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中国云南省新生儿乙型肝炎疫苗接种失败相关因素的调查。

Investigation of the risk factors associated with the failure of hepatitis B vaccination of neonates in Yunnan province, China.

机构信息

Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping District, Beijing 102206, PR China.

Center for Disease Control and Prevention of Yunnan Province, Kunming 650022, PR China.

出版信息

Int J Infect Dis. 2018 Dec;77:90-95. doi: 10.1016/j.ijid.2018.09.026. Epub 2018 Oct 5.

Abstract

OBJECTIVE

This study aimed to investigate HBsAg positive rates and risk factors of HBV infection among the children less than 15 years old in Yunnan province, a remote southwest part of mainland China.

METHODS

Multi-stage sampling was used to randomly select study subjects from 9,360,000 individuals. Hepatitis B vaccine inoculation rate and HBsAg positive rate were investigated, and then propensity score and generalized linear mixed model (GLMMs) were applied to the case-control study.

RESULTS

The average HBsAg positive rate was 1.81%, with 1.2% in urban areas and 2.4% in rural areas. Rate of first-dose-in-time in urban areas was 77.7%, obviously higher than 49.5% in rural areas (χ=2811.71, P<0.01). Similarly, 3-dose completion coverage rate in urban areas was 93.7%, also higher than 79.0% in rural areas (χ=1561.43, P<0.01). Maternal HBeAg positivity and HBsAg positivity were proved to be the main risk factors of children with HBV infection. Moreover, paternal HBeAg positivity, paternal HBsAg positivity, the absence and unknown status of HBV vaccine inoculation were risk factors of children with HBV infection as well.

CONCLUSION

It was very important to improve the HBV vaccine inoculation rates. Delivering babies in hospital and timely inoculation with HBV vaccine were efficient ways to prevent HBV vertical transmission.

摘要

目的

本研究旨在调查中国西南偏远地区云南省 15 岁以下儿童乙型肝炎表面抗原(HBsAg)阳性率及乙型肝炎病毒(HBV)感染的危险因素。

方法

采用多阶段抽样方法,从 936 万人中随机选择研究对象。调查乙型肝炎疫苗接种率和 HBsAg 阳性率,并采用倾向评分和广义线性混合模型(GLMMs)进行病例对照研究。

结果

平均 HBsAg 阳性率为 1.81%,城市为 1.2%,农村为 2.4%。城市地区首针及时接种率为 77.7%,明显高于农村地区的 49.5%(χ=2811.71,P<0.01)。同样,城市地区 3 剂全程接种覆盖率为 93.7%,也高于农村地区的 79.0%(χ=1561.43,P<0.01)。母亲 HBeAg 阳性和 HBsAg 阳性是儿童 HBV 感染的主要危险因素。此外,父亲 HBeAg 阳性、父亲 HBsAg 阳性、HBV 疫苗接种缺失和未知状态也是儿童 HBV 感染的危险因素。

结论

提高 HBV 疫苗接种率非常重要。在医院分娩和及时接种 HBV 疫苗是预防 HBV 垂直传播的有效方法。

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