Kuo Ching-Chia, Huang Yhu-Chering, Hsieh Yu-Chia, Huang Ya-Ling, Huang Yu-Chiau, Hung Yung-Tai
Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
J Microbiol Immunol Infect. 2017 Jun;50(3):327-332. doi: 10.1016/j.jmii.2015.07.006. Epub 2015 Jul 31.
BACKGROUND/PURPOSE: Pertussis has been considered a vaccine-preventable "childhood disease", but a shift in age distribution has been reported worldwide. We conducted a seroepidemiological study in 2013 in Taiwan to elucidate the seroprevalence of pertussis among elementary school children.
With a multilevel randomized method, which included 14 variables (4 population variables, 4 socio-educational variables, and 6 medical facilities' variables), the 29 executive districts of New Taipei City, Taiwan, were categorized into five strata. From each stratum, the number of school children as well as the number of elementary schools were proportionally selected. Enzyme immunoassay was applied for pertussis immunoglobulin-G measurement.
A total of 936 children from 14 schools were recruited. Most participants (98.89%) received at least three doses of acellular diphtheria-tetanus-pertussis vaccine. The overall seropositive rate for pertussis was 33.97%. The seropositive rate was highest for students in Grade 1 (49.36%) and then declined with time, except for Grade 6 students. Students from Grade 1 to Grade 4 had a significant higher seropositive rate (37.18% vs. 27.56%, p = 0.002) than those from Grade 5 to Grade 6, but a lower geometric mean titer (18.71 NovaTec Unit/mL vs. 20.04 NovaTec Unit/mL, p = 0.20). For the class grades, geometric mean titers were positively correlated with seroprevalence (p < 0.005).
Currently, almost one-third of elementary school children in Taiwan were seropositive for pertussis, a rate lower than expected. Seroprevalence declined with increasing class grades except for Grade 6. The current national immunization program may not provide adequate protection for children against pertussis.
背景/目的：百日咳一直被视为一种可通过疫苗预防的“儿童疾病”，但全球范围内均有报道其年龄分布发生了变化。2013年我们在台湾进行了一项血清流行病学研究，以阐明小学生中百日咳的血清阳性率。
采用多水平随机方法，该方法包括14个变量（4个人口变量、4个社会教育变量和6个医疗设施变量），将台湾新北市的29个行政区分为五个层次。从每个层次中按比例选取学童数量和小学数量。采用酶免疫法检测百日咳免疫球蛋白G。
共招募了来自14所学校的936名儿童。大多数参与者（98.89%）接种了至少三剂无细胞白喉-破伤风-百日咳疫苗。百日咳的总体血清阳性率为33.97%。一年级学生的血清阳性率最高（49.36%），之后随时间下降，但六年级学生除外。一年级至四年级的学生血清阳性率（37.18%对27.56%，p = 0.002）显著高于五年级至六年级的学生，但几何平均滴度较低（18.71诺华单位/毫升对20.04诺华单位/毫升，p = 0.20）。对于班级年级，几何平均滴度与血清阳性率呈正相关（p < 0.005）。
目前，台湾近三分之一的小学生百日咳血清呈阳性，这一比率低于预期。除六年级外，血清阳性率随年级升高而下降。当前的国家免疫规划可能无法为儿童提供足够的百日咳防护。
