安徽省黃山市甲肝流行病學(xué)調(diào)查及免疫策略研究
發(fā)布時(shí)間：2019-06-27 18:59
【摘要】：目的 研究黃山市甲肝流行病學(xué)特征,了解黃山市健康人群甲型肝炎抗體水平及影響滴度因素,了解甲型肝炎疫苗的免疫狀況,分析健康人群發(fā)生HAV自然感染的影響因素,為甲肝防控提供科學(xué)依據(jù)。 方法 對(duì)黃山市2004-2011年甲肝疫情資料進(jìn)行流行病學(xué)分析；用分層整群隨機(jī)抽樣的方法,以黃山市健康人群為研究對(duì)象,通過(guò)問(wèn)卷調(diào)查收集研究對(duì)象的人口學(xué)和飲食行為等相關(guān)信息,用ELISA方法定性檢測(cè)調(diào)查對(duì)象血清樣本中的甲型肝炎抗體及滴度水平,分析影響研究對(duì)象HAV自然感染的因素。 結(jié)果 2004-2011年黃山市甲肝年均發(fā)病率為2.00/10萬(wàn),以黟縣最高為2.39/10萬(wàn),發(fā)病率由2004年的4.71/10萬(wàn)降至2011年的0.66/10萬(wàn)；共納入調(diào)查對(duì)象1622名,甲型肝炎總抗體陽(yáng)性為926名,陽(yáng)性率為57.09%。調(diào)查對(duì)象中甲型肝炎總抗體陽(yáng)性率最高為6-10歲年齡組,陽(yáng)性率90.98%,最低為16-20歲年齡組,陽(yáng)性為10.69%,20歲以上人群陽(yáng)性率在70%以上；有甲型肝炎疫苗接種史的人群的甲型肝炎抗體陽(yáng)性率顯著高于無(wú)接種記錄的對(duì)象,接種2針次的甲肝抗體陽(yáng)轉(zhuǎn)率明顯高于接種1針次的,為80.09%,免疫后抗體水平會(huì)隨著時(shí)間推移逐漸下降；使用不衛(wèi)生廁所、飯前喝便后不洗手、喝生水和健康知識(shí)知曉率低等是發(fā)生HAV感染的危險(xiǎn)因素；20歲以下人群的甲肝抗體滴度水平都以1：5居多,而20歲以上人群的甲肝抗體滴度水平都以1：40居多。結(jié)論 黃山市甲肝防制已取得明顯成效。既往黃山市的甲型肝炎疫苗接種策略顯著提高了兒童和青少年部分年齡組人群的甲型肝炎抗體水平,自然感染的人群甲肝抗體滴度高于接種甲肝疫苗的人群,2針次免疫程序產(chǎn)生的抗體滴度明顯好于1針次的,因而說(shuō)明自然人群感染甲肝病毒獲得的免疫力長(zhǎng)久,接種甲肝疫苗產(chǎn)生的抗體滴度存在隨著時(shí)間推移逐漸消退的可能,需要考慮加強(qiáng)免疫,必要是也可對(duì)免疫程序進(jìn)行調(diào)整。健康人群中曾獲得HAV感染的比率較高,特別是20歲以上人群,大多數(shù)人都產(chǎn)生了特異性抗體,顯示自然感染過(guò)甲肝病毒,此現(xiàn)象應(yīng)引起足夠的重視,做好其防治工作；同時(shí)加強(qiáng)食品衛(wèi)生管理,開(kāi)展飲食衛(wèi)生和甲肝防治知識(shí)健康教育。繼續(xù)實(shí)行以保護(hù)易感人群和切斷傳播途徑為主的綜合防制策略,提高預(yù)防甲肝的能力。
[Abstract]:Objective to study the epidemiological characteristics of hepatitis A in Huangshan City, to understand the antibody level and titer factors of hepatitis A in healthy people in Huangshan City, to understand the immune status of hepatitis A vaccine, and to analyze the influencing factors of natural infection of HAV in healthy people, so as to provide scientific basis for the prevention and control of hepatitis A. Methods Epidemiological analysis was carried out on the epidemic data of hepatitis A in Huangshan City from 2004 to 2011, and the demographic and dietary behavior of healthy people in Huangshan City were collected by stratified cluster random sampling, and the antibody and titer of hepatitis A in serum samples were qualitatively detected by ELISA, and the factors affecting the natural infection of hepatitis A were analyzed. Results the average annual incidence of hepatitis A in Huangshan City was 2.00 / 100000 in 2004, the highest was 2.39 / 100000 in Yixian County, and the incidence decreased from 4.71 / 100000 in 2004 to 0.66 / 100000 in 2011. A total of 1622 subjects were included in the survey, and the total antibody positive rate of hepatitis A was 926, the positive rate was 57.09%. The positive rate of total antibody against hepatitis A was the highest in the age group of 6 years old and 10 years old, the positive rate was 0998%, the lowest was the age group of 16 years old, the positive rate was 10.69%, and the positive rate of the population over 20 years old was more than 70%. The positive rate of hepatitis A antibody in the population with history of hepatitis A vaccination was significantly higher than that in the subjects without vaccination record, and the positive conversion rate of hepatitis A antibody inoculated with 2 times was significantly higher than that of one injection (80.09%). The antibody level decreased gradually with the passage of time. The risk factors of HAV infection were unsanitary toilet, not washing hands after drinking stool before and after meals, drinking raw water and low awareness rate of health knowledge. The titer of hepatitis A antibody in people under 20 years old was higher than that in people over 20 years old at 1:5, while the titer level of hepatitis A antibody in people over 20 years old was higher than that in people over 20 years old. Conclusion the prevention and control of hepatitis A in Huangshan City has achieved remarkable results. The hepatitis A vaccination strategy in Huangshan City has significantly increased the level of hepatitis A antibody in some age groups of children and adolescents. The titer of hepatitis A antibody in the naturally infected population is higher than that in the population vaccinated with hepatitis A vaccine, and the antibody titer produced by the two immunization procedures is significantly better than that of the first injection, which indicates that the immunity obtained by the natural population infected with hepatitis A virus is long. The antibody titer produced by hepatitis A vaccine may gradually fade with the passage of time. It is necessary to consider strengthening immunization and adjust the immunization procedure. The rate of HAV infection was high in healthy people, especially in people over 20 years old. Most people produced specific antibodies, which showed that they had naturally infected hepatitis A virus, which should be paid enough attention to, and their prevention and control work should be done well. At the same time, food hygiene management should be strengthened and knowledge and health education of diet hygiene and hepatitis A prevention and treatment should be carried out. We will continue to implement comprehensive prevention and control strategies to protect the susceptible population and cut off transmission routes to improve the ability to prevent hepatitis A.
【學(xué)位授予單位】：中國(guó)疾病預(yù)防控制中心
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R512.61
本文編號(hào)：2507054
[Abstract]:Objective to study the epidemiological characteristics of hepatitis A in Huangshan City, to understand the antibody level and titer factors of hepatitis A in healthy people in Huangshan City, to understand the immune status of hepatitis A vaccine, and to analyze the influencing factors of natural infection of HAV in healthy people, so as to provide scientific basis for the prevention and control of hepatitis A. Methods Epidemiological analysis was carried out on the epidemic data of hepatitis A in Huangshan City from 2004 to 2011, and the demographic and dietary behavior of healthy people in Huangshan City were collected by stratified cluster random sampling, and the antibody and titer of hepatitis A in serum samples were qualitatively detected by ELISA, and the factors affecting the natural infection of hepatitis A were analyzed. Results the average annual incidence of hepatitis A in Huangshan City was 2.00 / 100000 in 2004, the highest was 2.39 / 100000 in Yixian County, and the incidence decreased from 4.71 / 100000 in 2004 to 0.66 / 100000 in 2011. A total of 1622 subjects were included in the survey, and the total antibody positive rate of hepatitis A was 926, the positive rate was 57.09%. The positive rate of total antibody against hepatitis A was the highest in the age group of 6 years old and 10 years old, the positive rate was 0998%, the lowest was the age group of 16 years old, the positive rate was 10.69%, and the positive rate of the population over 20 years old was more than 70%. The positive rate of hepatitis A antibody in the population with history of hepatitis A vaccination was significantly higher than that in the subjects without vaccination record, and the positive conversion rate of hepatitis A antibody inoculated with 2 times was significantly higher than that of one injection (80.09%). The antibody level decreased gradually with the passage of time. The risk factors of HAV infection were unsanitary toilet, not washing hands after drinking stool before and after meals, drinking raw water and low awareness rate of health knowledge. The titer of hepatitis A antibody in people under 20 years old was higher than that in people over 20 years old at 1:5, while the titer level of hepatitis A antibody in people over 20 years old was higher than that in people over 20 years old. Conclusion the prevention and control of hepatitis A in Huangshan City has achieved remarkable results. The hepatitis A vaccination strategy in Huangshan City has significantly increased the level of hepatitis A antibody in some age groups of children and adolescents. The titer of hepatitis A antibody in the naturally infected population is higher than that in the population vaccinated with hepatitis A vaccine, and the antibody titer produced by the two immunization procedures is significantly better than that of the first injection, which indicates that the immunity obtained by the natural population infected with hepatitis A virus is long. The antibody titer produced by hepatitis A vaccine may gradually fade with the passage of time. It is necessary to consider strengthening immunization and adjust the immunization procedure. The rate of HAV infection was high in healthy people, especially in people over 20 years old. Most people produced specific antibodies, which showed that they had naturally infected hepatitis A virus, which should be paid enough attention to, and their prevention and control work should be done well. At the same time, food hygiene management should be strengthened and knowledge and health education of diet hygiene and hepatitis A prevention and treatment should be carried out. We will continue to implement comprehensive prevention and control strategies to protect the susceptible population and cut off transmission routes to improve the ability to prevent hepatitis A.
【學(xué)位授予單位】：中國(guó)疾病預(yù)防控制中心
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R512.61
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