沙特大规模乙肝疫苗接种计划实施8年后儿童乙肝病毒感染的血清流行病学研究

Seroepidemiology of hepatitis B virus infection in Saudi children 8 years after a mass hepatitis B vaccination programme.

作者信息

Al-Faleh F Z, Al-Jeffri M, Ramia S, Al-Rashed R, Arif M, Rezeig M, Al-Toraif I, Bakhsh M, Mishkkhas A, Makki O, Al-Freihi H, Mirdad S, AlJuma A, Yasin T, Al-Swailem A, Ayoola A

机构信息

Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

出版信息

J Infect. 1999 May;38(3):167-70. doi: 10.1016/s0163-4453(99)90245-1.

DOI:10.1016/s0163-4453(99)90245-1

PMID:10424796

Abstract

OBJECTIVES

On October 1 1989, a programme was begun in Saudi Arabia in which the HBV vaccine was added as the 'seventh' primary immunogen of the Extended Programme of Immunization (EPI). In 1990, another programme was launched by the Ministry of Health to vaccinate all school children. Eight years after this mass vaccination programme, the efficacy of HBV vaccine was evaluated in a community-based study.

METHODS

A community-based study was carried out in Saudi children in urban and rural areas, covering all the regions of Saudi Arabia. After informed consent, blood samples were obtained and tested for HBV markers.

RESULTS

Among 4791 vaccinated Saudi children aged 1-12 years, only 15 were found to be HbsAg-positive (0.31%). HbsAg-positivity was 0.16% in children vaccinated at birth compared with 0.7% in those vaccinated at school entry. The overall HbsAg carrier rate dropped from 6.7% in 1989 to 0.3% in 1997 (P<0.00001). Similarly, there was a significant reduction in the prevalence of anti-HBc from 4.2% in 1989 to 0.46% in 1997 (P<0.00001). The overall seroconversion rate to HB vaccine among 4087 Saudi children up to 12 years of age was about 77%. Seroconversion rate in those vaccinated at birth was 77% compared with 71% in those vaccinated at school entry. After 8 years of receiving the third vaccine dose, close to 65% of the children had an anti-HBs titre of more than 10 IU/l compared with about 28% who had an anti-HBs titre of more than 100 IU/l after the same period.

CONCLUSION

The result of this study demonstrates the tremendous impact of the mass HB vaccination programme on the seroepidemiology of HBV infection in Saudi Arabia. The ultimate goal of preventing HBV-related chronic liver disease and hepatocellular carcinoma in Saudi Arabia is foreseeable in the near future.

摘要

目的

1989年10月1日，沙特阿拉伯启动了一项计划，将乙肝疫苗作为扩大免疫规划（EPI）的“第七种”主要免疫原加入其中。1990年，卫生部又发起了一项为所有学童接种疫苗的计划。在这项大规模疫苗接种计划开展八年后，在一项基于社区的研究中对乙肝疫苗的效果进行了评估。

方法

在沙特阿拉伯城乡地区的儿童中开展了一项基于社区的研究，覆盖沙特阿拉伯所有地区。在获得知情同意后，采集血样并检测乙肝标志物。

结果

在4791名1至12岁接种疫苗的沙特儿童中，仅15名被发现乙肝表面抗原（HbsAg）呈阳性（0.31%）。出生时接种疫苗的儿童中HbsAg阳性率为0.16%，而入学时接种疫苗的儿童中该阳性率为0.7%。总体HbsAg携带率从1989年的6.7%降至1997年的0.3%（P<0.00001）。同样，乙肝核心抗体（anti-HBc）的流行率也显著降低，从1989年的4.2%降至1997年的0.46%（P<0.00001）。4087名12岁及以下沙特儿童中乙肝疫苗的总体血清转化率约为77%。出生时接种疫苗的儿童血清转化率为77%，而入学时接种疫苗的儿童血清转化率为71%。在接种第三剂疫苗8年后，近65%的儿童乙肝表面抗体（anti-HBs）滴度超过10 IU/l，而同期约28%的儿童anti-HBs滴度超过100 IU/l。