潍坊市甲、乙肝疫苗预防效果分析
发布时间：2019-06-03 11:46
【摘要】： 目的:病毒性肝炎是长期困扰人民群众身体健康的主要传染病之一,潍坊市自1992年开始使用甲、乙肝疫苗,研究1992～2006年潍坊市甲、乙肝疫苗应用后对甲肝、乙肝的发病情况的影响,提出甲、乙肝疫苗推广应用中存在的问题,为制定潍坊市甲肝、乙肝控制策略提供科学依据。 方法:1.收集潍坊市疫情资料年报表、疫情资料汇编,对1992～2006年甲肝、乙肝发病情况按地区分布、年龄、性别分布、职业分布、季节分布进行统计,用Excel 2000建立数据库。用描述性分析的方法分析潍坊市1992～2006年甲肝和乙肝的流行病学特征。 2.收集潍坊市1992～2006年甲肝疫苗接种统计月报表、乙肝疫苗接种统计月报表、预防接种情况统计月报表、接种率抽样调查资料,用Excel 2000建立数据库。用抽样调查的接种率来评价报告接种率是否可信,利用SPSS 13.0软件对甲、乙肝疫苗接种率与甲、乙肝发病率的关系进行相关分析。 3.收集甲肝、乙肝血清学检测资料,分析甲、乙肝疫苗的免疫效果。 4.甲肝与细菌性痢疾的传播途径相似,收集潍坊市1992～2006年细菌性痢疾发病资料,比较1992～2006年甲肝和细菌性痢疾的发病情况,探讨是否还有卫生状况的改变影响甲肝的发病。 结果:1.潍坊市1992～2006年病毒性肝炎的发病率总体上呈下降趋势,发病率由1992年的35.90/10万下降到2002年的最低点9.92/10万,1992～1995年病毒性肝炎发病主要受甲肝的影响,且发病曲线与甲肝的发病曲线相似,1996～2006年病毒性肝炎发病主要受乙肝的影响,且发病曲线与乙肝的发病曲线相似。甲肝的发病率从1992年的26.23/10万,急剧下降到1994年的6.41/10万,1995年后下降平稳,且维持在低水平,2006年发病率最低,为0.48/10万。乙肝的发病率变化不大,1995年发病率最低,为6.81/10万,2004年出现一个小高峰,发病率为15.99/10万,并有上升趋势。 2.潍坊市1992～2006年病毒性肝炎发病较高的地区有青州、寿光、临朐、高密。甲肝发病有秋季高峰,乙肝发病无明显的季节高峰,12月份甲、乙肝的发病率均为全年最低。甲、乙肝病例中,14岁以下人群发病构成比呈逐年下降的趋势。甲肝的发病以学生、农民为主,构成比分别为29.42%和28.93%;乙肝发病以农民为主,构成比为54.92%。甲、乙肝的发病率男性均高于女性,且有显著性(x_(甲肝)~2=385.12,x_(乙肝)~2=1896.81)。 3.甲肝疫苗的接种率由1992年的0.01%上升到2006年的95.24%;乙肝疫苗的接种率由1992年的0.47%上升到2006年的99.57%。甲肝疫苗接种率与14岁以下儿童发病率呈负相关,相关系数为-0.979(P＜0.01);甲肝疫苗接种率与全人口发病率呈也负相关,相关系数为-0.967(P＜0.01)。乙肝疫苗接种率与14岁以下儿童发病率呈负相关,相关系数为-0.861(P＜0.01),乙肝疫苗接种率与全人口发病率相关关系并不明显(P＞0.05)。 4.甲肝血清学检测调查1456名,其中有接种史1266名,无接种史190名,抗-HAV阳性率分别为88.78%和36.32%,两者有显著性差异(x~2=108.62,P＜0.01)。乙肝血清学检测调查0～14岁儿童1174名,HBsAg、抗-HBs、抗-HBc阳性率分别为1.11%、71.12%、8.18%,未开展接种前的1991年抽样调查0～14岁儿童756名,HBsAg、抗-HBs、抗-HBc阳性率分别为3.17%、12.96%、10.05%,开展接种前后HBsAg、抗-HBs阳性率比较有非常显著差异(x_(HBsAg)~2=10.52,x_(抗-HBs)~2=624,P＜0.01)。 5.甲肝和细菌性痢疾的发病率均逐年下降,甲肝的发病数由1992年的2142例下降到2006年的41例,下降了98.09%,细菌性痢疾的发病数由1992年的2931例下降到2006年的852例,下降了70.93%。从发病曲线看,甲肝和细菌性痢疾的发病从1992年到1995年为快速下降期;从1996年开始甲肝的发病率继续下降,且处于较低水平,细菌性痢疾的发病率下降不明显,提示卫生状况的改善能够降低甲肝的发病,但甲肝疫苗的接种能够将甲肝发病控制在最低水平。 结论:潍坊市1992年以来甲肝疫苗的接种能够降低甲肝的发病率;乙肝疫苗的接种仅能够降低14岁以下儿童乙肝的发病率,应扩大应用范围,使总人口的发病率大幅降低。 对策与建议:1.加强领导,保证资金投入 潍坊市政府应建立病毒性肝炎防治研究专项基金,保障经费投入,研究当地肝炎流行特点和规律,制定适合潍坊市的肝炎防治战略规划,做好肝炎控制工作。 2.加大甲、乙肝炎疫苗推广应用力度 在做好14岁以下儿童免疫接种的基础上,根据甲肝的流行特征和人群免疫水平,对重点人群和重点地区开展甲肝疫苗的接种工作。除推行新生儿接种乙肝疫苗的预防策略外,还需要关注其他人群的乙肝疫苗免疫策略。 3.开展宣传教育,增强防病意识 应充分利用各种媒体开展多种形式的病毒性肝炎防治宣传,积极主动开展健康教育活动,使广大群众清楚地认识到病毒性肝炎对人体健康的严重危害,了解科学防治知识,增强强身健体的防病意识,消除人们恐惧感。 4.加强病毒性肝炎的监测 完善病毒性肝炎监测网络,积极开展病毒性肝炎发病及流行情况的监测、疫苗接种率和人群免疫水平监测,深入了解和掌握病毒性肝炎的流行特征与发病规律,为预测疾病流行趋势、制定有效预防控制措施提供科学依据。 5.加强医源性感染控制工作 严格执行《传染病防治法》和《献血法》等相关法律法规,加强对采供血机构和血液制品生产单位的监督,加大对血液、血制品和医疗机构消毒的监管力度,实施安全注射,防止医源性感染。
[Abstract]:Objective: To study the effect of hepatitis A and hepatitis B vaccine on the incidence of hepatitis A and hepatitis B after the application of hepatitis A and hepatitis B vaccine from 1992 to 2006. The existing problems in the promotion and application of hepatitis B vaccine provide a scientific basis for the development of the control strategy of hepatitis A and hepatitis B in the city. The method 1. Collect the annual report and epidemic information of the epidemic information of the Fangfang City, and make statistics on the incidence of hepatitis A and hepatitis B from 1992 to 2006 according to the regional distribution, age, sex distribution, occupational distribution and seasonal distribution, and set up the number with Excel 2000. Analysis of the epidemiology of hepatitis A and hepatitis B from 1992 to 2006 in Fangfang City by means of descriptive analysis Characteristics.2. Collect the monthly report of the vaccination statistics of the hepatitis A vaccine from 1992 to 2006, the monthly report of the hepatitis B vaccine, the monthly report of the monthly vaccination, the data on the sampling survey of the vaccination rate, and use Excel 2000. To establish a database. The rate of vaccination with a sample survey was used to evaluate the reliability of the reported vaccination rate. The relationship between the rate of hepatitis B and the incidence of hepatitis A and hepatitis B was measured by using the SPSS 13.0 software. Line-related analysis.3. Collection of serologic test data of hepatitis A and hepatitis B, and analysis of A and B The immune effect of the liver vaccine was similar to that of the bacillary dysentery. The incidence of bacillary dysentery from 1992 to 2006 was collected from 1992 to 2006, and the incidence of hepatitis A and bacillary dysentery in 1992 to 2006 was compared. the change of the condition The incidence of viral hepatitis was decreased from 35.90 per 100,000 in 1992 to 9.92 per 100,000 in 2002, and the incidence of viral hepatitis in 1992 to 1995 was mainly affected by alpha-liver. The incidence of viral hepatitis was mainly affected by hepatitis B during the period from 1996 to 2006, and the incidence of viral hepatitis in 1996-2006 was mainly affected by hepatitis B. The incidence of hepatitis A was similar to that of hepatitis B. The incidence of hepatitis A decreased from 26.23/1 million in 1992 to 6.41/10 million in 1994, decreased steadily after 1995, and maintained at a low level. The lowest rate of incidence of hepatitis B was 0.48/ 100,000. The incidence of hepatitis B was low, with the lowest incidence in 1995, which was 6.81/ 100,000, a small peak in 2004, with a prevalence of 15. .99/ 100,000, and there is a rising trend.2. The incidence of viral hepatitis from 1992 to 2006 in the Fangfang City. The higher area has Qingzhou, Shouguang, Linyi, and Gaomi. The onset of hepatitis A has a peak in autumn, and there is no obvious seasonal peak in the incidence of hepatitis B.1 In February, the incidence of hepatitis B was the lowest in the whole year. In case of hepatitis A and hepatitis B, the incidence of hepatitis B was 14 years. The incidence of hepatitis A in the following population is decreasing year by year. The incidence of hepatitis A is mainly based on students and farmers. The composition ratio is 29.42% and 28.93%, respectively. The rate of incidence of hepatitis A and hepatitis B was higher than that of female, and there was significant difference (x _ (liver) ~ 2 = 385.12. The coverage rate of hepatitis B vaccine increased from 0.01% in 1992 to 95.24% in 2006, and the vaccination rate of hepatitis B vaccine was increased by 1992 0.47% increased to 99.57% in 2006. The rate of hepatitis A vaccine was negatively correlated with the incidence of children under 14 years of age. The correlation coefficient was-0.979 (P <0.01), and the rate of hepatitis A vaccine was negatively correlated with the incidence of whole population. And the correlation coefficient was-0.967 (P <0.01). The vaccination rate of hepatitis B vaccine was negatively correlated with the incidence of children under 14 years of age, the correlation coefficient was-0.861 (P <0.01), and the vaccination rate of hepatitis B vaccine was similar to that of the whole population. The incidence of the incidence of hepatitis A was not significant (P> 0.05).4. The serologic test of the hepatitis A was 1456, including 1266 of the history of inoculation,190 without the history of inoculation, 88.78% of the anti-HAV positive rate and 36.32% of the anti-HAV, respectively. The positive rates of HBsAg, anti-HBs and anti-HBc were 1.11%, 71.12% and 8.18%, respectively. The positive rates of anti-HBc were 1.11%, 71.12% and 8.18%, respectively. The rate of anti-HBs was 3.17%, 12.96% and 10.05%, respectively. The positive rate of HBsAg and anti-HBs was significantly different before and after inoculation (x _ (HBsAg) ~ 2 = 10.52. The incidence of hepatitis A and bacillary dysentery decreased year by year. The incidence of alpha-liver decreased from 2142 in 1992 to 41 in 2006, and the incidence of bacillary dysentery decreased by 98.09%, and the number of bacillary dysentery was 29 in 1992. From the onset of the disease, the incidence of alpha-and bacillary dysentery was from 1992 to 1995. The incidence of alpha-and bacillary dysentery began to decline from 1992 to 1995, and the incidence of alpha-and bacillary dysentery began to decrease from 1992 to 1995, and the incidence of bacillary dysentery was low. It is not obvious that the improvement of the sanitary condition can reduce the hepatitis A. The infection of hepatitis A vaccine can be controlled at the lowest level. Conclusion: The vaccination of hepatitis A vaccine since 1992 can reduce the incidence of hepatitis A. The inoculation of hepatitis B vaccine can only be reduced below 14 years of age. The incidence of hepatitis B in children The application scope should be expanded to make the total The incidence of the population is significantly reduced. Countermeasures and suggestions:1. Strengthen the leadership and ensure that the government of the city and the city should set up a special fund for the prevention and control of viral hepatitis, to guarantee the input of the funds and to study the local area The characteristics and laws of the epidemic of hepatitis are formulated to be suitable for the city. the prevention and control strategic planning of hepatitis and the control of the hepatitis.2. The promotion and application of the hepatitis A and the hepatitis B vaccine are carried out to the basis of the immunization of children under the age of 14 On the basis of the prevalence of the hepatitis A and the level of immunization of the population, the joint of the hepatitis A vaccine was carried out on the key population and the key areas. work. In addition to the introduction of a neonatal inoculation of hepatitis B In addition to the prevention strategy of the vaccine, it is also necessary to pay attention to the immunization strategy of the hepatitis B vaccine of other people.3. Carry out the publicity and education, strengthen the disease prevention consciousness, and take full advantage of various media to carry out various forms of virus To promote the prevention and control of hepatitis, to actively carry out the activities of health education, to make the broad masses clear Recognition of viral hepatitis on human body To improve the monitoring network of viral hepatitis and to actively carry out the development of the monitoring network of viral hepatitis. Surveillance of the incidence and prevalence of viral hepatitis, the vaccination rate and the population's immune water Level monitoring, in-depth understanding and mastery of the virus To strengthen the control of iatrogenic infection, the prevention and control of infectious diseases and the blood donation should be strictly implemented. Law> and other relevant legal methods
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R186
本文编号：2491913
[Abstract]:Objective: To study the effect of hepatitis A and hepatitis B vaccine on the incidence of hepatitis A and hepatitis B after the application of hepatitis A and hepatitis B vaccine from 1992 to 2006. The existing problems in the promotion and application of hepatitis B vaccine provide a scientific basis for the development of the control strategy of hepatitis A and hepatitis B in the city. The method 1. Collect the annual report and epidemic information of the epidemic information of the Fangfang City, and make statistics on the incidence of hepatitis A and hepatitis B from 1992 to 2006 according to the regional distribution, age, sex distribution, occupational distribution and seasonal distribution, and set up the number with Excel 2000. Analysis of the epidemiology of hepatitis A and hepatitis B from 1992 to 2006 in Fangfang City by means of descriptive analysis Characteristics.2. Collect the monthly report of the vaccination statistics of the hepatitis A vaccine from 1992 to 2006, the monthly report of the hepatitis B vaccine, the monthly report of the monthly vaccination, the data on the sampling survey of the vaccination rate, and use Excel 2000. To establish a database. The rate of vaccination with a sample survey was used to evaluate the reliability of the reported vaccination rate. The relationship between the rate of hepatitis B and the incidence of hepatitis A and hepatitis B was measured by using the SPSS 13.0 software. Line-related analysis.3. Collection of serologic test data of hepatitis A and hepatitis B, and analysis of A and B The immune effect of the liver vaccine was similar to that of the bacillary dysentery. The incidence of bacillary dysentery from 1992 to 2006 was collected from 1992 to 2006, and the incidence of hepatitis A and bacillary dysentery in 1992 to 2006 was compared. the change of the condition The incidence of viral hepatitis was decreased from 35.90 per 100,000 in 1992 to 9.92 per 100,000 in 2002, and the incidence of viral hepatitis in 1992 to 1995 was mainly affected by alpha-liver. The incidence of viral hepatitis was mainly affected by hepatitis B during the period from 1996 to 2006, and the incidence of viral hepatitis in 1996-2006 was mainly affected by hepatitis B. The incidence of hepatitis A was similar to that of hepatitis B. The incidence of hepatitis A decreased from 26.23/1 million in 1992 to 6.41/10 million in 1994, decreased steadily after 1995, and maintained at a low level. The lowest rate of incidence of hepatitis B was 0.48/ 100,000. The incidence of hepatitis B was low, with the lowest incidence in 1995, which was 6.81/ 100,000, a small peak in 2004, with a prevalence of 15. .99/ 100,000, and there is a rising trend.2. The incidence of viral hepatitis from 1992 to 2006 in the Fangfang City. The higher area has Qingzhou, Shouguang, Linyi, and Gaomi. The onset of hepatitis A has a peak in autumn, and there is no obvious seasonal peak in the incidence of hepatitis B.1 In February, the incidence of hepatitis B was the lowest in the whole year. In case of hepatitis A and hepatitis B, the incidence of hepatitis B was 14 years. The incidence of hepatitis A in the following population is decreasing year by year. The incidence of hepatitis A is mainly based on students and farmers. The composition ratio is 29.42% and 28.93%, respectively. The rate of incidence of hepatitis A and hepatitis B was higher than that of female, and there was significant difference (x _ (liver) ~ 2 = 385.12. The coverage rate of hepatitis B vaccine increased from 0.01% in 1992 to 95.24% in 2006, and the vaccination rate of hepatitis B vaccine was increased by 1992 0.47% increased to 99.57% in 2006. The rate of hepatitis A vaccine was negatively correlated with the incidence of children under 14 years of age. The correlation coefficient was-0.979 (P <0.01), and the rate of hepatitis A vaccine was negatively correlated with the incidence of whole population. And the correlation coefficient was-0.967 (P <0.01). The vaccination rate of hepatitis B vaccine was negatively correlated with the incidence of children under 14 years of age, the correlation coefficient was-0.861 (P <0.01), and the vaccination rate of hepatitis B vaccine was similar to that of the whole population. The incidence of the incidence of hepatitis A was not significant (P> 0.05).4. The serologic test of the hepatitis A was 1456, including 1266 of the history of inoculation,190 without the history of inoculation, 88.78% of the anti-HAV positive rate and 36.32% of the anti-HAV, respectively. The positive rates of HBsAg, anti-HBs and anti-HBc were 1.11%, 71.12% and 8.18%, respectively. The positive rates of anti-HBc were 1.11%, 71.12% and 8.18%, respectively. The rate of anti-HBs was 3.17%, 12.96% and 10.05%, respectively. The positive rate of HBsAg and anti-HBs was significantly different before and after inoculation (x _ (HBsAg) ~ 2 = 10.52. The incidence of hepatitis A and bacillary dysentery decreased year by year. The incidence of alpha-liver decreased from 2142 in 1992 to 41 in 2006, and the incidence of bacillary dysentery decreased by 98.09%, and the number of bacillary dysentery was 29 in 1992. From the onset of the disease, the incidence of alpha-and bacillary dysentery was from 1992 to 1995. The incidence of alpha-and bacillary dysentery began to decline from 1992 to 1995, and the incidence of alpha-and bacillary dysentery began to decrease from 1992 to 1995, and the incidence of bacillary dysentery was low. It is not obvious that the improvement of the sanitary condition can reduce the hepatitis A. The infection of hepatitis A vaccine can be controlled at the lowest level. Conclusion: The vaccination of hepatitis A vaccine since 1992 can reduce the incidence of hepatitis A. The inoculation of hepatitis B vaccine can only be reduced below 14 years of age. The incidence of hepatitis B in children The application scope should be expanded to make the total The incidence of the population is significantly reduced. Countermeasures and suggestions:1. Strengthen the leadership and ensure that the government of the city and the city should set up a special fund for the prevention and control of viral hepatitis, to guarantee the input of the funds and to study the local area The characteristics and laws of the epidemic of hepatitis are formulated to be suitable for the city. the prevention and control strategic planning of hepatitis and the control of the hepatitis.2. The promotion and application of the hepatitis A and the hepatitis B vaccine are carried out to the basis of the immunization of children under the age of 14 On the basis of the prevalence of the hepatitis A and the level of immunization of the population, the joint of the hepatitis A vaccine was carried out on the key population and the key areas. work. In addition to the introduction of a neonatal inoculation of hepatitis B In addition to the prevention strategy of the vaccine, it is also necessary to pay attention to the immunization strategy of the hepatitis B vaccine of other people.3. Carry out the publicity and education, strengthen the disease prevention consciousness, and take full advantage of various media to carry out various forms of virus To promote the prevention and control of hepatitis, to actively carry out the activities of health education, to make the broad masses clear Recognition of viral hepatitis on human body To improve the monitoring network of viral hepatitis and to actively carry out the development of the monitoring network of viral hepatitis. Surveillance of the incidence and prevalence of viral hepatitis, the vaccination rate and the population's immune water Level monitoring, in-depth understanding and mastery of the virus To strengthen the control of iatrogenic infection, the prevention and control of infectious diseases and the blood donation should be strictly implemented. Law> and other relevant legal methods
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R186
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