广西壮族自治区2013年健康人群白喉抗体水平调查

Antibody Levels against Diphtheria among a Healthy Population in Guangxi Zhuang Autonomous Region,2013

目的了解广西2013年健康人群白喉抗体水平及其变化趋势,为预防控制白喉策略提供参考。方法在广西5个县采集0~60岁健康人群血清标本,利用酶联免疫吸附试验(Enzyme-linked Immunosorbent Assay,ELISA)检测白喉抗体。结果 2013年共采集健康人群血清标本3 191份,白喉抗体阳性率81.13%,中位数抗体浓度(Median Antibody Concentration,MAC)为0.046IU/ml。5个县白喉抗体阳性率在69.97%~90.47%之间(χ~2=104.99,P<0.001),MAC在0.029IU/ml^0.068 IU/ml之间(H=112.90,P<0.001)。各年龄组白喉抗体阳性率在75.34%(11~20岁组)~86.76%(51~60岁组)之间(χ~2=57.01,P<0.001),MAC在0.032IU/ml(0~10岁组)~0.111IU/ml(31~40岁组)之间(H=144.78,P<0.001)。男、女性白喉抗体阳性率分别为82.00%和80.51%(χ~2=1.13,P=0.287),MAC分别为0.051IU/ml和0.042IU/ml(U=1 155 974.50,P=0.001)。结论白喉抗体血清学调查结果可反映当地儿童免疫规划工作情况,预测广西近几年不会发生白喉流行,需对白喉抗体水平较低的地区和年龄组进行强化免疫以进一步巩固白喉免疫屏障;同时应严格按照含白喉类毒素疫苗接种程序对适龄儿童进行全程接种,防止出现某些剂次疫苗漏种的现象。

Objective To investigate antibody levels against diphtheria among a healthy population in Guangxi in 2013,and to provide scientific evidence for diphtheria prevention.Methods Serum samples were collected from a healthy population,aged 0-60 years,in 5 counties of Guangxi.Antibody against diphtheria was tested by the enzyme-linked immunosorbent assay（ELISA）.Results A total of 3 191 serum samples were collected from this healthy population in 2013;the positive rate of antibody against diphtheria was 81.13%,and the median antibody concentration（MAC） was 0.046 IU/ml.Positive rates of antibody among the 5 counties ranged from 69.97% to 90.47%（χ~2=104.99,P〈0.001）,and MACs ranged from 0.029 IU/ml to 0.068 IU/ml（H=112.90,P〈0.001）.The positive rates of antibody by age groups ranged from 75.34%（11-20 years） to 86.76%（51-60 years）（χ~2=57.01,P〈0.001）,and MACs ranged from 0.032 IU/ml（0-10 years） to 0.111 IU/ml（31-40 years）（H =144.78,P〈0.001）.The positive rates of antibody in male and female population were 82.00% and 80.51%,respectively（χ~2=1.13,P=0.287）,and MACs were 0.051 IU/ml and 0.042 IU/ml（U =1 155 974.50,P=0.001）.Conclusions Antibody levels against diphtheria may reflect performance of expanded program on immunization（EPI） in local areas.Using the results of this study,we can predict that an outbreak of diphtheria is not likely to occur in Guangxi.However,booster immunization of diphtheria toxoid containing vaccine should be carried out in counties and age groups having low antibody levels in order to improve the immunity barrier against diphtheria in Guangxi.The immunization schedule of diphtheria toxoid containing vaccine for eligible children should be adhered to strictly to avoid drop-outs of vaccination.