Sathiyanarayanan S, Kumar Pawan, Rao Chythra R, Kumar Arun, Kamath Asha, Kamath Veena
Department of Community and Family Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India.
Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Indian J Community Med. 2020 Jan-Mar;45(1):83-88. doi: 10.4103/ijcm.IJCM_259_19.
The current recommendation in India to commence first dose of measles immunization is at 9 months of age. The effectiveness of measles vaccination is greatly impacted by the level of maternal measles antibody (MMA) during infancy.
To find the prevalence of MMA and to study the maternal and infant factors associated with persistence of MMA among the infants in a Indian rural community.
Dried blood spot sample was collected before vaccination among infants aged 9 months and above when they came for first dose of measles vaccine to assess measles-specific maternal IgG antibody titers by enzyme immunoassay. Maternal and child factors influencing persistence of MMA were collected by interviewing the mothers. Association between various factors affecting seropositivity was tested using univariate logistic regression analysis and strength of association is reported as risk ratio with 95% confidence interval.
Based on the qualitative estimation among all the recruited children (250) in the study, 4 (1.6%) infants showed the presence of MMA whereas 25 (10%) of children had MMA on quantitative estimation. The effect of maternal factors, child nutrition, and sociodemographic factors on the presence of MMA was not found to be statistically significant.
The prevalence of persistent MMA (IgG titer ≥200 mIU/ml) among the infants aged 9-12 months was 10%. The choice of vaccinating infants at the end of 9 months for the first dose of measles vaccine is justified as the remaining (90%) of infants were susceptible for measles infection at this age.
印度目前的建议是在9月龄时开始接种第一剂麻疹疫苗。婴儿期母亲麻疹抗体（MMA）水平对麻疹疫苗接种效果有很大影响。
在印度农村社区中，了解MMA的流行情况，并研究与婴儿体内MMA持续存在相关的母婴因素。
在9月龄及以上前来接种第一剂麻疹疫苗的婴儿接种前采集干血斑样本，通过酶免疫测定法评估麻疹特异性母亲IgG抗体滴度。通过与母亲访谈收集影响MMA持续存在的母婴因素。使用单因素逻辑回归分析检验影响血清学阳性的各种因素之间的关联，并将关联强度报告为风险比及95%置信区间。
根据本研究中所有招募儿童（250名）的定性估计，4名（1.6%）婴儿显示存在MMA，而定量估计时有25名（10%）儿童存在MMA。未发现母亲因素、儿童营养和社会人口学因素对MMA存在的影响具有统计学意义。
9至12月龄婴儿中持续存在MMA（IgG滴度≥200 mIU/ml）的比例为10%。在9个月末为婴儿接种第一剂麻疹疫苗的选择是合理的，因为在此年龄其余（90%）的婴儿对麻疹感染易感。
