2018年大理州健康人群麻疹抗体水平分析

Analysis on level of measles antibody among healthy population in Dali Prefecture in 2018

目的了解2018年大理州健康人群麻疹抗体水平及麻疹流行情况,评估麻疹疫苗预防接种效果,为制定大理州麻疹的预防控制策略提供科学依据。方法通过分层整群抽样方法调查2018年大理州3783名健康者,应用酶联免疫吸附法测定血清中麻疹IgG抗体,采用描述性流行病学方法对麻疹流行情况及抗体水平监测的结果进行统计分析。结果2018年大理州报告麻疹病例42例,发病率为11.91/100万。发病年龄主要以3岁以下婴幼儿及35~44岁年龄段的人群为主;无免疫史和免疫史不详的25例,占报告病例总数的59.53%,其抗体阳性率、保护率和抗体几何平均浓度(geometric mean concentration,GMC)最低,接种2剂次的阳性率最高,接种3剂次的保护率和GMC最高;健康人群麻疹抗体水平监测结果显示,抗体阳性率、保护率和GMC均以1~2岁组最高,<1岁组阳性率最低,25~34岁组保护率和GMC最低,各年龄组间的差异均有统计学意义(P均<0.05)。结论大理州基本形成预防麻疹的免疫屏障,但3岁以下婴幼儿和35~44岁年龄段人群麻疹发病的风险高。应在加强常规免疫工作的同时,调整免疫策略,在高危人群中开展查漏补种和强化免疫,降低麻疹发病率。

Objective To understand the level of measles antibodies and the prevalence of measles among healthy population in Dali Prefecture in 2018,evaluate the efficacy of preventive inoculation with measles vaccine,and provide scientific evidence for formulating the prevention and control strategies of measles in Dali prefecture.Methods A stratified cluster sampling method was used to survey 3783 healthy people in Dali Prefecture in 2018.Enzyme-linked immunosorbent assay was used to determine the measles IgG antibody in serum.Descriptive epidemiology method was used to statistically analyze the prevalence of measles and surveillance results of antibody level.Results In 2018,42 cases of measles were reported in Dali Prefecture,and the incidence rate was 11.91/million.The age of onset was mainly infants under 3 years old and adults in 35-44 years old.There were 25 cases with no or unknown history of vaccination and immunization,accounting for 59.53%of the total number of reported cases.Their positive rate,protective rate and geometric mean concentration(GMC)of antibodies were the lowest.The positive rate reached the peak after 2 vaccinations.The protective rate and GMC reached the peak after 3 vaccinations;the surveillance results of measles antibody level in healthy population showed that the positive rate,protective rate and GMC of antibodies reached the peak in group of 1-2 years old.The positive rate was the lowest in group of<1 year old,and the protective rate and GMC were the lowest in group of 25-34 years old.The differences among age groups were statistically significant(P<0.05).Conclusions The immune barrier against measles has been basically formed in Dali Prefecture,but the risk of measles is high in infants under 3 years old and adults in 35-44 years old.To strengthen routine immunization,we should adjust the immunization strategy,and carry out leak-detection,catch up immunization among high-risk population and reduce the incidence of the disease.