广东省甲型肝炎血清流行病学调查

The Study on Seroepidemiology of Hepatitis A Virus in Guangdong Province

为了解广东省 10年来甲型肝炎 (甲肝 )疫苗推广应用情况和人群抗甲肝病毒IgG抗体 (抗 HAV IgG)阳性率 ,在全省采用分层多阶段随机抽样方法 ,抽取 12个县的 2 4个村 36 90人作为样本 ,用酶联免疫吸附试验 (ELISA)检测抗 HAV IgG ,进行甲肝血清流行病学调查。结果显示 :甲肝疫苗接种率为 2 2 74 % ,随着年龄的增长 ,接种率降低 ;1～ 5岁接种率为 5 0 16 % ,6～ 9岁为 4 4 6 4 % ,10～ 15岁为 2 3 79%。各年龄组的城市居民接种率都比乡村居民高。 2 0 0 2年全省抗 HAV IgG阳性率为 70 84 % (2 6 14 /36 90 ) ,标化率为 79 11%。农村抗 HAV IgG阳性率(72 4 5 % )高于城市 (6 5 93% ) ;女性 (74 4 0 % )高于男性 (6 7 4 7% )。 1～ 14岁有甲肝疫苗接种史者抗 HAV IgG阳性率 (6 9 38% )高于同年龄组无甲肝疫苗接种史者 (4 7 4 6 % )。无甲肝疫苗接种史者年龄越小 ,抗 HAV IgG阳性率越低。 2 0岁以后 ,无论是否接种甲肝疫苗 ,人群抗 HAV IgG阳性率均 >90 %。目前广东省属于甲肝中流行区 ,预防和控制甲肝爆发或流行的主要免疫策略是 :对儿童实施常规免疫接种 ;加速实施对较大年龄儿童的扩大免疫接种。

For investigating the situation of hepatitis A(HA)vaccination and the anti-HAV-IgG positive rate in population of Guangdong Province since 1992,we adopted the stratified multistage random sampling method in July-August 2002 to select 3,690 residents from 24 villages(residential committee)of 12 counties(city,district, the same below)of four different economic levels.Their blood samples were collected and detected by ELISA assay for anti-HAV-IgG.The results showed that the HA vaccine coverage rate in the population was 22.74%, it decreased along with the age growing as showed by 50.16%,44.64% and 23.79% in age groups of 1-5 years,6-9 years and 10-15 years respectively.The vaccine coverage rate of each age group was higher in urban residents than that in rural residents.In 2002,the positive rate of anti-HAV-IgG in the population was 70.84%(2,614/3,690),the standard positive rate was 79.11%,it was higher in rural area (72.45%)than that in urban area (65.93%), also was higher in female(74.40%)than in male(67.47%).Children of 1-14 years old having HA vaccination history had a higher anti-HAV-IgG positive rate(69.38%)than that of unvaccinated children(47.46%)of the same age.The younger the age of unvaccinated children was,the lower the anti-HAV-IgG positive rate was.In the age group of ≥20 years,no matter they were vaccinated or not,the anti-HAV-IgG positive rate was>90%.Since Guangdong Province belongs to middle epidemic area now,for the aim of controlling and preventing HA outbreak or epidemic,the major strategy is to implement the routine HA immunization to young children and the expanded immunization to elder children.