2003和2005年东莞市托幼儿童乙型肝炎免疫状况调查

Immune State of Hepatitis B Among Preschool-age Children in Dongguan During the Period of 2000～2005

目的了解东莞市托幼儿童乙型肝炎免疫状况,评价防治效果,为制定防治对策提供科学依据。方法采用分层随机抽样方法,2003和2005年分别抽取东莞市五个镇区5所和4所村办幼儿园,每间幼儿园抽取大、中、小班各一个,被抽中班级的儿童均为调查对象,对各调查对象进行乙肝免疫状况调查。结果2003年和2005年,乙肝疫苗接种率分别为61.22%和93.18%,HBsAg携带率分别为1.48%和0.51%,抗-HBs阳性率分别为62.34%和67.42%;在只完成3针基础免疫的儿童中抗-HBs阳性率均较低,分别为57.22%和59.15%,而在有加强免疫史的儿童中,抗-HBs阳性率明显升高,加强了一针的托幼儿童中抗体阳性率分别为81.72%和76.31%,加强了二针或以上的托幼儿童抗体阳性率则分别达90.00%和92.86%;不同年份有相同免疫次数儿童的抗-HBs阳性率差异无显著性意义;抗-HBs阳性率有随免疫次数增加而增高的趋势。结论东莞市托幼儿童乙肝疫苗接种率2005年较2003年明显提高,HBsAg携带率已控制在较低的水平,两年的抗-HBs阳性率差异不显著。抗-HBs阳性率随免疫次数的增加而增高,建议抗-HBs阴性的儿童应进行加强免疫。

Objective To study the immune state of hepatitis B among preschool age children in the kindergartens of Dongguan, and to evaluate the protective effects after hepatitis B vaccination. Methods Stratified random sampling method was used in this cross - sectional study. Five district kindergartens and4 village kindergartens were sampled in 2003 and 2005 respectively, 3 classes from grade one to grade three were chosen and all of children in these classes were surveyed on the serum markers of hepatitis B by ELISA. Results The positive rate of HBsAg was 1. 48 % in 2003 and 0.51% in 2005. The total positive rate of anti- HBs was 62.34 % in 2003 and 67.42 % in 2005. The positive rate of anti- HBs among the children who received only initial vaccination was 57.22 % in 2003 and 59.15 % in 2005, but the positive rate increased significantly among those who received additional booster vaccination, which were 81.72% in 2003 and 76.31% in 2005, and 90.00% and 92.86% among those who had twice or more booster vaccination. There was no significant difference among those who received immunization in different years, but the positive rate of anti - HBs increased as the times of vaccination increased. Conclusions Among the kindergarten children of Dongguan, the rate of hepatitis B vaccine immunized in 2005 is higher than that in 2003, the positive rate of HBsAg is low, and the total positive rate of anti- HBs shows no statistically significant difference between these two years. The results suggest that it is necessary to have booster immunization in anti- HBs negative children.