云南省婴幼儿乙型肝炎病毒感染现状及乙肝疫苗接种状况分析

Investigation on current satuation of hepatitis B virus infection and hepatitis B vaccination status in infants and young children in Yunnan province

目的分析2019年云南省婴幼儿乙型肝炎病毒感染现状及乙肝疫苗接种状况。方法按照分层抽样方法在云南省16个州(市)129个县(市、区)抽取了387个乡镇的1149个调查点,再采用简单随机抽样方法,共调查8~23月龄婴幼儿7500名。婴幼儿分为8个年龄组,即:8月龄、9月龄、10月龄、11月龄、12月龄~、15月龄~、18月龄~、21~23月龄。现场通过问卷调查收集婴幼儿的乙肝疫苗接种情况及个人基本信息,采集血样,采用酶联免疫吸附试验检测HBsAg、Anti-HBs及Anti-HBc,并将结果录入数据库进行统计分析。结果7500名婴幼儿乙肝疫苗首次及时接种率为80.99%,全程接种三针剂占96.73%,接种两针剂占2.51%,接种一针剂占0.29%,免疫史不详占0.47%;城镇与乡村接种率差异均无统计学意义(P>0.05)。保护性抗体阳性率为88.33%,各年龄组间保护性抗体阳性率差异有统计学意义(χ^(2)=98.78,P<0.05),随着年龄逐渐增长,到11月龄达高峰,之后逐渐下降。HBV血清标志物组合模式中,既无抗体也未感染模式(三项全阴)占10.28%;通过接种疫苗产生抗体模式(Anti-HBs单项阳性)占78.40%;感染乙型肝炎病毒模式占0.28%,各年龄组间差异无统计学意义(χ^(2)=7.86,P>0.05)。结论2019年云南省8~23月龄婴幼儿乙肝疫苗全程接种率较高,城市与乡村疫苗接种率差异无统计学意义;保护性抗体阳性率各年龄组间差异显著,11月龄组最高,之后逐渐降低。乙型肝炎病毒感染状况城市与乡村差异不大。

Objective To investigate current satuation of hepatitis B virus(HBV)infection and hepatitis B vaccination status in infants and young children in Yunnan province in the year 2019.Methods 1,149 investigation sites were selected from 387 towns in 129 counties(cities and districts)of 16 prefectures(cities)of Yunnan province in stratified sampling method.A total of 7,500 infants aged from 8 months to 23 months were investigated in simple random sampling method.The infants and young children were divided into 8 age groups:8-month-old group,9-month-old group,10-month-old group,11-month-old group,12-month-old group,15-month-old group,18-month-old group and 21-month-old group.Face-to-face questionnaire survey for hepatitis B vaccination and personal general information was conducted and blood sample of the investigated subject was collected on the spot.Hepatitis B surface antigen(HBsAg),hepatitis B surface antibody(anti-HBs)and hepatitis B core antibody(anti-HBc)were detected by using enzyme-linked immunosorbent assay(ELISA),and the results were recorded and enrolled into the database for statistical analysis.Results In 7500 infants and young children,the rate of first hepatitis B vaccination at time was 80.99%,96.73% of them received the whole course of three vaccinations,2.51% of them received two vaccinations,0.29% of them received one time of vaccination,and 0.47% of them unknown their immunization history.There was no significant difference in inoculation rate between urban and rural areas(P>0.05).The positive rate of protective antibody was 88.33%,and there was statistically significant difference among different age groups(χ^(2)=98.78,P<0.05).The positive rate of protective antibody increased gradually with age increase,and reached the peak at 11 months of age,and then decreased gradually.In HBV serum marker combination pattern,the pattern of neither antibody nor infection(negative all three indexes)accounted for 10.28%;The pattern of antibody production(positive single anti-HBs)after vaccination accounted for 78.40%;The pattern of current infection of HBV accounted for 0.28%,and there was no significant difference among different age groups in HBV infection rate(χ^(2)=7.86,P>0.05).Conclusion The whole course vaccination rate of hepatitis B vaccine in infants and young children aged from 8 to 23 months in Yunnan province in 2019 was relatively high,and there was no significant difference between urban and rural areas.The positive rate of protective antibody was significantly different among different age groups,the highest one was in the 11-month-old group,and then it decreased gradually.There was no significant difference in HBV infection in the infants and young children between urban and rural areas.