2016年上海市浦东新区高东社区儿童青少年乙肝病毒感染及乙肝疫苗接种状况调查

Prevalence of hepatitis B virus infection and coverage of hepatitis B vaccination among children and adolescents in Gaodong Community,Pudong New District of Shanghai,2016

目的调查上海市浦东新区高东社区儿童青少年乙肝病毒感染现状及乙肝疫苗接种状况,为该社区的乙肝防控工作提供依据。方法 2016年3-4月,随机抽取高东社区幼儿园、小学及初级中学各1所,对每所学校每个年级抽取的1个班级中所有学生开展乙肝病毒感染及乙肝疫苗接种相关问卷调查,同时采集静脉血进行乙肝血清指标及HBV DNA定量检测,分析该社区儿童青少年乙肝疫苗接种情况、乙肝病毒感染血清标志物分布情况及其影响因素。结果高东社区儿童青少年乙肝疫苗接种率95.50%(276/289),年龄组越小的儿童青少年乙肝疫苗接种率越高(P<0.01);10岁以下学生接种率高于≥10岁学生(P<0.01);HBsAg、HBcAb和HBsAb阳性率分别为1.04%(3/289)、1.38%(4/289)和32.18%(93/289);未接种乙肝疫苗及未全程接种者HBsAg和HBcAb阳性率均高于接种乙肝疫苗及全程接种者(P<0.05);女性HBcAb阳性率高于男性(P<0.05);≥10岁学生HBcAb阳性率高于3~<10岁学生(P<0.05);年龄组越大的儿童青少年HBsAb阳性率越低(P<0.01);HBsAb阳性学生抗体滴度水平分布以低水平(10 m IU/ml≤HBsAb<100 m IU/ml)为主(占81.33%,61/75),无年龄分布差异(P>0.05)。结论 2016年该社区儿童青少年的乙肝疫苗接种率高于95%,HBsAg、HBcAb阳性率较2012年上海市的调查结果下降明显。

Objective To investigate the prevalence of hepatitis B virus （HBV） infection and the coverage of HBV vaccination among children and adolescents in Gaodong Community, Pudong New District of Shanghai so as to provide evidence for preventing and controlling HBV infection in the community. Methods One kindergarten, one primary school and one middle school were randomly selected in Gaodong Community from March to April in 2016, and then a questionnaire survey of HBV infection and HBV vaccination was conducted among all students from one class which was selected in each grade of each school. Venous blood samples were simultaneously collected for detecting HBV serum markers and HBV DNA. The status of HBV vaccination and the distribution and influencing factors of HBV serum markers in children and adolescents in the community were analyzed. Results The coverage rate of HBV vaccination in children and adolescents in Gaodong Community was 95.5% （276/289）.The younger the children and adolescents, the higher the vaccination coverage rate （P〈0.01）. The vaccination coverage rate of students aged〈10 years was higher than that of students aged ≥10 years （P〈0.01）. The positive rates of HBsAg, HBcAb and HBsAb were 1.04% （3/289）, 1.38% （4/289） and 32.18% （93/289） respectively. The positive rates of HBsAg and HBcAb in students without HBV vaccination and without a complete course of vaccination were respectively higher than those of students with HBV vaccination and with a complete course of vaccination （both P〈0.05）. The positive rate of HBcAb was higher in females than in males as well as higher in students aged ≥10 years than in ones aged 3-〈10 years （both P〈0.05）. The older the children and adolescents, the lowerthe HBsAb positive rate（P〈0.01）. The antibody titer of most students with positive HBsAb （accounting for 81.33%, 61/75） was at the low level （10 mIU/ml ≤ HBsAb 〈100 mIU/ml）, and no difference was observed in the age distribution （P〉0.05）. Conclusions The coverage rate of HBV vaccination in children and adolescents in Gaodong Community in 2016 was higher than 95%, and the positive rates of HBsAg and HBcAb declined apparently as compared with the surveyed results in Shanghai in 2012.