提高乙肝疫苗及时出生剂量覆盖率：2005-2009 年中国五个示范项目的经验。

Improving hepatitis B vaccine timely birth dose coverage: lessons from five demonstration projects in China, 2005-2009.

机构信息

WHO China Country Office, Beijing, China.

WHO Western Pacific Regional Office, Manila, Philippines.

出版信息

Vaccine. 2013 Dec 27;31 Suppl 9:J49-55. doi: 10.1016/j.vaccine.2013.03.025.

DOI:10.1016/j.vaccine.2013.03.025

PMID:24331021

Abstract

BACKGROUND

Delivery of a timely (within 24h) hepatitis B vaccine birth dose (TBD) is essential to prevent the long-term complications of hepatitis B virus (HBV) infection. China made substantial progress in hepatitis B immunization coverage, however, in 2004, TBD coverage was lower in Western, poorer provinces.

METHODS

We reviewed five demonstration projects for the promotion of TBD in rural counties in Qinghai, Gansu and Ningxia. Interventions consisted of (1) work to increase TBD coverage in hospitals, including training of health-care workers, (2) information, education and communication [IEC] with the population and (3) micro-plans to deliver TBD for home births. We evaluated outcome through measuring TBD coverage for home and hospital births.

RESULTS

These projects were implemented in the context of national efforts to promote institutional deliveries that lead to increases ranging from 10% to 17% to reach 43-97% proportion of institutional births at the end of the projects. Among institutional births, TBD coverage increased by 2% to 13% to reach post implementation coverage ranging from 98% to 100%. Among home births, TBD coverage increased by 7% to 56% to reach post implementation coverage ranging from 29% to 88%. Overall, TBD coverage increased by 4% to 36% to reach post implementation coverage ranging from 82% to 88%.

CONCLUSIONS

Demonstration projects based on combined interventions increased TBD coverage. Increases in institutional births amplified the results obtained. Use of standardized indicators for such projects would facilitate evaluation and identify intervention components that are most effective.

摘要

背景

及时（24 小时内）接种乙肝疫苗是预防乙肝病毒（HBV）感染长期并发症的关键。中国在乙肝免疫接种覆盖率方面取得了重大进展，但在 2004 年，西部地区和较贫困省份的乙肝疫苗及时接种率较低。

方法

我们回顾了青海、甘肃和宁夏农村县促进乙肝疫苗及时接种的五个示范项目。干预措施包括（1）加强医院乙肝疫苗接种工作，包括培训医务人员，（2）对人群进行信息、教育和宣传（IEC），（3）为家庭分娩提供乙肝疫苗的微型计划。我们通过测量家庭和医院分娩的乙肝疫苗及时接种率来评估结果。

结果

这些项目是在国家促进机构分娩努力的背景下实施的，这些努力导致机构分娩比例从项目开始时的 10%至 17%增加到 43%至 97%。在机构分娩中，乙肝疫苗及时接种率从 2%增加到 13%，达到项目实施后的接种率范围为 98%至 100%。在家庭分娩中，乙肝疫苗及时接种率从 7%增加到 56%，达到项目实施后的接种率范围为 29%至 88%。总体而言，乙肝疫苗及时接种率从 4%增加到 36%，达到项目实施后的接种率范围为 82%至 88%。