杭州市儿童接种b型流行性感冒嗜血杆菌多糖结合疫苗影响因素的调查分析

Influencing Factors of Haemophilus Influenzae Type b Polysaccharide Conjugate Vaccine Vaccination in Children in Hangzhou City

目的探讨影响杭州市儿童接种b型流行性感冒嗜血杆菌（Haemophilus influenzae Type b,Hib）多糖结合疫苗（Polysaccharide Conjugate Vaccine）（Hib疫苗）的因素,提出促进儿童接种Hib疫苗的策略。方法采用多级抽样方法,对杭州市4个区（县）458名儿童家长开展接种Hib疫苗影响因素的问卷调查。结果 458名儿童Hib疫苗接种率为55.68%。将是否接种Hib疫苗进行单因素分析,户籍为常住儿童[比值比（Odds Ratio,OR）=0.634,95%可信区间（Confidence Interval,CI）：0.437-0.918,P=0.016]、参加医疗保险（OR=0.580,95%CI：0.393-0.856,P=0.006）、母亲文化程度高（OR=0.631,95%CI：0.435-0.915,P=0.015）、家庭人均年收入高（OR=0.484,95%CI：0.305-0.768,P=0.002）、收到接种Hib疫苗的告知（OR=0.196,95%CI：0.156-0.244,P〈0.001）、知晓Hib可引起多种疾病（OR=0.055,95%CI：0.031-0.097,P〈0.001）、知晓Hib疫苗（OR=0.031,95%CI：0.018-0.052,P〈0.001）是接种Hib疫苗的促进因素,而Hib疫苗价格高（OR=1.980,95%CI：1.311-2.994,P=0.001）是接种Hib疫苗的阻碍因素。在单因素分析的基础上,进行非条件逻辑斯谛回归分析,户籍为常住儿童（OR=0.512,95%CI：0.3-0.876,P=0.015）、收到接种Hib疫苗告知（OR=0.218,95%CI：0.094-0.505,P〈0.001）是接种Hib疫苗的促进因素,而Hib疫苗价格高（OR=1.403,95%CI：1.116-1.894,P=0.036）是接种Hib疫苗的阻碍因素。结论影响杭州市儿童接种Hib疫苗的因素主要有户籍、家长是否收到接种Hib疫苗的告知、Hib疫苗的价格等。

Objective To determine factors affecting Haemophilus Influenzae Type b （Hib） Polysaccharide Conjugate Vaccine vaccination of children in Hangzhou, and to provide some strategies to promote Hib Pol- ysaccharide Conjugate Vaccine vaccination. Methods Using a multistage sampling method and a standard- ized questionnaire,458 parents from four districts in Hangzhou were surveyed about influencing factors of Hib Polysaccharide Conjugate Vaccine vaccination. Results Among 458 children, the vaccination rate for Hib Polysaccharide Conjugate Vaccine vaccination was 55.68%. Univariate analysis was used to determine characteristics of those who received Hib Polysaccharide Conjugate Vaccine. Being a resident child [ Odds Ratio （OR） = 0. 634,95% Confidence Interval （CI） ：0. 437 - 0. 918, P = 0. 016 ], having health insurance （OR = 0. 580, 95% CI：0. 393 - 0. 856, P = 0. 006 ）, having an educated mother （ OR = 0. 631, 95 % CI： 0. 435 -0. 915, P =0. 015 ）, residing in a family with a high income（ OR =0. 484,95% CI：0. 305 -0. 768 ; P =0.002）, having received a Hib Polysaccharide Conjugate Vaccine notification（OR =0. 196,95% CI： 0. 156 -0. 244, P 〈0. 001 ）, knowing that Hib could cause many diseases（ OR =0. 055,95% CI：0. 0310. 097,P 〈0. 001 ）, and knowing the effectiveness of Hib Polysaccharide Conjugate Vaccine （OR = 0. 031,95% CI： 0. 018 - 0. 052, P 〈 0. 001 ） were significant motivations for Hib vaccination. The high price of Hib Polysaccharide Conjugate Vac- cine（OR = 1. 980,95% CI： 1. 311 - 2. 994, P =0. 001 ） was a barrier to Hib vaccination. Non-conditional logistic stepwise regression showed that household registration as a resident （ OR = 0. 512,95 % CI： 0. 3 - 0. 876, P = 0. 015 ） and having received Hib Polysac- charide Conjugate Vaccine notification （ OR = 0. 218,95 % CI：0. 094 - 0. 505, P 〈 0. 001 ） were motivations for Hib vaccination, while the high price of Hib Polysaccharide Conjugate Vaccine（ OR = 1.403,95% CI： 1.116 - 1. 894,P = 0. 036） was a barrier to Hib vaccination. Conclusions The main factors affecting the Hib Polysaccharide Conjugate Vaccine vaccination were household registration, parents＇ awareness of Hib vaccine, and the high price of Hib Polysaccharide Conjugate Vaccine.