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中国杭州 2009-2017 年百日咳血清流行病学研究。

Seroepidemiology of pertussis in Hangzhou, China, during 2009-2017.

机构信息

Imunoprevention institute, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.

出版信息

Hum Vaccin Immunother. 2019;15(11):2564-2570. doi: 10.1080/21645515.2019.1608130. Epub 2019 May 22.

Abstract

To delineate seroepidemiology of pertussis in Hangzhou, to evaluate the protection levels of pertussis among healthy populations, for improving prevention strategy of pertussis. During 2009-2017, a multistage stratified random sampling method was employed to select participants included via physical examination for subjects in several Community Health Centers in Hangzhou. Enzyme-Linked Immunosorbent Assay (ELISA) was used to detect Immunoglobulin G (IgG) antibodies against pertussis in serum samples. Results were compared among 11 age groups. Univariate and multivariate analysis were used to analyze the associations among the rates of pertussis IgG seropositivity and the geometric mean concentration (GMC) levels of pertussis IgG and the related factors. A total of 3360 subjects with available information were included, with 1745 male and 1615 female. Of these, 59.6% subjects had a clear immunization history of diphtheria-tetanus-pertussis vaccine (DTP). The vaccination rates of DTP had a declined trend with older age. The rate of pertussis IgG seropositivity was 69.9% (95% confidence interval: 68.3-71.5) and the GMC for pertussis IgG was 48.46 U/ml. Significantly higher seropositivity and GMC for pertussis IgG were found in subjects that had inoculation vaccine history or unknown history when compared those without inoculation of vaccine, lower in age groups <10, 20-29, and 30-39 y when compared to the other age groups evaluated. There are different distribution profiles both of the seropositivity and GMC for pertussis IgG for different age groups and immunization history of vaccine groups. In order to prevent pertussis occurrence, it is important to employ a booster dose of pertussis vaccine in adolescents and adults.

摘要

为了描绘杭州市百日咳的血清流行病学情况,评估健康人群中百日咳的保护水平,从而改进百日咳的预防策略。2009 年至 2017 年期间,采用多阶段分层随机抽样方法,选取杭州市多个社区卫生服务中心体检人群作为研究对象。采用酶联免疫吸附试验(ELISA)检测血清样本中针对百日咳的免疫球蛋白 G(IgG)抗体。对 11 个年龄组的结果进行了比较。采用单因素和多因素分析方法分析了百日咳 IgG 血清阳性率、百日咳 IgG 的几何平均浓度(GMC)水平与相关因素之间的关系。共纳入 3360 名可提供信息的研究对象,其中男性 1745 名,女性 1615 名。59.6%的研究对象有明确的白喉-破伤风-百日咳疫苗(DTP)免疫史。DTP 的接种率随年龄增长呈下降趋势。百日咳 IgG 血清阳性率为 69.9%(95%置信区间:68.3-71.5),百日咳 IgG 的 GMC 为 48.46 U/ml。与未接种疫苗者相比,有接种疫苗史或史未知的研究对象的百日咳 IgG 血清阳性率和 GMC 更高,年龄<10 岁、20-29 岁和 30-39 岁的年龄组比其他年龄组更低。不同年龄组和疫苗接种史组的百日咳 IgG 血清阳性率和 GMC 分布情况不同。为预防百日咳的发生,在青少年和成年人中使用百日咳疫苗加强剂非常重要。

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