安徽省A、C群脑膜炎球菌多糖结合疫苗纳入免疫规划11年适龄儿童抗A、C、W135、Y群IgG抗体水平调查

A survey of anti Neisseria meningitidis A, C, W135 and Y groups IgG levels in children in Anhui province 11 years after group A and C meningococcal polysaccharide conjugate vaccine was included in immunization programme

目的了解安徽省将A、C群脑膜炎球菌多糖结合疫苗纳入免疫规划11年后适龄儿童抗脑膜炎奈瑟菌(Neisseria meningitidis, Nm)IgG抗体水平, 为进一步完善疫苗免疫策略提供参考。方法采用多阶段随机抽样方法, 在安徽省6个市抽取0~11岁健康儿童开展问卷调查并采集血液标本, 采用ELISA定量检测抗A、C、W135、Y群IgG抗体水平, 并对数据进行统计分析。结果共调查1 002名儿童, 抗Nm A、C、W135、Y群IgG抗体浓度达到保护性水平的儿童所占比例(阳性率)分别为89.82%、92.12%、31.04%、66.87%;中位抗体浓度分别为9.93、10.55、4.63、7.75 μg/ml。不同年龄组人群抗4个血清群IgG抗体阳性率差异均有统计学意义, χ^(2)值分别为27.75、17.70、132.00、122.55, P均<0.05。采用A、C、Y、W135群脑膜炎球菌多糖疫苗进行加强免疫的儿童, 其抗W135群和Y群Nm IgG抗体阳性率显著高于接种AC群脑膜炎球菌多糖疫苗的儿童(χ^(2)值分别为10.30和38.25, P均<0.05)。结论安徽省0~11岁儿童抗A、C群Nm IgG抗体水平较高, A、C群脑膜炎球菌多糖结合疫苗纳入免疫规划11年后Nm防控效果成效显著。但该人群抗W135、Y群IgG抗体水平仍较低, 应加强宣教工作, 提升流行性脑脊髓膜炎多价疫苗的接种率。

Objective To investigate the IgG antibody levels against Neisseria meningitidis serogroups among children after group A and C meningococcal polysaccharide conjugate vaccine(MPCV-AC)was included in the immunization program in Anhui province for 11 years,to provide reference for further optimizing of the immunization strategy against epidemic meningococcal meningitis.Methods A multi-stage random sampling method was employed to select healthy children under 11 years old from six cities in Anhui province.Questionnaires were conducted and blood specimens were collected.ELISA was used to detect the levels of antibody against groups A,C,Y and W135,and the data were statistically analyzed.Results A total of 1002 children were investigated.The proportions of children with protective antibody concentrations against serogroups A,C,W135 and Y were 89.82%,92.12%,31.04%and 66.87%,respectively.The median antibody concentrations were 9.93,10.55,4.63 and 7.75μg/ml,respectively.The positive rates of serum anti-Nm IgG antibodies in four different age groups were statistically significantly different,withχ^(2) values of 27.75,17.70,132.00 and 122.55,respectively,and P<0.05.Children who received booster immunization with group A,C,Y,W135 meningococcal polysaccharide vaccine had significantly higher positive rates of anti-Nm IgG antibodies in W135 and Y groups compared to those who received MPCV-AC(χ^(2) values were 10.30 and 38.25,P<0.05).Conclusions The IgG antibody levels against serogroups A and C of Nm among children aged 0 to 11 years in Anhui province are relatively high after the inclusion of MPCV-AC in the immunization schedule,showing significant effectiveness in meningococcal prevention and control.However,the IgG antibody levels against serogroups W135 and Y remain relatively low in this population,indicating a need for strengthened educational efforts to improve the vaccination rate of meningococcal polyvalent vaccine.