潍坊市疑似预防接种异常反应监测分析

目的分析山东省潍坊市2011～2012年疑似预防接种异常反应(adverse events following immunization,AEFI)的发生特征,评价AEFI监测系统运转情况及预防接种安全性。方法通过AEFI监测系统,收集全市2011年1月1日至2012年12月31日报告的AEFI个案数据,采用描述性流行病学方法和卡方检验进行数据分析。结果 2011～2012年全市AEFI监测系统共报告AEFI 1 836例,报告发生率为39.75/10万,2012年报告发生率(42.79/10万)高于2011年(36.57/10万),差异有统计学意义(P<0.01)。在1 836例AEFI中,男女性别比为1.34∶1;≤1岁占79.63%;病例报告主要集中在8～11月份,占52.67%;报告疫苗以国家免疫规划疫苗(National Immunization Program,NIP)为主;一般反应占97.50%,报告发生率为38.76/10万,以单纯发热、局部红肿伴有硬结和单纯局部红肿为主,异常反应占2.07%,报告发生率为0.83/10万,以过敏性反应和卡介苗淋巴结炎为主,偶合症占0.33%,报告发生率为0.13/10万,心因性反应和待定分别1例,占0.05%,报告发生率为0.02/10万,大多数病例已痊愈。估算全市NIP不良反应报告发生率为6.45～109.30/10万。2011～2012年全市12个县市区均有AEFI个案报告,报告县覆盖率、48 h及时报告率和48 h及时调查率均达到100%。结论全市AEFI系统的监测灵敏性尚需继续提高,AEFI多发生在低年龄儿童和夏秋季节,疫苗以NIP为主,应重点监测;NIP不良反应报告发生率均在预期发生范围内,安全性良好。     

哈尔滨市2011年疑似预防接种异常反应监测分析

目的分析哈尔滨市2011年疑似预防接种异常反应(Adverse event following immunization,AEFI)的特征,评价AEFI监测系统运转情况。方法对《疑似预防接种异常反应信息管理系统》报告的哈尔滨市2011年AEFI数据进行描述性分析。结果 2011年哈尔滨市共报告188例AEFI,以一般反应为主,占报告总数的86.7%;下半年报告的病例占全年总数的72.9%;年龄≤1岁和1岁<年龄≤2岁组报告病例最多,分别占总数的42.0%和36.2%;吸附无细胞百白破联合疫苗因接种针次多,AEFI发生数也最多,占总数的49.5%;一般反应中,报告最多的是发热、红肿、硬结,占85.1%。结论哈尔滨市AEFI及时报告率、及时调查率、调查表及时上报率等监测指标均达到较高水平。今后应加强对基层人员的培训和督导检查,在乡级单位开展网络直报,进一步提高AEFI监测系统的敏感性和及时性。     

2012年包头市疑似预防接种异常反应监测数据分析

目的分析内蒙古包头市2012年疑似预防接种异常反应(adverse event following immunization,AEFI)监测数据,评价包头市AEFI监测系统运转情况。方法通过全国疑似预防接种异常反应信息管理系统,收集包头市2012年报告的AEFI个案,采用描述性方法对相关指标进行流行病学分析。结果 2012年包头市共报告AEFI 53例,报告发生率为9.03/10万,所有区县均有报告;AEFI多发生在6~11月;男女AEFI发生比例为1.12∶1;相似文献   

天津市河北区疑似预防接种异常反应监测分析

目的分析天津市河北区2008²012年疑似预防接种异常反应(adverse event following immunization,AEFI)的发生特征,评价AEFI监测系统的运转情况、疫苗的安全性和预防接种服务质量。方法收集天津市河北区20082012年疑似预防接种异常反应(adverse event following immunization,AEFI)的发生特征,评价AEFI监测系统的运转情况、疫苗的安全性和预防接种服务质量。方法收集天津市河北区2008²012年AEFI监测系统报告的个案数据,利用Excel建立数据库,采用描述性流行病学方法对相关指标进行分析。结果天津市河北区20082012年AEFI监测系统报告的个案数据,利用Excel建立数据库,采用描述性流行病学方法对相关指标进行分析。结果天津市河北区2008²012共报告AEFI 469例,报告发生率为61.79/10万,其中男性259例(55.22%),女性210例(44.78%),病例发生年龄主要集中在3岁以内,一般反应227例(48.40%),异常反应197例(42.00%),偶合症45例(9.59%),无疫苗质量事故、接种事故及心因性反应的发生;48 h及时报告率93.39%,48 h及时调查率97.98%,以街道为单位报告覆盖率为100%;AEFI涉及的22类疫苗中,以麻疹减毒活疫苗为主,235例(50.11%),其次为吸附无细胞百白破疫苗;76.33%的AEFI反应发生在接种后1 d或1 d内,间隔最短的为55 min,为接种23价肺炎球菌多糖疫苗后发生的血管性水肿,间隔最长的为9个月,为接种卡介苗后发生的异常反应(卡介苗淋巴结炎);469例AEFI治愈465例,好转3例,偶合死亡1例。结论河北区AEFI监测系统运转正常,疫苗的安全性和预防接种质量良好。     

地中海贫血儿童的预防接种建议及探讨

地中海贫血又称珠蛋白生成障碍贫血,是由于一种或多种珠蛋白肽链合成受阻或完全抑制,导致Hb成分组成异常引起的慢性溶血性贫血,其中以α、β-地中海贫血较常见,α-地中海贫血有静止型、标准型、中间型及Hb Bart胎儿水肿综合征4种临床分型;β-地中海贫血有轻型、中间型及重型3种临床类型[1]。该贫血为全球分布最广、累积人数最多的常染色体隐性单基因遗传病,在中国广东、广西、海南发病率较高。     

邢台市2013~2014年疑似预防接种异常反应监测数据分析

目的分析邢台市2013~2014年疑似预防接种异常反应(adverse events following immunization,AEFI)发生情况,为评价疫苗的安全性提供科学依据。方法通过中国疾病预防控制信息管理系统AEFI信息管理系统,收集邢台市2013~2014年AEFI个案数据,采用描述性流行病学方法对数据进行分析。结果 2013~2014年,邢台市报告AEFI分别为894和939例,县级覆盖率100%,48 h及时报告率和调查率均为100%。在报告的AEFI病例中,男性多于女性,≤2岁儿童占绝大多数。报告的AEFI以一般反应较多,并以一类疫苗为主,较多的为无细胞百日咳-白喉-破伤风联合疫苗、麻疹风疹联合减毒活疫苗、A群脑膜炎球菌多糖疫苗、乙型脑炎减毒活疫苗、冻干甲型肝炎减毒活疫苗等。异常反应中以过敏性皮疹、卡介苗淋巴结炎、血小板减少性紫癜发生率较高。结论我市疫苗安全性总体良好,但仍需提高AEFI监测质量,尤其是异常反应的监测能力。     

黄山市2010~2013年疑似预防接种异常反应监测分析

目的分析黄山市2010~2013年疑似预防接种异常反应(adverse events following immunization,AEFI)的发生特征,评价预防接种的安全性。方法采用描述性流行病学方法对2010~2013年黄山市AEFI监测资料进行分析。结果 2010~2013年全市共报告AEFI 116例,其中一般反应99例(85.34%),异常反应11例(9.48%),偶合症5例(4.31%),接种事故1例(0.86%)。各区县均有AEFI报告,48 h内报告率为93.10%,48 h内调查率为97.14%;男女性别比为1.27∶1,年龄≤1岁占43.10%,报告疫苗以国家免疫规划(National Immunization Programme,NIP)疫苗为主;报告的AEFI病例主要集中在5~9月份,68.97%发生在接种后1 d内;AEFI报告发生率为7.39/10万,其中一般反应为6.30/10万,异常反应为0.70/10万,一般反应以发热、红肿、硬结为主,异常反应以过敏性皮疹、卡介苗淋巴结炎为主。结论全市AEFI监测质量有待继续提高,各区县报告数据差异较大。AEFI常发生于低年龄组儿童和NIP疫苗,为监测重点;各疫苗不良反应报告发生率均在预期发生范围内,安全性良好。     

预防接种与过敏性休克的研究进展

过敏性休克是全身血管张力极度下降,组织灌注严重不良,导致细胞受损及功能障碍病理状态,其通常发生突然,且剧烈,若不及时处理,常可危及生命。疫苗作为一类抗原物质,有可能引起过敏性休克。随着扩大国家免疫规划的实施,接种疫苗数量增加,出现疑似预防接种异常反应(Adverse Events Following Immunization,AEFI)的几率增加,过敏性休克属于严重的AEFI,其发生的可能性也有所增加。本文通过中国知网及万方数据中1992~2012年期间的文献,就AEFI中过敏性休克的发生情况、致病机制、临床表现、诊断及疫苗预防接种中过敏性休克的预防和注意事项作一综述。     

北京市顺义区2008～2014年疑似预防接种异常反应监测分析

目的分析北京市顺义区2008~2014年疑似预防接种异常反应(adverse events following immunization,AEFI)的发生特征,评价监测系统运转情况。方法采用描述性流行病学方法对2008~2014年顺义区AEFI监测资料进行分析。结果 2008~2014年顺义区共接种疫苗3 304 208剂次,报告AEFI 1 072例,报告发生率为32.44/10万;AEFI 48 h内报告率为99.63%,48 h内调查率为99.72%,街乡覆盖率为93.88%。共报告一般反应825例(24.96/10万),发热、红肿、硬结占84.50%;异常反应120例(3.63/10万),过敏性皮疹占90.83%,严重异常反应7例(0.21/10万);偶合症113例(3.42/10万),上呼吸道感染占91.19%;心因反应14例(0.42/10万)。病例报告集中于5~9月份,≤3岁组病例占总数的77.61%。流感(亚单位)疫苗、流脑A+C(结合)疫苗、百白破+IPV+Hib五联疫苗3种疫苗不良反应发生率最高。疫苗接种后当天发生反应的占54.10%,AEFI病例的治愈好转率为100%。结论北京市顺义区AEFI监测系统整体工作质量较高,但报告街乡覆盖率偏低。目前所用疫苗安全性好,应加强禁忌筛查,以较少偶合症发生。AEFI常发生在3岁以内儿童接种后24 h内,应重点监测。有关政策的出台对AEFI监测工作有效开展起到积极作用。     

Vitamin A deficiency and inflammatory markers among preschool children in the Republic of the Marshall Islands

Background  

The exclusion of individuals with elevated acute phase proteins has been advocated in order to improve prevalence estimates of vitamin A deficiency in surveys, but it is unclear whether this will lead to sampling bias. The purpose of the study was to determine whether the exclusion of individuals with elevated acute phase proteins is associated with sampling bias and to characterize inflammation in children with night blindness.     

Novel interactions between iron and n‐3 fatty acids in cognition and immune function

Many children, particularly from low‐ and middle‐income countries, may suffer from both iron deficiency and inadequate omega‐3 fatty acid intake due to poor quality diets. Both, iron and omega‐3 fatty acids are important for the development and functioning of the brain and immune system. Using a translational research approach, we therefore investigated potential interactive effects of iron and omega‐3 fatty acid deficiencies and supplementation on cognition and immune‐related outcomes. Our results indicate that in children with iron deficiency and poor omega‐3 fatty acid intake, it may be crucial to administer iron in combination with omega‐3 long‐chain polyunsaturated fatty acids to ensure optimal cognition and immune function.     

高职医学女生艾滋病知信行现状调查

目的了解高职医学女生艾滋病知信行情况,为健康教育提供依据。方法选择某校644名高职医学女生为研究对象,采用自制调查问卷,以匿名方式统一调查,用epidata3.1建库并输入数据,用SPSS13.0进行统计分析。结果学生关于艾滋病的知识系统性不强,准确性不够,但自我感知较好。结论学生自我认知不准确,缺乏预防艾滋病的生活技能,现有的宣传教育方式亟待改进。     

The effects of oral iron supplementation on cognition in older children and adults: a systematic review and meta-analysis

Background  

In observational studies anaemia and iron deficiency are associated with cognitive deficits, suggesting that iron supplementation may improve cognitive function. However, due to the potential for confounding by socio-economic status in observational studies, this needs to be verified in data from randomised controlled trials (RCTs).     

Obesity in prematurely born children and adolescents: follow up in pediatric clinic

Understanding associated risk for obesity is a prerequisite to develop early life interventions to arrest the increasing epidemic of metabolic syndrome and obesity among preterm born children and adolescents. A retrospective review of 160 charts was conducted to determine the associated risk of being obese during childhood and adolescent period in preterm children. Birth weight, gestational age, weight gain, demographics, maternal health, socioeconomics, and clinical factors during early neonatal life were evaluated. The number of obese children increased with age and was observed more in the adolescent population. Obese children were significantly heavier at age 24 months old compared to their peers (p = 0.001). Analysis of associated risk for maternal demographics, maternal age, maternal marital status or race, prenatal factors, maternal substance abuse or diabetes, neonatal factors, weight for gestational age or birth weight did not show any statistically significant risk for future obesity. Duration of gestational age (OR 1.6; p = 0.017) and heavier birth weight (OR 3.2; p = 0.001) were associated with risk of obesity. Among preterm born babies in the study, the highest risk of developing excessive weight during childhood and adolescent periods are babies born at more advanced gestational age. Strong positive association was found between birth weight and body weight in childhood. By 24 months old, there was a distinguished group of toddlers, who were heavier than their peers and remained with excessive weight as they got older. Primary care pediatricians should draw attention to premature babies, overweight infants and toddlers.     

贵阳市云岩区适龄儿童常规疫苗接种率及免疫效果评价

目的评价2014年贵州省贵阳市云岩区适龄儿童常规疫苗接种率及接种疫苗后的免疫效果。方法抽取云岩区15个社区卫生服务中心(镇卫生院)接种疫苗的2~6岁儿童995名,采集手指或耳垂血,ELISA法检测脊髓灰质炎、麻疹、腮腺炎、风疹、甲型肝炎、乙型脑炎抗体,资料统计分析采用χ2检验。结果 995名调查对象中,除2人未接种腮腺炎疫苗,1人未接种甲型肝炎疫苗外,6种疫苗合格接种率均高于95%,抗体总体阳性率均高于98%;不同性别人群6种抗体阳性率差异均无统计学意义(P0.05);接种脊髓灰质炎、甲型肝炎、乙型脑炎灭活疫苗与减毒活疫苗的抗体阳性率差异均无统计学意义(P0.05)。结论保持疫苗高接种率及高免疫成功率,是疫苗可预防传染病发病率保持在一个较低水平的关键环节。     

Optimal vaccination schemes for epidemics among a population of households, with application to variola minor in Brazil

This paper is concerned with stochastic models for the spread of an epidemic among a community of households, in which individuals mix uniformly within households and, in addition, uniformly at a much lower rate within the population at large. This two-level mixing structure has important implications for the threshold behaviour of the epidemic and, consequently, for both the effectiveness of vaccination strategies for controlling an outbreak and the form of optimal vaccination schemes. A brief introduction to optimal vaccination schemes in this setting is provided by presenting a unified treatment of the simplest and most-studied case, viz. the single-type SIR (susceptible -->infective --> removed) epidemic. A reproduction number R*, which determines whether a trace of initial infection can give rise to a major epidemic, is derived and the effect of a vaccination scheme on R* is studied using a general model for vaccine action. In particular, optimal vaccination schemes which reduce R* to its threshold value of one with minimum vaccination coverage are considered. The theory is illustrated by application to data on a variola minor outbreak in S?o Paulo, which, together with other examples, is used to highlight key issues related to vaccination schemes.     

Prevalence of sub-clinical vitamin A deficiency and malnutrition in slum children in Maraicabo - Venezuela

The present cross sectional study was carried out to estimate the prevalence of vitamin A deficiency among children by means of clinics and conjunctival impression cytology (CIC), and nutritional status by anthropometric indicators H//A, W//A, W//H. The study population included 157 children 2-6 y old, from urban and rural slums of Maracaibo, Venezuela, Conjunctival impression cytology was performed by ICEPO standard procedure. Z-score was applied to anthropometric data with reference values of NCHS-WHO. No evidence of clinical or ophthalmologic signs of vitamin A deficiency were detected. The prevalence of subclinical vitamin A deficiency, as detected by abnormal CIC, was 35.4%, being higher in rural children (48.3%). These prevalence values are higher than the criteria laid down by WHO/UNICEF to indicate a public health problem (> 20%). Mild or moderate protein-energy global malnutrition and stunting were detected in 36.1% and 44.6% of children, respectively. Abnormal CIC was indistinctly observed (approximately equal to 35%) as much in children with adequate nutrition as in malnourished ones. There was no significant difference in the distribution of the CIC results in relation to nutritional status. The findings indicate that CIC and Z-score of nutritional anthropometric data are useful to characterize the risk of vitamin A deficiency and of malnutrition in communities. Beside the implementation of an integral nutritional program which includes supplementation, food fortification and dietary diversification, improvement of socio-economic and sanitation conditions and also the educational level, with emphasis on nutritional and health education, are highly recommended.