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目的评估全州县选择性群体预防接种对伤寒的影响。方法以全州县整个人群为基础,用被动监测法获得的血培养细菌阳性的伤寒病例为研究对象,并以细菌阳性的甲型副伤寒病例作对照,以控制除伤寒Vi预防接种以外的其他混杂因子的干扰,分析使用Vi疫苗后对伤寒发病率的影响。结果1995~1999年全州县学生接种覆盖率为42.2%时,观察到在学生及其他人群中伤寒的发病率均有下降。2000~2004年学生累积接种率为80.3%时,伤寒发病率急剧下降,学生的伤寒发病率比1995~1999年平均下降了97%(P<0.001),其他人群也下降了84%。从2001年后,全县无伤寒爆发疫情,同时也观察到副伤寒甲病例明显上升。结论选择性对高危人群进行大规模免疫的方案表明伤寒Vi预防接种有高效率,而且能产生明显的群体免疫和群体保护效应。
Objective To evaluate the effect of selective vaccination on typhoid in Quanzhou county. Methods Based on the whole population in Quanzhou County, the blood culture bacteria positive typhoid fever cases obtained by passive monitoring method were selected as the research objects. Bacteria-positive paratyphoid A cases were used as control to control other than typhoid Vi vaccination Confounding of confounding factors, the impact of Vi vaccination on typhoid morbidity was analyzed. Results When the coverage of students in Quanzhou County was 42.2% from 1995 to 1999, the incidence of typhoid fever was observed in both students and other groups. The incidence of typhoid fever dropped sharply from 2000 to 2004 when the cumulative immunization rate was 80.3%. The incidence rate of typhoid fever among students dropped by 97% (P <0.001) on average from 1995 to 1999, and decreased by 84% in other groups. Since 2001, there have been no outbreaks of typhoid fever in the county, and a significant increase in cases of paratyphoid fever has also been observed. Conclusion The selective immunization program for high-risk groups indicates that vaccination against typhoid Vi is highly effective and can produce significant population immunity and population protection.