中国脊髓灰质炎实验室工作人员免疫现状及其影响因素的调查分析

发布时间：2018-05-02 14:10

本文选题：脊髓灰质炎 + 实验室感染　；参考：《中国疾病预防控制中心》2017年硕士论文

【摘要】：研究背景脊髓灰质炎(简称脊灰)是一种严重危害人类的急性病毒性传染病[1],引起脊髓灰质炎的病原体是脊灰病毒。脊灰病毒是一种人肠道病毒,感染人体后,通过侵袭脊髓的运动神经元引起典型麻痹症状。脊髓灰质炎是目前全球第二个正在消灭的传染性疾病。中国从事脊灰相关防控工作的是各省级疾控中心的脊灰网络实验室,这些网络实验室的日常工作包括脊灰病毒细胞培养、病毒分离、脊灰病毒的中和定型及型内鉴定工作,还包括对急性弛缓性麻痹(AFP)病例、接触者、流动人口、健康人群及环境中和样本的检测分析[2],为消除和维持我国无脊灰状态发挥着重要作用。在脊灰实验室工作中,对于脊灰实验室工作人员来说,存在意外暴露和接触感染性样本或病毒的较高风险。同时,由于我国周边少数国家仍然存在脊灰野病毒流行,我国面临着输入脊灰疫情风险[3]。因此,作为高危职业人群,这些实验室工作人员仍然处于脊灰的威胁之中[4-5],其健康与否不仅关乎自身利益,也同样关乎国家安全和社会稳定。对脊髓灰质炎病毒实验室工作人员实施免疫预防策略,是降低实验室人员感染并传播脊灰病毒风险的重要手段之一。研究目的了解全国各省级疾控中心脊髓灰质炎网络实验室工作人员免疫接种情况和免疫意愿及其影响因素,为提出符合我国国情的适合脊髓灰质炎网络实验室工作人员的免疫策略提供参考,从实验室生物安全管理角度,为维持无脊灰状态及消灭脊灰做出应有贡献。研究方法2016年10月-12月选取全国省级疾控中心脊髓灰质炎网络实验室从业人员为调查对象,采用问卷调查的方式,收集该人群基本信息、免疫接种情况、免疫意愿等资料,并利用SAS软件及卡方检验、精确概率法对免疫接种情况和免疫意愿进行影响因素的统计学分析,以P0.05为差异有统计学意义。研究结果1.参与本次调查人数为77人,其中男性28人(36.4%),女性49人(63.6%);20～岁年龄组16人(20.8%),30～岁组33人(42.8%),40～岁组19人(24.7%),≥50岁9人(11.7%);初级职称者17人(22.0%),中级职称者30人(39.0%),副高职称者17人(22.1%),正高职称者13人(16.9%);大专及以下学历10人(13.0%),本科及以上67人(87.0%)。人员整体素质较高,配置合理。2.免疫接种情况及其影响因素完成脊髓灰质炎基础免疫的为60人(约占78%),17人基础免疫情况不清楚(约占22%)。从事脊髓灰质炎病毒工作后接种疫苗为66人(约占86%),11人接种记录不完整(约占14%)。免疫影响因素..年龄与接种情况,卡方值(χ2=2.48),P0.05;职称与接种情况,卡方值(χ2=2.51),P0.05;工作时间与接种情况,P0.0001;学历与接种情况,卡方值(χ2=0.74),P=0.46;性别与接种情况,卡方值(χ2=0.46),P=0.50。3.接种疫苗意愿及其影响因素愿意接种疫苗共有75人,占全部人员的97.4%;选择接种脊髓灰质炎灭活疫苗(IPV)50人(占66.7%),选择接种脊髓灰质炎减毒活疫苗(0PV)25人(占33.3%);愿意在脊髓灰质炎病毒中和抗体水平低和入职前时接种人数居多;对疫苗接种有顾虑的13人中,11人(占84.6%)担心疫苗引起的不良反应。以年龄、职称、学历、性别、工作时间为影响因素对免疫意愿进行分析显示,年龄与疫苗选择情况,卡方值(χ2=l.78),P0.05。结论研究结果显示,中国脊灰网络实验室人员免疫接种情况较好,其中完成≥3剂次者占41%,且接种信息记录完整;在接种意愿方面,该人群更倾向于在入职时和脊灰中和抗体水平低时接种IPV疫苗。总体来说,中国脊灰网络实验室工作人员免疫现状较好,具备了提出和制定相应免疫策略的良好基础。主要存在问题(1)部分工作人员基础免疫接种信息记录不清;(2)部分工作人员工作后接种脊灰疫苗信息不完整;(3)大部分工作人员愿意接种IPV疫苗,但是现在提供的接种疫苗为OPV疫苗;(4)缺乏针对脊髓灰质炎实验室工作人员的规范完整的免疫接种策略;(5)缺乏对脊髓灰质炎实验室人员感染脊髓灰质炎感染风险的评估。对策建议(1)建立适合我国国情的规范完整的脊髓灰质炎实验室人员免疫接种策略。(2)定期监测脊髓灰质炎网络实验室人员体内抗体水平,结合接种情况合理评估其感染脊髓灰质炎的风险。(3)将IPV纳入到脊髓灰质炎实验室人员免疫规划中。(4)完善疫苗可预防疾病的实验室人群免疫规划策略。
[Abstract]:Background poliomyelitis (poliomyelitis) is an acute viral infectious disease ([1]), which is seriously harmful to human beings. Polio is the pathogen of poliomyelitis. Poliovirus is a human enterovirus, which infects the human body and causes typical paralysis by the motoneurons that invade the spinal cord. Poliomyelitis is second of the world. China's polio related prevention and control work is the polio network laboratory at the provincial CDC. The daily work of these network laboratories includes polio cell culture, virus isolation, neutralization and internal identification of poliovirus, and cases of acute flaccid paralysis (AFP). The detection and analysis of the migrants, the floating population, the healthy population and the environment and the sample [2] play an important role in eliminating and maintaining the polio free state of our country. In the polio laboratory work, there is a high risk of accidental exposure and exposure to infectious samples or viruses for the polio laboratory staff. China still exists polio virus epidemic, China faces the risk of polio epidemic [3]., so as high-risk occupations, these laboratory workers are still in the threat of polio [4-5]. Their health is not only related to their own interests, but also related to national security and social stability. The implementation of immunization prevention strategies is one of the important means to reduce the risk of infection and spread of poliovirus in laboratory personnel. The purpose of this study is to understand the immunization situation, the immune will and the influence factors of the staff of the poliomyelitis network laboratory at the provincial CDC, and to put forward the suitable spinal cord to meet the national conditions of our country. The immunization strategy of the network laboratory staff is provided for reference. From the laboratory biological safety management point of view, it is necessary to contribute to the maintenance of the state of polio free and the elimination of polio. The research method was selected by the national provincial CDC workers in the Network Laboratory of poliomyelitis in -12 month of October 2016. Methods, the basic information of the population, immunization, and the willingness to immunization were collected, and SAS software and chi square test were used to analyze the influence factors of immunization and the intention of immunization. The difference was statistically significant with the difference of P0.05. The number of 1. participants in this survey was 77, of which 28 men were male. (36.4%) 49 women (63.6%); 20 to age group 16 (20.8%), 30 to 33 (42.8%), 40 years old group 19 (24.7%), more than 50 years of 9 (24.7%); junior professional title person, secondary professional title person, senior professional title person, college and below educational background, undergraduate and above. The overall quality of the personnel was high. 60 people (about 78%) had completed the poliomyelitis basic immunization with a reasonable.2. immunization and its influencing factors. The basic immunity of 17 people was not clear (about 22%). 66 people (about 86%) were vaccinated after the poliovirus, 11 (about 14%) were inoculated (about 14%). The immune influence causes Age and inoculation, chi square value (chi 2=2.48), P0.05; title and vaccination status, chi square value (x 2=2.51), P0.05; working hours and inoculation conditions, P0.0001; education and inoculation, chi square value (chi square), P=0.46; sex and vaccination, chi square value (chi square), P=0.50.3. vaccination intention and its influence factors willing to vaccinate 75 People, 97.4% of all, 50 (66.7%) selected inoculation poliomyelitis inactivated vaccine (IPV), 25 (33.3%) inoculated poliomyelitis live attenuated vaccine (0PV), low level of poliovirus neutralization antibody and the number of inoculation before entry; 11 (84.6%) worried about the vaccine among the 13 people who were worried about the vaccination. The effects of age, title, educational background, sex and working time on immune willingness were analyzed, age and vaccine selection, chi square value (chi square 2=l.78). The results of P0.05. conclusion showed that the immunization of Chinese polio network laboratory personnel was better, with more than 3 doses of 41%, and inoculation information. The population was more inclined to inoculate the IPV vaccine at the time of entry and the low level of polio neutralization antibody. In general, the immune status of the workers in the Chinese polio network laboratory was better, and had a good basis for putting forward and formulating the corresponding immunization strategies. The main problems were (1) the basic immunity of some staff members. The inoculation information was not well documented; (2) the information on the inoculation of polio vaccine was incomplete after some staff work; (3) most of the staff were willing to vaccinate IPV vaccines, but the present vaccination was OPV vaccine; (4) a lack of standardized and complete immunization strategies for polio laboratory staff; and (5) lack of poliomyelitis. Assessment of the risk of poliomyelitis infection in laboratory staff. Recommendations (1) to establish a standardized and complete polio immunization strategy suitable for China's national conditions. (2) to regularly monitor the level of antibody in the network laboratory personnel of poliomyelitis, and to assess the risk of poliomyelitis in a reasonable manner in combination with the vaccination situation. (3) IPV was incorporated into the immunization program for poliomyelitis laboratory. (4) to improve the immunization strategy of vaccine population in laboratory population.

【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R186

【参考文献】