常州市不同等级两所医院新生儿卡介苗接种效果及影响因素研究

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目的了解常州市不同等级的两所医院新生儿卡介苗接种效果及其影响因素,为提高接种质量和人群免疫水平提供依据。方法选择1个市级医院、1个县级医院作为哨点,监测2013年1-12月不同批次菌苗对符合条件新生儿的接种情况,3个月后进行结核菌素试验(PPD),观察硬结纵横径和直径,评价接种效果;采用Logistic回归模型,对接种效果进行多因素回归分析。结果共接种卡介苗新生儿2 254例,接种成功2 090人,接种成功率92.7%。单因素分析显示,不同单位、季节、疫苗批次卡介苗接种成功率差异有统计学意义(P<0.05);金坛市人民医院接种成功率为95.15%,明显大于市妇幼保健院(90.17%),差异有统计学意义(P<0.05);经组间比较,秋季接种成功率(97.94%)明显高于冬季(90.76%,χ2=14.080,P=0.000)。疫苗批号201003a015-1接种成功率明显低于其他各批号,批号201003a012-2接种成功率明显低于批号201101a004-1和201012a083-2,差异均有统计学意义(均P=0.000)。多因素logistic回归分析,疫苗批号(OR=1.754,95%CI:1.477~2.084)是卡介苗接种成功的影响因素。结论常州市市县不同等级医院新生儿卡介苗接种成功率均较高,疫苗不同批次是影响接种成功的影响因素。 Objective To understand the effects of neonatal BCG vaccination in two hospitals of different grades in Changzhou City and its influencing factors so as to provide evidence for improving vaccination quality and population immunity. Methods One municipal hospital and one county hospital were selected as sentinel sites to monitor the vaccination of eligible batches from January to December in 2013. Three months later, tuberculin test (PPD) , The diameter and diameter of the hardened knot were observed to evaluate the effect of inoculation. Logistic regression model was used to analyze the effect of inoculation on multivariate regression analysis. Results A total of 2 254 newborns with BCG were vaccinated and 2 090 were inoculated successfully. The success rate of inoculation was 92.7%. Univariate analysis showed that the success rate of BCG vaccination among different units, seasons and batches was statistically different (P <0.05). The success rate of inoculation of Jintan People’s Hospital was 95.15%, significantly higher than that of MCH hospital (90.17%). (P <0.05). The success rate of autumn inoculation (97.94%) was significantly higher than that in winter (90.76%, χ2 = 14.080, P = 0.000). Vaccination 201003a015-1 vaccination success rate was significantly lower than the other lot number, lot number 201003a012-2 vaccination success rate was significantly lower than the lot number 201101a004-1 and 201012a083-2, the difference was statistically significant (P = 0.000). Multivariate logistic regression analysis showed that the vaccine batch number (OR = 1.754, 95% CI: 1.477 ~ 2.084) was the influencing factor of BCG vaccination success. Conclusions The successful rate of neonatal BCG vaccination in different grades of hospitals in Changzhou is high. Different batches of vaccine affect the success of vaccination.
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