天津市百日咳流行病学特征及相关因素分析

Epidemiology of pertussis and related factors in Tianjin city

目的了解天津市百日咳流行病学特征及相关影响因素。方法利用描述流行病学方法对历年百日咳疫情资料进行分析,应用酶联免疫吸附试验对社区人群抗体水平进行定量检测。结果天津市从1953-2009年百日咳年平均发病率为63.02/10万,流行周期为3～5年。每年以春夏季高发。高发人群以散居儿童为主,成年人发病构成比呈增加趋势。流动人口发病所占比例逐年增高。百白破疫苗报告接种率与百日咳发病率呈负相关(r=-0.842)。白喉、破伤风类毒素和无细胞百日咳疫苗(DTaP)中百日咳免疫成功率为73.33%。2007年、2009年百日咳抗体阳性率分别为66.42%和47.11%,<7岁人群抗体阳性率显著低于≥7岁组人群,差异有统计学意义。结论天津市随着疫苗接种率的提高,百日咳发病率逐年下降。为防止天津市百日咳的再现,应进一步做好适龄儿童的免疫接种、有效接种,适时调整百日咳免疫策略。同时应积极开展百日咳社区监测工作,提高百日咳的报告率和确诊率。

Objective To analyze the epidemiological characteristics and related factors of pertussis in Tianjin and provide evidence for the prevention and control of pertussis. Methods The descriptive epidemiological analysis was conducted on the data of pertussis from national notifiable communicable diseases reporting system. The IgG antibody to pertussis among community population was tested quantitatively by ELISA. Results The average annual incidence of pertussis was 63.02/lakh from 1953 to 2009, the epidemic cycle was 3 -5 years. Most pertussis cases occurred in spring and in summer of a year, which were mainly distributed in children. The proportion of pertussis cases in adult showed a increase trend and the proportion of pertussis cases in floating population increased too. The reported DPT vaccination rate was negatively correlated with the incidence of pertussis （ r = - 0. 842 ）. The seroconversion rate to pertussis antigen was 73.33% by DTaP vaccination. The positive rate of IgG against pertussis was 66. 42% in 2007and 47. 11% in 2009. The positive rate of IgG against pertussis in children aged 〈 7 years was lower than that in children aged 〉 7 years （ P 〈 0. 001 ）. Conclusion The incidence of pertussis decreased as the expansion of vaccination coverage in Tianjin. In order to prevent the reemergence of pertussis in Tianjin, it is necessary to improve the vaccination of purtussis in eligible children, revise immunization strategy in time, strengthen the surveillance of pertussis in community and increase the reporting rate and diagnosis rate of pertussis.