| 李立,刘文和,廖寿恒,胡淑勤,茅莉莉,程锦珍,杨幼泉,何香,林樟馨,戴起蛟.新生儿破伤风发病因素及免疫预防研究[J].Chinese journal of Epidemiology,1996,17(2):83-86 |
| 新生儿破伤风发病因素及免疫预防研究 |
| Research on Factors Affecting Neonatal Tetanus and Its Prevention Through Immunization |
| Received:May 17, 1995 Revised:July 14, 1995 |
| DOI： |
| KeyWord: 新生儿破伤风 发病因素 免疫预防 |
| English Key Word: Neonatal tetanus Affected factors Immunization prevention |
| FundProject:本课题被列为省医药卫生科研项目 |
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| Abstract: |
| 新生儿破伤风是WHO列为EPI重点控制的疾病之一,闽西一些县、市发病率超过控制指标。采用回顾性前瞻研究方法,发现农村孕产妇住院分娩率仅占8.66%(319/3 683),病例中由未受训人员接生率高达94.85%(129/136),围产期母婴配对检测血清破伤风抗毒素(TAT)达到保护水平者分别为23.81%(37/155)及20.65%(32/155),提示产程卫生处理不良及孕产妇抗体水平低下是新生儿破伤风发病率升高的主因。应用破伤风类毒素(破类)免疫的母婴配对血清,TAT保护抗体分别为100.00%(99/99)及93.94%(93/99),育龄期妇女破类免疫后3年TAT保护水平仍达90.40%(113/125)。观察经全程破类免疫孕妇的活产儿8 882人,未发生破伤风病例,同期观察未接种破类孕妇的活产儿4 835人,破伤风发病率高达5.28‰,表明对育龄期妇女开展破类免疫是预防新生儿破伤风的主要策略。 |
| English Abstract: |
| Neonatal Tetanus (NT) has been set by WHO as one of the most important diseases to be under control. Its incidence rate at some counties and cities in Southern Fujian province exceeded set out levels. Both retrospective and cohort studies were carried, It was found that in rural areas only 8.66% (319/3 683) pregnant women gave births at hospital and 94. 850% (129/136) NT cases were delivered by untrained midwives. When TAT was tested in mothers and newborns, only 23.81% and 20.65% of them reached protective level. This shows the main reasons for high NT incidence rate were due to poor medical treatment during delivery and low antibody level. Using tetanus toxin (TT) to fully immunize pregnant women, no side effects were observed and TAT antibody levels for mothers and newborns were increasing to reach 100% (99/99)and 93.94% (93/99)relatively. When immunizing women at child-bearing age with TT, 90.40% (113/125) of them still had TAT up to protective level in 3 years, A total number of 8 882 newborns whose mothers had been fully vaccinated with TT were investigated, no NT case occured. Among 4 835 newborns whose mothers did not receive vaccination, some NT cases were identified. The incidence rate was as high as 5.28‰. These results showed that the TT vaccination in women at child-bearing age should be considered as the major strategy for NT prevention. |
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