Evaluation of the Impact of Hepatitis B Vaccination among Children Born during 1992-2005 in China
Evaluation of the Impact of Hepatitis B Vaccination among Children Born during 1992-2005 in China
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DOI：
10.1086/599332
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发表时间：
2009-07-01
影响因子：
6.4
通讯作者：
Wang, Yu
中科院分区：
文献类型：
--
作者：
Liang, Xiaofeng;Bi, Shengli;Wang, Yu
背景地方性B型肝炎病毒（HBV）感染在我国是一个严重的健康问题。婴儿B型肝炎疫苗接种于1992年引入，并在随后的15年中逐步扩大。方法。我们进行了一项全国性的血清调查，参与者通过多阶段随机抽样选择。通过问卷调查和疫苗接种记录回顾性调查收集人口学特征和B肝炎疫苗接种史，采用酶联免疫吸附法检测血清中B肝炎表面抗原、B肝炎核心抗原抗体和B肝炎表面抗体。B型肝炎疫苗（3剂）的覆盖率从1992年出生儿童的30.0%提高到2005年出生儿童的93.4%。在此期间出生的儿童及时接受出生剂量从22.2%增加到82.6%。多因素分析显示，年龄较大，西部和农村居住，在家里出生，和某些种族的风险因素，接种疫苗的完整系列和及时出生剂量。所有儿童中B型肝炎表面抗原的流行率降至2.1%，1999年以后出生的儿童中降至1.0%。出生时及时接种B型肝炎疫苗的有效率为88. 3%。中国已成功将B肝炎疫苗纳入婴儿常规免疫，目前大多数婴儿在出生后24小时内接种，1992年以后出生的儿童中B肝炎表面抗原的流行率已大大降低。
Background. Endemic hepatitis B virus (HBV) infection is a serious health problem in China. Hepatitis B vaccination of infants was introduced in 1992 and was progressively expanded during the subsequent 15 years.Methods. We conducted a national serosurvey, with participants selected by multiple-stage random sampling. Demographic characteristics and hepatitis B vaccination history were collected by a questionnaire and a review of vaccination records, and serum specimens were tested for hepatitis B surface antigen, antibody to hepatitis B core antigen, and hepatitis B surface antibody by enzyme-linked immunosorbent assay.Results. Hepatitis B vaccine coverage (3 doses) increased from 30.0% for children born in 1992 to 93.4% for children born in 2005. Receipt of a timely birth dose increased from 22.2% to 82.6% for children born during this interval. Multivariate analysis showed that older age, western and rural residence, birth at home, and certain ethnicities were risk factors for undervaccination with both full vaccine series and timely birth dose. The prevalence of hepatitis B surface antigen was reduced to 2.1% among all children and 1.0% among children born after 1999. The efficacy of hepatitis B vaccination with a timely birth dose was 88.3%.Conclusions. Hepatitis B vaccine has been successfully integrated into routine infant immunization in China, now reaching most infants within 24 h after birth, and the prevalence of hepatitis B surface antigen has been greatly reduced among children born after 1992.