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山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (11): 113-120.doi: 10.6040/j.issn.1671-7554.0.2022.0357

• 公共卫生与管理学 • 上一篇    下一篇

济南市1 614名HBsAg阳性产妇新生儿首针乙肝疫苗接种时间分布及影响因素

邹丽萍1,贺玉静1,谢元忠2,赵建云1,许春华1,马永胜1,李传彬1,刘晓雪1,刘翀3,赵小冬1,孙红云1   

  1. 1.济南市疾病预防控制中心免疫预防所, 山东 济南 250021;2.济南市平阴县疾病预防控制中心免疫科, 山东 平阴 250499;3.济南市康养事业发展中心, 山东 济南 250002
  • 出版日期:2022-11-10 发布日期:2022-11-04
  • 通讯作者: 刘晓雪. E-mail:freesia_xue@163.com
  • 基金资助:
    中国肝炎防治基金会中国乙肝防控科研基金(YGFK20200041)

Time distribution and influencing factors of hepatitis B vaccine birth dose in 1,614 newborns of HBsAg positive women, Jinan City

ZOU Liping1, HE Yujing1, XIE Yuanzhong2, ZHAO Jianyun1, XU Chunhua1, MA Yongsheng1, LI Chuanbin1, LIU Xiaoxue1, LIU Chong3, ZHAO Xiaodong1, SUN Hongyun1   

  1. 1. Department of Expanded Program of Immunization, Jinan Center for Disease Control and Prevention, Jinan 250021, Shandong, China;
    2. Department of Expanded Program of Immunization, Pingyin Center for Disease Control and Prevention, Pingyin 250499, Shandong, China;
    3. Jinan Health Care Development Center, Jinan 250002, Shandong, China
  • Online:2022-11-10 Published:2022-11-04

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摘要： 目的 了解济南市HBsAg阳性产妇所生新生儿首针乙肝(hepatitis B vaccine, HepB)疫苗接种时间分布,评价医疗机构母婴阻断实施工作存在的问题和困难。 方法 采用描述性统计方法对目标人群的人口学特征、首针HepB疫苗接种情况进行描述, χ2检验和Logistic回归方法分析及时接种的影响因素。定性资料采用主题框架法对产科母婴阻断实施操作现状和存在问题进行分析归纳和总结。 结果 2020年济南市住院分娩HBsAg阳性产妇共计1 614名,其新生儿HepB疫苗24 h内和12 h内首针接种率分别为98.76%和78.81%。新生儿出生时间在8~11时、14~16时(产科接种高峰时段)的新生儿接种及时性最高。多因素分析结果显示,与>12 h接种有关联的因素包括阴道分娩(OR=2.083)、新生儿低出生体质量(OR=2.793)、出生时间在夜间(OR=1.260)、头胎(OR=1.515),P均<0.05。定性访谈发现,首针接种时限要求提高后,人员和培训需求增加。 结论 2020年济南市HBsAg阳性产妇新生儿HepB疫苗首针接种及时率较高。剖宫产、非出生低体质量、非头胎、接近接种高峰时段前出生的新生儿更容易及时接种。人员和培训需求是时限要求提高后的主要诉求。建议从医疗机构产科操作层面加强人员培训,合理安排接种班次,进一步提高及时接种率。

关键词: HBsAg阳性, 新生儿, 乙肝疫苗, 首针接种率, 影响因素

Abstract: Objective To investigate the time distribution of the birth dose of hepatitis B(HepB)vaccine in newborns of HBsAg-positive mothers in Jinan, and to evaluate possible problems and difficulties of hospitals in implementing the scheme. Methods Descriptive analysis was applied to describe general information and distribution of birth dose of HepB vaccine. Chi-square test and binary Logistic regression were used to analyze influencing factors. Qualitative field interview materials were analyzed and summarized with subject frame method to investigate the status and problems of current implementation practice. Results In 2020, 1,614 HBsAg positive pregnant women were hospitalized and gave birth at hospital. The rate of HepB vaccine birth dose within 24 hours and 12 hours were 98.76% and 78.81%, respectively. Newborns born at 8-11 and 14-16 oclock had the highest timely vaccination rate. Natural birth(OR=2.083), low birth weight(OR=2.793), birth time at night(OR=1.260)and first birth(OR=1.515)were risk factors affecting timely vaccination(all P<0.05). Qualitative interviews found that personnel and training needs increased after stricter time limit was issued. Conclusion The timely vaccination rate of HepB birth dose among infants of HBsAg positive women was high in 2020 in Jinan. Newborns delivered by caesarean section, with non-low birth weight, non-first-born and born before the peak time of obstetrical vaccination are more likely to be vaccinated in time. Personnel and training needs are the main concerns after stricter time limit is issued. It is suggested to strengthen the training of medical personnel and arrange the vaccination shifts reasonably in order to improve the timely vaccination rate.

Key words: HBsAg positive, Newborns, Hepatitis B vaccine, Birth dose, Influencing factors

中图分类号: 

  • R186
[1] 张国民, 缪宁, 郑徽, 等. 中国2005—2016年乙型病毒性肝炎报告发病的年龄和地区特征[J]. 中国疫苗和免疫, 2018, 24(2): 121-126. ZHANG Guomin, MIAO Ning, ZHENG Hui, et al. Incidence by age and region of hepatitis B reported in China from 2005 to 2016[J]. Chinese Journal of Vaccines and Immunization, 2018, 24(2): 121-126.
[2] 徐靓亮, 郑徽, 王富珍, 等. 乙型肝炎表面抗原阳性母亲所生儿童免疫后血清学检测实施进展[J]. 中国疫苗和免疫, 2019, 25(5): 605-610. XU Liangliang, ZHENG Hui, WANG Fuzhen, et al. Progress on implementation of post-vaccination serologic testing among children born to hepatitis B surface antigen positive mothers[J]. Chinese Journal of Vaccines and Immunization, 2019, 25(5): 605-610.
[3] 王富珍, 张国民, 沈立萍, 等. 1992和2014年中国不同流行地区1~29岁人群乙型肝炎血清流行病学调查结果对比分析[J]. 中华预防医学杂志, 2017, 51(6): 462-468. WANG Fuzhen, ZHANG Guomin, SHEN Liping, et al. Comparative analyze on hepatitis B seroepidemiological surveys among population aged 1-29 years in different epidemic regions of China in 1992 and 2014[J]. Chinese Journal of Preventive Medicine, 2017, 51(6): 462-468.
[4] Blumberg EA. Prevention of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices: a summary of the MMWR report[J]. Am J Transplant, 2018, 18(5): 1285-1286.
[5] 王贵强, 王福生, 庄辉, 等. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669. WANG Guiqiang, WANG Fusheng, ZHUANG Hui, et al. Guidelines for the prevention and treatment of chronic hepatitis B(version 2019)[J]. Journal of Clinical Hepatol, 2019, 35(12): 2648-2669.
[6] 中华人民共和国国家卫生健康委员会. 国家卫生健康委关于印发国家免疫规划疫苗儿童免疫程序及说明(2021年版)的通知[EB/OL].[2021-07-16] (2022-03-24). http://www.nhc.gov.cn/jkj/s3581/202103/590a8c7915054aa682a8d2ae8199e222.shtml.
[7] 杜娜. 2013年朝阳区新生儿首针乙肝疫苗未及时接种原因分析[D]. 太原: 山西医科大学, 2014.
[8] 陈健,刘建华,蔡衍珊,等. 广州市新生儿乙肝疫苗首针及时接种率及其影响因素分析[J]. 华南预防医学, 2010, 36(2): 11-14. CHEN Jian, LIU Jianhua, CAI Yanshan, et al. Timely birth dose coverage rate of hepatitis B vaccine and its affecting factors in Guangzhou[J]. South China Journal of Preventive Medicine, 2010, 36(2): 11-14.
[9] Gale NK, Heath G, Cameron E, et al. Using the framework method for the analysis of qualitative data in multi-disciplinary health research[J]. BMC Med Res Methodol, 2013, 13: 117. doi: 10.1186/1471-2288-13-117.
[10] 缪宁, 郑徽, 王富珍, 等. 服务提供方对开展乙型肝炎表面抗原阳性母亲所生新生儿免疫后血清学监测的态度定性调查[J]. 中国疫苗和免疫, 2020, 26(1): 34-37, 52. MIAO Ning, ZHENG Hui, WANG Fuzhen, et al. Attitudes of service providers towards post-vaccination serological testing of newborns of mothers positive to hepatitis B surface antigen: a qualitative survey[J]. Chinese Journal of Vaccines and Immunization, 2020, 26(1): 34-37, 52.
[11] 李巍巍,蔡永铭,蔡巧,等. 儿童预防接种信息系统数据利用研究进展[J]. 中国公共卫生, 2017, 33(6): 878-882. LI Weiwei, CAI Yongming, CAI Qiao, et al. Utilization of data from children immunization information system: a review[J]. Chinese Journal of Public Health, 2017, 33(6): 878-882.
[12] 王红迁,汪鹏,王飞,等. 多元数据融合的临床辅助决策系统的研究与应用[J]. 中国数字医学, 2019, 14(11): 18-20. WANG Hongqian, WANG Peng, WANG Fei, et al. Research and application of clinical decision support system based on multivariate data fusion[J]. China Digital Medicine, 2019, 14(11): 18-20.
[13] 李伟英. 基层医院新生儿首针乙肝疫苗和卡介苗接种情况调查分析[J]. 中国实用医药, 2020, 15(28): 178-179.
[14] 刘中芹,崔佳,崔晓,等.2004~2013年寿光市产妇HBsAg携带及新生儿首针乙肝疫苗接种情况分析[J]. 预防医学论坛, 2016, 22(1): 44-46. LIU Zhongqin, CUI Jia, CUI Xiao, et al. Analysis on first dose of hepatitis B vaccination among puerperants with HBsAg and their newborns, Shouguang City, 2004-2013[J]. Preventive Medicine Tribune, 2016, 22(1): 44-46.
[15] 王建勋. 武威市孕产妇 HBsAg 筛检和新生儿乙肝疫苗首针及时接种率的调查[D]. 西安: 第四军医大学, 2014.
[16] 焦艳英. 10 000例新生儿首针乙肝疫苗接种分析[J]. 中国实用医药, 2016, 11(14): 276-277.
[17] 刘格琳, 田鹏. 2014年洛阳市新生儿首针乙肝疫苗接种情况分析[J]. 河南科技大学学报( 医学版), 2016, 34(4): 284-285, 293. LIU Gelin, TIAN Peng. Analysis of first dose hepatitis B vaccination among newborns in Luoyang in 2014[J]. Journal of Henan University of Science & Technology(Medical Science), 2016, 34(4): 284-285, 293.
[18] 山东省卫生健康委员会,山东省发展和改革委员会,山东省教育厅,等. 关于印发山东省病毒性肝炎防治行动计划的通知[S].[2019-02-25] (2022-03-25). http://www.jining.gov.cn/attach/0/16586cc22000481c85171af98ab7006b.pdf.
[19] 罗涛, 潘宏, 侯兴华, 等. 黔东南州实施提高新生儿乙肝疫苗首针及时接种率项目效果分析[J]. 华南预防医学, 2014, 40(1): 25-28. LUO Tao, PAN Hong, HOU Xinghua, et al. Evaluation of MOH /GAVI project for improving timely birth dose coverage of hepatitis B vaccination in Qiandongnan, Guizhou[J]. South China Journal of Preventive Medicine, 2014, 40(1): 25-28.
[20] 王平贵,高丽,安婧,等.甘肃省新生儿乙肝疫苗首针及时接种率试点项目评价[J]. 中国公共卫生, 2013, 29(8): 1199-1202. WANG Pinggui, GAO Li, AN Jing, et al. Evaluation on a pilot project for coverage promotion of timely-birth dose of hepatitis B vaccine among neonates in Gansu Province[J]. Chinese Journal of Public Health, 2013, 29(8): 1199-1202.
[21] 张海霞, 张海洋, 任东颖. 乌兰浩特市2014—2015年新生儿首针乙肝疫苗接种情况分析[J]. 疾病监测与控制杂志, 2016, 10(12): 992-993.
[22] 刘小莉, 杨晨璐, 周虹. 中国西部14个县0~35月龄儿童乙肝疫苗首剂及时接种率及影响因素分析[J]. 中国儿童保健杂志, 2018, 26(8): 846-848, 868. LIU Xiaoli, YANG Chenlu, ZHOU Hong, et al. Status and influencing factors of timely vaccination rate of the first dose of hepatitis B vaccine for children aged 0-35 months from 14 countries in western China[J]. Chinese Journal of Child Health Care, 2018, 26(8): 846-848, 868.
[23] 陈兴华,王长双,肖占沛.河南省产科新生儿首针乙肝疫苗和卡介苗接种情况分析[J]. 中国初级卫生保健, 2015, 29(3): 87-88. CHEN Xinghua, WANG Changshuang, XIAO Zhanpei. Analysis on first dose hepatitis B vaccine and bacillus calnnette-guerin vaccine of newborns at Obstetrical Department in Henan Province[J]. Chinese Primary Health Care, 2015, 29(3): 87-88.
[24] 尕日毛, 马小军, 红雅, 等. 青海同德藏族自治县医院出生新生儿首针乙肝疫苗未及时接种的原因分析[J]. 医学动物防制, 2018, 34(11): 1112-1114. GA Rimao, MA Xiaojun, HONG Ya, et al. Analysis of the causes of the lack of timely immunization of the first-born hepatitis B vaccine in neonatal born in hospitals in Tongde Tibetan Autonomous County of Qinghai[J]. Journal of Medical Pest Control, 2018, 34(11):1112-1114.
[25] World Health Organization. Global hepatitis report, 2017[EB/OL].[2017-04-19] (2022-03-24). https://www.who.int/publications/i/item/global-hepatitis-report-2017.
[26] World Health Organization. Global health sector strategy on viral hepatitis, 2016-2021[EB/OL].[2016-05-17] (2022-03-24). https://www.who.int/publications/i/item/WHO-HIV-2016.06.
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