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为了解农村地区乙型肝炎 (乙肝 )疫苗免疫效果及影响因素 ,提出相应措施提高乙肝疫苗的保护效果。在南江、旺苍两县 ,采用多阶段随机整群抽样方法 ,抽取 5 2 7名 2 0 0 0年出生儿童及其 4 99名母亲 ,采血检测血清乙肝病毒表面抗原 (HBsAg)。结果显示 :儿童乙肝疫苗免疫接种率和全程免疫接种率分别为 99 0 5 %、95 4 5 % ;首针及时接种率和全程及时接种率分别为 6 8 39%、6 1 6 9%。住院分娩和在家分娩儿童首针及时接种率分别为 83 5 9%、5 6 90 % ,两者的差异有非常显著的统计学意义 (P <0 0 1)。≥第 2胎儿童的首针及时接种率非常明显的低于第 1胎儿童 (χ2 =34 1178,P <0 0 1)。被调查儿童母亲的HBsAg阳性率为 6 6 1% ;儿童HBsAg阳性率为 1 5 2 % ,7例均为阳性母亲所生儿童。由此可见 ,在农村推广乙肝疫苗免疫接种将大大降低HBsAg阳性率。在经济欠发达的边远地区和山区农村 ,对孕妇进行HBsAg筛查 ,重点对HBsAg阳性产妇的新生儿及时接种乙肝疫苗 ,将会取得事半功倍的效果
In order to understand the effect and influencing factors of Hepatitis B (HBV) vaccine in rural areas, we put forward corresponding measures to improve the protective effect of Hepatitis B vaccine. In Nanjiang and Wangcang counties, 527 children born in 2000 and 499 mothers were sampled by multistage random cluster sampling method, and blood was collected to detect serum hepatitis B virus surface antigen (HBsAg). The results showed that the rates of immunization and full immunization of hepatitis B vaccine in children were 99 0 5% and 95 4 5% respectively. The timely immunization coverage rate and timely vaccination coverage of the first needle were 68 39% and 61 69% respectively. The timely inoculation rates of hospital delivery and delivery at home were 83 59% and 56 90% respectively, with significant differences (P <0.01). ≥ The first needle of the second child was significantly less timely than the first child (χ2 = 34 1178, P <0.01). The HBsAg positive rate of the investigated children was 6 6 1%, that of the children was 15 2%, and 7 cases were all children born to positive mothers. Thus, in rural areas to promote hepatitis B vaccine immunization will greatly reduce the HBsAg-positive rate. In economically underdeveloped remote areas and mountainous areas, HBsAg screening of pregnant women, focusing on newborns HBsAg positive mothers vaccinated hepatitis B vaccine in a timely manner, will achieve a multiplier effect