麻疹IgG抗体。结果①被调查儿童麻疹抗体平均阳性率为92．9％，最低年龄段为88．7％，最高年龄段为94．4%；抗体几何平均浓度（GMC）为1．23国际单位／毫升（IU／ml），GMC随着年龄的增长总体呈明显的下降趋势。②四种疫苗不同免疫覆盖率县的不同年龄段儿童麻疹抗体阳性率相差较大，最高的为100．0％，最低的仅为78．6％。③2004年全国计划免疫审评调查儿童的麻疹抗体阳性率分别为92．2％、92．4％、88．7％。④麻疹抗体阳性率与此次接种率调查结果明显的不一致。⑤麻疹减毒活疫苗（MV）初次免疫合格和不合格儿童之间的麻疹抗体阳性率差异无显著的统计学意义。结论被调查地区儿童麻疹抗体阳性率低于世界卫生组织西太平洋区消除麻疹队列人群免疫力95％的指标，麻疹抗体GMC总体保持在较高水平。儿童MV的接种率不能客观反映儿童麻疹的抗体水平。

Objective To investigate the immunity level of measles antibody of children at different 4-vaccine coverage levels stratified by the National Immunization Program（NIP）review in 2004. Method According to the 4-vaccine coverage rates of NIP review in 2004,there are 3 levels. We selected 2 counties in each level, 10 villages in each selected county and investigated 42 children born from 1992 to 2003. We used ELISA quantitative method to test IgG of measles. Results ① Investigated average positive rate of measles antibody is 92. 9 ~, this rate is 88.7 % in youngest age group and 94. 4% in oldest age group. The GMC is 1.23IU/mL with a trend of decreasing as age＇s increasing. The certificate rate are respectively 66. 5% and 75.3%. ② Positive rates of measles in different aged children vary a lot in counties at different levels of 4-vaccine coverage rates, with the highest as 100 % and lowest as 78.6 %. ③ Positive rates of children investigated by NIP review in 2004 are respectively 92.2% ,92.4%, and 88. 7%. ④ Positive rates of measles accord with those from NIP review in 2004, however, they are obviously different from coverage rates numerically. ⑤ There is no significant difference of measles antibody positive rates between children with eligible routine immunization and those with ineligible one. Conclusions Positive rates of measles in investigated children are lower than 95% which is the target of WPR＇s measles elimination initiation. The GMC of them is generally high. Coverage rate of measles vaccine can not reflect children＇s immunity from measles.