合肥市适龄儿童麻疹疫苗强化免疫效果评价

Evaluate on effect of measles vaccine supplementary immunization activities among 8 months to 14 years children

目的了解合肥市适龄儿童麻疹疫苗(MV)强化免疫活动(SIA)效果及影响因素,为调整和实施消除麻疹策略提供参考。方法应用分层随机抽样法,选择合肥市社区疫苗接种门诊、幼儿园、小学、中学等作为研究点,分析8月龄～14岁儿童SIA前后麻疹抗体水平。SIA前后分别调查儿童340名和348名,应用描述统计方法,分析SIA前后麻疹流行状况。结果合肥市适龄儿童MV总体接种率为98.04%。SIA后麻疹抗体阳性率、几何平均滴度(GMT)均上升,麻疹抗体阳性率为91.38%。1～4岁组、≥3次免疫史者GMT分别为最高,Logistic多元回归分析显示,1次免疫史者抗体保护水平低。2010年麻疹发病率为0.81/10万,较2009年下降91.86%,发病年龄以婴儿为主,≥2次免疫史者病例构成比最低。结论在麻疹逐渐减弱流行阶段,需要规范适龄儿童首剂次、2剂次MV常规免疫,开展必要强化免疫,加强免疫规划和病例监测质量管理。

Objective To analyze the effect and influencing factors of Measles Vaccine（MV） Supplementary Immunization Activities（SIA） among 8 months to 14 years children in Hefei,monitor status of population immunization and epidemic disease.Methods Measles Vaccine SIA was implemented among 8 months to 14 years children all over the city in October 2009.A stratified random sampling method was adopted to focus study on community vaccination clinics,kindergartens,elementary schools and middle schools,analyze the antibody level of the target population before and after SIA.Study epidemic status of measles cases before and after SIA with statistical description method.Results The total rate of MV vaccination was 98.04%.Measles antibody positive rate and the GMT level rose after SIA and measles antibody positive rate was 91.38%.The GMT level of 1-4 years children and≥3 MV doses individuals were the highest,respectively,logistic multiple regression analysis revealed significant difference between the GMT level of ≥3 MV doses and one MV dose individuals.The measles incidence was 8.1 per million in 2010,decreased 91.86% compared with that of 2009.The largest number of cases occurred among 1 years children,the proportion of cases with ≥2 MV doses were the lowest.Conclusion In the epidemic stage of measles gradually reduction,important aspects of measures are the regulation of routine vaccination of 1 dose and 2 doses MV targeting children timely,the conducting of MV supplementary immunization activities at suitable time.Strengthening the quality management of immune programming and cases monitoring are also the critical factors.