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目的了解玉溪市1～10岁儿童白喉免疫状况,评价儿童免疫接种质量,以期为全面控制和消除白喉提供科学依据。方法采用容量比例概率抽样法对不同年龄段儿童进行麻疹、脊髓灰质炎、百白破、卡介苗、乙型肝炎5种疫苗接种率调查的同时,采集被调查儿童的血样用间接血凝法(IHA)检测白喉抗体。结果检测2006—2007年具有百白破三联制剂(DPT)免疫史的儿童1501人,白喉抗体阳性率89.14%,保护率79.75%,几何平均滴度(GMT)1∶35.19,抗毒素平均含量(ATC)0.132U/ml。不同地区白喉免疫抗体阳性率、保护率和GMT差异均有统计学意义(χ12=33.46、χ22=27.21、F=20.25,均P<0.05)。不同年龄组阳性率、保护率、GMT差异均有统计学意义(χ12=66.18、χ22=94.76、F=40.58,均P<0.05)。不同年度阳性率、保护率、GMT差异均有统计学意义(χ12=14.55、χ22=16.54、u=-3.29,均P<0.05)。不同居住形式阳性率、GMT差异有统计学意义(χ12=13.78、u=2.92,均P<0.05),但保护率无统计学意义(χ22=2.07,P>0.05)。男女之间阳性率、保护率、GMT均无统计学意义(χ12=0.14、χ22=0.59、u=0.22,均P>0.05)。结论玉溪市儿童DPT接种质量和血清抗体保护理想,能有效地预防和控制白喉的发生。提示加大对辖区内流动儿童管理力度,认真做好查验预防接种证工作,及时清除免疫空白人群是目前预防和控制白喉的工作重点。
Objective To understand the immune status of diphtheria in children aged 1 ~ 10 in Yuxi City and evaluate the quality of immunization in children so as to provide a scientific basis for the comprehensive control and elimination of diphtheria. Methods The method of volume proportional probability sampling was used to investigate the vaccination rate of measles, poliomyelitis, diphtheria, BCG and hepatitis B in children of different ages. At the same time, the blood samples of the investigated children were collected by indirect hemagglutination (IHA Test for diphtheria antibodies. Results A total of 1501 children with a history of diphtheria triadimentium (DPT) immunization from 2006 to 2007 were detected. The positive rate of diphtheria antibody was 89.14%, the protection rate was 79.75%, the geometric mean titer (GMT) was 1:35.19, the average level of antitoxin ) 0.132U / ml. The positive rate of diphtheria immune antibody in different areas, the protective rate and the GMT difference were statistically significant (χ12 = 33.46, χ22 = 27.21, F = 20.25, all P <0.05). The positive rate, protective rate and GMT in different age groups were statistically significant (χ12 = 66.18, χ22 = 94.76, F = 40.58, all P <0.05). The positive rate, protection rate and GMT in different years were statistically significant (χ12 = 14.55, χ22 = 16.54, u = -3.29, all P <0.05). The positive rate of different forms of living, GMT difference was statistically significant (χ12 = 13.78, u = 2.92, both P <0.05), but the protection rate was not statistically significant (χ22 = 2.07, P> 0.05). The positive rate, protection rate and GMT between men and women were not statistically significant (χ12 = 0.14, χ22 = 0.59, u = 0.22, all P> 0.05). Conclusion The quality of DPT vaccination and serum antibody protection in children in Yuxi City can effectively prevent and control the occurrence of diphtheria. Prompted to step up the management of migrant children in the area, conscientiously do a good job vaccination card work, timely clearance of immune blank population is currently the focus of prevention and control of diphtheria.