海南省消除新生儿破伤风研究报告

Research report on the control of neonatal tetanus in Hainan Province

目的 通过在海南省开展消除新生儿破伤风的研究,为我国制订消除新生儿破伤风策略与措施提供科学依据。方法 用回顾性和PPS调查方法调查NT死亡率、育龄妇女TT接种率、抗体水平;开展NT病例监测,对育龄妇女进行TT突击接种并与儿童常规免疫系统同时运行,开展广泛的社会动员。结果 三亚、琼中NT发病率逐年下降,2001年三亚已降到1.07‰,琼中县达到0.92‰,育龄妇女TT3针累计接种率达到95.1％、97.8％,育龄妇女TAT水平血清学监测结果与接种率调查结果一致,育龄妇女TT1针接种后可产生保护水平TAT,并且有51％的人可维持13个月左右,在符合最短间隔条件下,不同免疫间隔TAT差异没有显著统计学意义。建议 将育龄妇女TT接种与计划生育工作密切挂钩,在育龄妇女领取计划生育指标时,必须出示TT接种证,使育龄妇女TT接种工作可持续发展。

Objective To conduct the study on the control of neonatal tetanus (NT) in Hainan Province and offer scientific basis for formulate effective strategy and measures.Methods The methods of retrospective survey and Probability Proportional sampling (PPS) were used in the investigation of NT Mortality rate, the inoculation rate of tetanus toxoid (TT)in the women of child - bearing age, antibody lavel; The work of NT surveillance,focus innoculation of TT in the women of child - bearing age and conventional vaccination of children was simultaneopusly carried out with wide mobilization of the community. Results The incidence of neonatal tetanus was reduced year by year in Sanya City and Qiongzhong County,the incidence in 2001 was reduced to 1.07‰ and 0.92‰,respectively, the accumulated vaccination rate of TT3 in women of child - bearing age was 95.1% and 97.8%, respectively. It was found that protective level of TAT as observed during serological surveillance in women of child - bearing age was coincident with that of the investigation of inoculation rate. The protective level of TAT could be observed after inoculation of TT1 in 51 % women of child - bearing age and the protective level of TAT in 51% of themcould lasting 13 month. In addition, under condition of shortest vaccination interval there was no statistical difference of TAT in women of child - bearing age with different intervals of vaccination. Suggestions The work of inoculation of TT in women of child - bearing age be combined with that of family planning, and the certificates of TT inoculation be requested when those who are applying for the birth certificates, so thet the practice of TT inoculation in women of child - bearing age can be sustainablely developed.