2014-2023年重庆市沙坪坝区百日咳流行特征及1~4岁人群抗体水平监测研究

Epidemiological characteristics of pertussis from 2014 to 2023 and pertussis antibody level in children aged 1-4 years in Shapingba district of Chongqing

  • 摘要:
    目的  分析2014—2023年重庆市沙坪坝区百日咳流行特征及1~4岁人群抗体水平。
    方法  利用中国疾病预防控制信息系统,收集2014—2023年重庆市沙坪坝区百日咳报告病例,描述性分析流行特征。 在本地区监测点内采集1~4岁健康常住儿童静脉血样本,以酶联免疫吸附测定法检测该人群血清百日咳抗体水平。
    结果  2014—2023年重庆市沙坪坝区报告百日咳559例,年均报告发病率4.48/10万。 <1岁、1~5岁、5~10岁、≥10岁发病数和发病率分别为326例(427.06/10万)、113例(31.49/10万)、107例(17.55/10万)、13例(0.10/10万)。 发病前百白破联合疫苗接种史分别为≥3月龄中0剂次64例(13.82%)、≥4月龄中<2剂次88例(20.85%)、≥5月龄中<3剂次76例(20.77%)、≥18月龄中<4剂次3例(1.78%)。 1~4岁各年龄儿童百日咳IgG抗体阳性率分别为45.83%、37.78%、13.64%、7.55% (χ2=27.798, P<0.01),几何平均浓度分别为71.80国际单位(IU)/mL、42.09 IU/mL、32.71 IU/mL、19.23 IU/mL(F=5.530, P=0.001)。
    结论  近十年来重庆市沙坪坝区百日咳发病水平较高,整体呈上升趋势,发病以<1岁儿童特别是无疫苗接种史或未完成3剂次接种的婴儿为主。 在1~4岁儿童中百日咳抗体水平随年龄增大而显著降低。 建议加强适龄儿童及时、全程接种,完善儿童百日咳疫苗免疫策略。

     

    Abstract:
    Objective To describe the epidemiological characteristics of pertussis and understand the antibody level in 1-4 year old population in Shapingba district of Chongqing from 2014 to 2023.
    Methods A descriptive epidemiological analysis was conducted on the incidence data of pertussis in Shapingba from 2014 to 2023, which were collected from China Disease Control and Prevention Information System. Blood samples collected from healthy children aged 1−4 years in Shapingba from September to November, 2022 were used for pertussis antibody level detection with enzyme-linked immunosorbent assay.
    Results From 2014 to 2023, a total of 559 cases of pertussis were reported in Shapingba, with an average annual incidence rate of 4.48/100 000. The pertussis cases were distributed in different age groups, i.e. 326 cases in age group <1 year (427.06/100 000), 113 cases in age group 1−5 years (31.49/100 000), 107 cases in age group 5−10 years ( 17.55/100 000), and 13 cases in age group ≥10 years ( 0.10/100 000). The study found that 64 cases (13.82%) received no dose of diphtheria, tetanus and pertussis (DTP) vaccine at age ≥3 months, 88 cases (20.85%) received less than two doses of DTP vaccine at age ≥4 months, 76 cases (20.77%) received less than three doses of DTP vaccine at age ≥5 months, and 3 cases (1.78%) received less than four doses of DTP vaccine at age ≥18 months. The positive rate of pertussis IgG was 45.83% in age group 1 year, 37.78% in age group 2 years, 13.64% in age group 3 years, and 7.55% in age group 4 years (χ2=27.798, P<0.01), with corresponding geometric mean concentrations of 71.80, 42.09, 32.71, and 19.23 IU/mL, respectively (F=5.530, P=0.001).
    Conclusion Over the past decade, the relatively high and increased incidence of pertussis was observed in Shapingba. The high incidence of pertussis was observed in infants, especially in those receiving no DTP vaccine or receiving less than 3 doses. In children aged 1-4 years, the level of pertussis antibody significantly decreased with age. It is necessary to strengthen the timely and full-series pertussis vaccination for age-eligible children and improve the childhood pertussis immunization strategy.

     

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