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目的了解乙肝疫苗(HepB)纳入免疫规划12年后,甘肃省<15岁儿童HepB接种情况,为制订乙肝预防控制策略提供参考。方法 2014年采用分层二阶段整群随机抽样方法首针,调查甘肃省1~14岁常住人口HepB接种情况以及基本情况。结果在调查的1 592名1~14岁儿童中,HepB1首针接种率、HepB1首针及时接种率和HepB全程接种率分别为96.36%、88.57%和95.85%,接种率均随年龄减小而明显升高(P<0.001)。不同性别、民族儿童HepB1接种率、HepB1及时接种率和HepB全程接种率均无明显差异(P>0.05)。城市儿童HepB1接种率、HepB1及时接种率和HepB全程接种率均明显高于农村儿童(P<0.001)。在调查的儿童中,住院分娩率为93.53%;其中57.29%的儿童出生在县级医院,分娩地点在市级以上医院、乡级医院、在家和不详的分别占17.96%、18.28%、4.33%和2.14%。市级以上医院出生儿童HepB1接种率和HepB1及时接种率最高,分别为99.30%和95.45%;在家分娩或出生地点不详儿童HepB1接种率和HepB1及时接种率最低,分别为83.50%和59.22%。不同地点出生儿童HepB1接种率(χ2=56.173,P<0.001)和HepB1及时接种率(χ2=1.053,P<0.001)差异均有统计学意义。结论甘肃省HepB纳入免疫规划后<15岁儿童HepB全程接种率和首针及时接种率明显提高,并保持在较高水平。提高住院分娩率是提高儿童HepB1及时接种率的关键。
Objective To understand HepB vaccination status of HepB in children <15 years old in Gansu province after 12 years of inclusion in Hepatitis B vaccine for reference. Methods In 2014, a stratified two-stage cluster random sampling method was used to investigate HepB inoculation status and basic situation of resident population aged from 1 to 14 in Gansu Province. Results Among the 1 592 children aged 1-14 years old, the first vaccination of HepB1, the first timely vaccination of HepB1 and the full vaccination of HepB were 96.36%, 88.57% and 95.85%, respectively. The vaccination rates decreased with age Was significantly higher (P <0.001). HepB1 vaccination rate, HepB1 timely vaccination rate and HepB full vaccination rate were not significantly different among different ethnic groups and ethnic minority children (P> 0.05). HepB1 vaccination rate, HepB1 timely vaccination rate and HepB full vaccination rate in urban children were significantly higher than those in rural children (P <0.001). Among the children surveyed, the hospital delivery rate was 93.53%; 57.29% of them were born in county-level hospitals and the delivery place was above the level of municipal hospitals, township hospitals, at home and unknown accounted for 17.96%, 18.28%, 4.33% And 2.14%. HepB1 vaccination rate and HepB1 timely vaccination rate were 99.30% and 95.45%, respectively. HepB1 vaccination rate and HepB1 timely vaccination rate were the lowest in children with birth or place of birth at home, accounting for 83.50% and 59.22% respectively. HepB1 vaccination rates (χ2 = 56.173, P <0.001) and HepB1 timely immunization rates (χ2 = 1.053, P <0.001) were significantly different among children born at different locations. Conclusion The HepB vaccination rate and first-dose timely vaccination rate of HepB in children <15 years old after Gansu Hepatitis B immunization program were significantly increased, and maintained at a high level. Increasing hospital delivery rate is the key to improve the timely vaccination rate of HepB1 in children.