2014年广东省部分地区白喉抗体水平调查

Diphtheria Antibody Levels in Selected Regions of Guangdong Province,2014

目的了解广东省人群白喉抗体水平,为评估白喉输入与传播风险提供依据。方法根据地域抽取河源、湛江、珠海3个地市共27所医疗机构作为监测点,采集902名0~49岁门诊病人的血清标本,采用酶联免疫吸附试验(ELISA)间接法检测白喉Ig G抗体,分析白喉抗体的分布特征。结果在902名调查对象中,白喉Ig G抗体滴度达到部分保护水平(≥0.01 IU/ml)占100%,达到安全保护水平(≥0.1IU/ml)占58.8%,达到长期保护水平(≥0.1IU/ml)占16.9%;抗体几何平均滴度(GMT)为0.203 IU/ml(95%CI:0.184 IU/ml^0.224 IU/ml)。年龄与白喉Ig G抗体滴度呈负相关(r=-0.43,P<0.001);其中0~9岁和10~49岁人群达到安全保护保护水平的比例分别为77.0%和39.0%。结论广东省人群白喉抗体水平较高,发生白喉暴发疫情的可能性不大。大年龄组人群白喉抗体水平低,建议对<50岁成人适时加强接种1剂含白喉类毒素成分疫苗。

Objective To determine diphtheria antibody levels in Guangdong province,and to assess the risk of diphtheria importation and transmission.Methods 27 hospitals in 3 prefectures of Guangdong were selected to collect serum specimens from 902 outpatients aged 0-49 years old and to test diphtheria Ig G antibody levels by enzyme-linked immunosorbent assay（ ELISA）.Results were analyzed by epidemiological methods.Results Diphtheria Ig G antibody levels among 100%,58.8%,and 16.9% of the902 subjects reached partial,adequate and long-term protective levels（ defined by antibody titers ≥0.01,≥0.1 and ≥1.0 IU/ml,respectively）;the geometric mean antibody titer（ GMT） was 0.203 IU/ml（ 95% CI：0.184-0.224 IU/ml）.Antibody levels decreased with age（ r =-0.43,P 0.001）.Proportions of adequate protective levels for diphtheria Ig G levels among subjects aged 0-9 years and10-49 years were 77.0% and 39.0%,respectively.Conclusions The Ig G levels of diphtheria in population 50 years old were generally high in Guangdong,indicating that risk of diphtheria outbreaks is low.The Ig G level among the 10-49 year old population was low.We suggest a booster dose of diphtheria-containing vaccine for adults at an appropriate time.