移民城市农民房居民区儿童麻疹疫苗漏种情况与发病的关系

Study on Relationship between Characteristics of Missing Immunization for Measles Vaccine and the Incidence of Measles among Children in Residential Areas for Farmers Housing in Immigrant City

目的了解移民城市农民房居民区儿童麻疹疫苗(麻苗)漏种特征与发病的关系,为制定麻疹预防控制措施提供科学依据。方法采用现场抽样调查和对麻疹病例电话调查的方法,对深圳市19个社康中心辖区内的553名儿童的调查资料进行描述流行病学分析。结果553名儿童中麻苗漏种率高达22.78%。l针漏种率为20.61%,2针漏种率为2.17%。在深圳居住时间<3个月外来儿童的漏种率高达30.99%,而深圳户籍的常居儿童麻苗漏种率仅为6.67%,RR为4.65,P<0.01。全部漏种儿童中的无证率为19.84%。其中,在深圳居住<3个月儿童的无证率为50.00%。麻苗漏种率最高的大浪街道,其儿童麻疹发病率也显著地高于其他漏种率低的街道。<8月龄未到麻苗初种年龄儿童,麻疹发病数占全部儿童病例数的36.36%。结论移民城市农民房居民区外来儿童是麻苗漏种的高危险人群;其漏种原因与其移居深圳时间短,未能及时获得预防接种证有关。因此认为,提高农民房居民区儿童,尤其是提高来深圳居住时间<3个月外来儿童的预防接种证及时办证率和加大麻苗查漏补种的频率,同时对妊娠前妇女进行一针麻苗强化免疫是有效降低这一高危险人群麻疹发病率的关键措施。

[ Objective] To understand the relationship between characteristics of missing immunization for measles vaccine and the incidence of measles at residential areas for farmers housing in immigrant city, so as to provide scientific evidence for the formulation of measures on prevention and control of measles. [ Methods] The methods of sampling survey on residential areas and telephone survey on measles cases were implemented. The epidemiologieal survey was performed on 553 children in the area where 19 community health center located. [ Results] Of 553 children, the missing immunization rate of measles vaccine was 22.78%. The missing immunization rate of 1 dose and 2 doses were 20.61% and 2.17%, respectively. The missing immunization rate among migrant children and among the local children under 3 months in Shenzhen City were 30.99% and 6.67% , respectively, RR was 4.65, P 〈0. 01. The rates of no establishing certificates among all children was 19.84 % and among the migrant children under 3 months in Shenzhen City was 50.00 %. The population of residential areas with the highest missing immunization rate of measles vaccine also had significandy higher incidence of measles than the population of residential areas with low the missing immunization rate of measles vaccine. Children, under 8 months, with measles, who had not yet reached the age of measles vaccination accounted for 36.36% of total measles cases of children. [ Conclusion] The immigrant children in residential areas for farmers housing in immigrant city is the population with high risk for missing immunization of measles vaccine. The reasons for missing immunization are short living time in Shenzhen and failing to obtain certificate of vaccination timely. Therefore, to improve the rates of establishing certificates of vaccination and enhance the frequency of supplementary immunization activities for children in residential areas for farmers housing, especially for the immigrant children living in Shenzhen less than 3 months, and to inoculate 1 dose of measles vaccine among women of pre-pregnancy are the key measures to reduce the incidence of measles for this population with high risk of measles.