Weinberg M S, Gunn R A, Mast E E, Gresham L, Ginsberg M
Health and Human Services Agency, San Diego, California, USA.
Am J Prev Med. 2001 May;20(4):272-6. doi: 10.1016/s0749-3797(01)00298-7.
People with chronic hepatitis B virus (HBV) infection are the major source of HBV transmission in the United States. The Public Health Service recommends prevention counseling for HBV-infected people and vaccination of their household contacts and sexual partners.
To describe the implementation of these recommendations by community physicians.
Telephone survey of 69 people with chronic HBV infection and their healthcare providers, October 1997 through November 1997, in San Diego, California.
Counseling of people with chronic HBV infection and vaccination of their household contacts and sexual partners.
Forty-three percent of providers reported providing prevention counseling to their HBV-infected patients to reduce transmission; 16% of patients reported receiving counseling. For the 32 pairs for which both the patient and provider could be reached and the patients were aware of their HBV infection, 20 (63%) providers reported counseling patients, and 10 (50%) of these providers' patients reported receiving counseling. Fifty-five percent of providers recommended vaccination of contacts; 13% of eligible adult household contacts and sexual partners and 20% of eligible child household contacts had begun hepatitis B vaccination.
Prevention counseling of people with chronic HBV infection and vaccination of their contacts occur infrequently despite guidelines and an effective vaccine. Collaborative efforts between providers and people involved in public health are needed to improve delivery of these preventive health services.
慢性乙型肝炎病毒(HBV)感染者是美国HBV传播的主要来源。公共卫生服务部门建议为HBV感染者提供预防咨询,并为其家庭接触者和性伴侣接种疫苗。
描述社区医生对这些建议的实施情况。
1997年10月至1997年11月,对加利福尼亚州圣地亚哥的69名慢性HBV感染者及其医疗服务提供者进行电话调查。
对慢性HBV感染者的咨询以及为其家庭接触者和性伴侣接种疫苗的情况。
43%的医疗服务提供者报告为其HBV感染患者提供了预防咨询以减少传播;16%的患者报告接受了咨询。对于32对医患双方都能联系上且患者知晓自己感染HBV的情况,20名(63%)医疗服务提供者报告为患者提供了咨询,其中10名(50%)医疗服务提供者的患者报告接受了咨询。55%的医疗服务提供者建议为接触者接种疫苗;13%符合条件的成年家庭接触者和性伴侣以及20%符合条件的儿童家庭接触者已开始接种乙肝疫苗。
尽管有相关指南和有效的疫苗,但对慢性HBV感染者的预防咨询以及为其接触者接种疫苗的情况并不常见。需要医疗服务提供者和公共卫生相关人员共同努力,以改善这些预防性健康服务的提供。