上海市浦东新区外来务工人员子女乙肝病毒感染及乙肝疫苗免疫状况调查研究

Investigation of HBV infection and hepatitis B vaccination coverage in children of migrant workers in Pudong New Area,Shanghai,China

目的 研究外来务工人员子女乙肝病毒感染及乙肝疫苗免疫现况,为乙肝防治工作提供依据。方法 从上海市浦东新区5个城郊结合社区的幼儿园与中小学中招募1 071名外来务工人员子女开展流行病学问卷调查,采集静脉血进行乙肝血清学指标及HBV DNA浓度检测。结果 乙肝疫苗接种率87.1%（933/1 071）,10岁以下学生接种率高于10岁及以上学生（P〈0.01）,汉族接种率高于少数民族（P〈0.001）,父母亲文化程度大专及以上学生的接种率高于父母亲文化程度高中及以下的学生（P〈0.001）。HBsAg阳性率0.7%（7/1 071）,年龄与家庭中有HBV感染亲属为HBsAg阳性的主要影响因素（P〈0.05）;HBcAb阳性率1.7%（18/1 071）,HBcAb阳性率与年龄呈正相关（P〈0.01）;HBsAb阳性率为33.9%（363/1 071）,3-14岁学生HBsAb阳性率随年龄增长而递减,15岁后再次升高（P〈0.001）,少数民族学生阳性率高于汉族（P〈0.001）。HBsAb滴度低水平比例随年龄增大而降低,正常水平与高水平比例随年龄增大而上升（P〈0.01）。结论 外来务工人员子女乙肝疫苗接种率低于所在地户籍儿童,HBsAg、HBcAb阳性率较浦东新区2006年阳性率显著下降,建议进一步加强该人群的乙肝疫苗预防接种服务与管理。

Objective To investigate the statuses of hepatitis B virus （HBV） prevalence and hepatitis B vaccination coverage in children of the migrant workers , so as to provide the evidence for HBV control and prevention in Shanghai. Methods An epidemiological survey was conducted with 1 071 children of the migrant workers; the children were from the kindergartens, primary and secondary schools in five urban-rural fringe communities in Pudong New Area of Shanghai. Fasting bloods samples were collected to detect the biomarkers and DNA titer of HBV. Results The hepatitis B vaccination coverage rate was 87. 1 % （933/1 071） ; the coverage rate of students under the age of ten was significantly higher than those at 10 years of age or older （P〈0 . 01） ; the coverage rate in children of the Han nationality was significantly higher than that of the other minorities （P〈 0. 001） , and the coverage rate in children whose parents with the college education background and above was higher than that of children whose parents with a lower education background （P〈0 . 001）. The positive rate of HBsAg was 0. 7% （7 /1 071） in this study. We found that age and HBV infected relatives in the family were the main risk factors of HBV infection in children （P〈0. 05）. The positive rate of HBcAb was 1. 7% （18/1 071） in the present study,which was positively correlated with the age of children （P〈0. 01）. The positive rate of HBsAb was 33. 9% （363/1 071） , and the rate decreased w ith the age increase between 3 to 14 years old and increased with the age increase after 15 years old （P〈0 . 001）. The positive rate of HBsAb was significantly higher in other minorities than that in the Han nationality （P〈0 . 001）. The proportion of children w ith low level of HBsAb titer decreased with the increase of age, while the proportion of children with normal and high level of HBsAb increased with the increase of age （P〈0. 01）. Conclusion The hepatitis B vaccination coverage rate in the children of migrant workers is lower than that in the local children of permanent residents. The positive rates of HBsAg and HBcAb witness a great decrease compared with those in 2006. More efforts should be made to strengthen the hepatitis B vaccination for the children of migrant workers.