上海市浦东新区初中阶段外来务工人员子女乙型肝炎病毒感染及乙型肝炎疫苗免疫状况调查

Investigation of hepatitis B virus infection and hepatitis B vaccination coverage in junior middle school children of migrant workers in Pudong New Area of Shanghai

目的调查上海市浦东新区初中阶段的外来务工人员子女HBV感染及乙肝疫苗免疫现状,为乙肝防治工作提供依据。方法从上海市浦东新区外来务工人员集聚的5个社区初中学校中招募298名外来务工人员子女,开展问卷调查和HBV血清学检测。结果298名学生中,乙肝疫苗接种率为70.8%(211/298),全程接种率为48.3%(144/298),少数民族学生接种率低于汉族学生(P<0.01);父亲为私营业主的外来务工人员子女接种率最高(P<0.001),父亲文化程度大专及以上的外来务工人员子女接种率高于父亲文化程度较低的外来务工人员子女(P<0.01)。HBsAg阳性率为2.3%(7/298)、HBcAb阳性率为4.7%(14/298),家庭中有HBV感染亲属为HBsAg阳性或HBcAb阳性的独立影响因素(P<0.01)。HBsAb阳性率为36.6%(109/298),少数民族外来务工人员子女HBsAb阳性率高于汉族外来务工人员子女(P<0.05);汉族外来务工人员子女HBsAb滴度低水平(10 mU/mL≤HBsAb<100 mU/mL)的比例高于少数民族外来务工人员子女,而少数民族外来务工人员子女正常水平(100 mU/mL≤HBsAb<1000 mU/mL)与高水平(HBsAb≥1000 mU/mL)比例高于汉族外来务工人员子女(P<0.05)。结论初中阶段的外来务工人员子女乙肝疫苗接种率较低,HBsAg、HBcAb阳性率略高,将成为未来上海等特大城市乙肝防治的重点人群之一,建议卫生健康部门加强外来务工人员及其子女乙肝防治的健康管理和宣教。

Objective To investigate the status of hepatitis B virus(HBV)infection and hepatitis B vaccination in junior middle school children of migrant workers in Pudong New Area of Shanghai,so as to provide evidence for prevention and treatment of hepatitis B.Methods A total of 298 children of migrant workers were recruited from junior middle schools of five communities in Pudong New Area,where migrant workers gathered.Questionnaire survey and HBV serological test were conducted.Results The 298 students had a hepatitis B vaccination coverage rate of 70.8%(211/298)and the whole-course vaccination coverage rate of 48.3%(144/298).The vaccination coverage rate of ethnic minority students was significantly lower than that of Han students(P<0.01).The vaccination coverage rate of children whose fathers were private business owners was the highest(P<0.001).The vaccination coverage rate of children whose fathers had junior college or above education background was significantly higher than those whose fathers had a lower one(P<0.01).The positive rates of hepatitis B virus surface antigen(HBsAg)and hepatitis B virus core antibody(HBcAb)in these children were 2.3%(7/298)and 4.7%(14/298),respectively.HBV infected family member was the independent influencing factors for positive HBsAg or HBcAb(P<0.01).HBsAb positive rate was 36.6%(109/298)in these children,with that of ethnic minority students being significantly higher than that of Han students(P<0.05).The proportion of low hepatitis B virus surface antibody(HBsAb)titer(10 mU/mL≤HBsAb<100 mU/mL)in Han students was higher than that of ethnic minority students,while the proportions of normal level(100 mU/mL≤HBsAb<1000 mU/mL)and high level(HBsAb≥1000 mU/mL)of ethnic minority students were significantly higher than those of Han students(P<0.05).Conclusion The hepatitis B vaccination coverage rate is relatively low in junior middle school children of migrant workers,and the positive rates of HBsAg and HBcAb are slightly higher,and these children are important targets for hepatitis B prevention and treatment in Shanghai and other megacities in the future.Health management and education of hepatitis B prevention and treatment should be strengthened for migrant workers and their children.