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目的了解咸宁市温泉城区扩大免疫规划前后适龄人群甲肝免疫状况及影响因素。方法采取随机抽样方式选取4 361名2~18岁人群为研究对象,按甲肝疫苗纳入免疫规划前后分成两组,采集外周静脉血3 ml,采用酶联免疫吸附试验检测甲肝病毒Ig G抗体。同时进行问卷调查,内容:年龄、性别等基本信息,甲肝疫苗免疫史及未种原因。结果纳入免疫规划前儿童接种率52.21%,甲肝Ig G抗体阳性率58.21%;纳入免疫规后接种率90.99%,抗体阳性率89.01%,两者间差异有统计学意义。未种原因:纳入免疫规划前,因经费原因占41.76%,不知道、不了解占48.00%。纳入免疫规划后,因禁忌症、生病占24.86%,经常变更居住地占22.65%,不知道要接种占26.52%,担心副作用占20.99%,其它原因占4.98%。结论纳入免疫规划后儿童接种率、抗体保护率明显高于纳入免疫规划前。纳入免疫规划前人群低接种率、低保护率不能形成免疫屏障,一旦有传染源介入,在这类人群中有可能导致甲肝暴发或流行。建议国家对在甲肝纳入免疫规划前(8~18岁组)的人群进行一次查漏补种。
Objective To understand the status and influencing factors of hepatitis A in school-age population before and after the expansion of immunization program in Hot Springs District of Xianning City. Methods A total of 4 361 subjects aged 2-18 years were enrolled in this study. Before and after the hepatitis A vaccine was included in the immunization schedule, the patients were divided into two groups. Peripheral venous blood was collected for 3 ml. ELISA was used to detect the Ig G antibodies of hepatitis A virus. At the same time a questionnaire survey, content: age, gender and other basic information, hepatitis A vaccine immunization history and reasons. Results The immunization coverage was 52.21% before immunization, and the positive rate of Ig G antibody was 58.21%. The immunization coverage was 90.99% and the antibody positive rate was 89.01%. The difference was statistically significant. Unexplained reasons: Before the inclusion of immunization programs, due to funding accounted for 41.76%, do not know, do not understand accounted for 48.00%. Due to contraindications, the illness accounted for 24.86% of the total, 22.65% of them regularly changed their places of residence, 26.52% did not know to be vaccinated, 20.99% worried about the side effects and 4.98% for other reasons. Conclusion The vaccination rate and antibody protection rate of children included in the immunization program were significantly higher than those before immunization program. Low immunization rates should be included in pre-immunization programs, and the low rates of protection should not lead to an immunological barrier. In these populations, there may be an outbreak or epidemic of hepatitis A in the presence of a source of infection. It is recommended that the state conduct a leak detection and replantation of the population before hepatitis A is enrolled in the immunization program (aged 8-18).