外来青年工人乙肝疫苗接种前最优筛检方案的研究

A study on the most-effective screening strategy of hepatitis B vaccination of young migrant workers

目的 确定东莞市外来青年工人乙肝疫苗接种前最优筛检方案。方法 以整群抽样的方法抽取东莞市某外资企业 312 2名外来青年工人为研究对象 ,对其进行乙肝三项指标的检测。以该人群乙肝病毒标志物阳性率为基本参数 ,采用费用 -效果分析法和决策树法确定外来青年工人乙肝疫苗接种前的最优筛检方案 ;采用灵敏度分析法探讨引入模型的参数对方案优化的贡献和阈值分析法检验参数的阳性率阈值。结果 东莞市外来青年工人乙肝疫苗接种前最优筛检方案为仅检测抗 - HBc;HBs Ag、抗 - HBs、抗 - HBc检测的阳性率阈值分别为 0 .4 0、0 .4 0、0 .4 0。结论 外来青年工人乙肝疫苗接种前可只检测抗 - HBc。

Objective To determine the most cost-effective screening strategy of hepatitis B vaccination of young migrant workers in Dongguan city. Methods 3 122 young migrant workers in a foreign enterprise were chosen and their hepatitis B virus markers were detected. The most cost-effective screening strategy of young migrant workers was determined by the cost-effect analysis and decision tree model. Sensitivity analysis was used to determine the changes of screening strategy by different costs of vaccine and screening tests. Threshold positive rates of the parameters introduced in model were evaluated by threshold analysis. Results The most-effective screening strategy of young migrant workers in Dongguan city was to test anti-HBc only and the positive rate threshold of HBsAg, anti-HBs and anti-HBc were 0.40, 0.40 and 0.40 respectively. Conclusions The most-effective screening strategy for young migrant workers is to test anti-HBc only. It has the same preventive effect as testing HBsAg, anti-HBs and anti-HBc.