社区儿童感染乙型肝炎病毒危险因素病例对照研究

A community-based case-control study for risk factors of hepatitis B infection in children

目的分析儿童乙型肝炎病毒(HBV)感染的危险因素,为降低其感染率提供依据。方法采取多阶段随机抽样方法抽取1～20岁常住儿童及青少年,对其乙肝疫苗接种情况及主要乙肝感染危险因素等进行问卷调查,并采集静脉血检测乙肝血清学指标,按是否感染HBV分为病例组和对照组,进行单因素分析并拟合多因素Logistic回归模型。结果 366名调查对象中感染HBV70例,感染率为19.12%;经单因素和多因素分析,密接者HBsAg状况、乙肝疫苗接种史、出生地点是影响儿童感染HBV的危险因素。结论当前降低HBV感染率的工作重点在于发现HBsAg阳性孕妇并建议其到较好的医院分娩,同时改善卫生状况较差的地区特别是农村儿童乙肝疫苗接种状况。

Objective To study the risk factors of hepatitis B infection in children and provide evidence for decreasing the infection rate.Methods A multistage randomized cluster sampling was used and the subjects were at age 1 to 20 years old.Every study subject＇s HepB immunization history and main risk factors were investigated through questionnaire.Venous blood samples were collected and then tested for HBV infection markers.The subjects were divided into study group and control group by their status of HBV infection.Univariate analysis and multivariate logistic regression analysis were used to identify the risk factors of HBV infection among children.Results Out of 366 children,70 of them were infected by HBV with the infection rate of 19.12%.Data from both univariate and multivariate analysis showed that the HBsAg status of their close contacts,the history of hepatitis B vaccination and place of birth appeared to be risk factors of hepatitis B infection.Conclusion The focus of decreasing the hepatitis B infection rate should be on the finding of HBsAg positive pregnant women,and encourage them to give birth in better hospitals,and at the mean time,try to improve the hepatitis B vaccination rate of the children especially in country areas.