云南省边境地区人群风疹抗体水平及免疫策略分析

余文; 袁书益; 李立群; 陈玉娟; 张杰; 赵智娴

doi:10.11847/zgggws1133234

云南省边境地区人群风疹抗体水平及免疫策略分析

Rubella antibody level and immunity strategy among Chinese residents and Burmese entering China in border regions of Yunnan province: a cross-sectional survey

摘要

摘要:
目的调查云南省边境地区健康人群风疹抗体水平，评估免疫效果，为边境防控风疹工作提供科学依据。
方法采用多阶段随机抽样方法，于2018年抽取云南省3个边境县9个乡（镇）27个村（居）委会共891名8月龄以上常住居民，采用医院便利抽样方法抽取891名缅籍入境人群进行问卷调查并采集血标本，采用酶联免疫吸附试验(ELISA)测定风疹IgG抗体，结果录入数据库，利用SPSS 21软件进行统计分析。
结果云南省常住居民风疹抗体阳性率为79.35 %（95 % CI = 72.03 %～84.94 %），抗体几何平均浓度为31.37 IU/mL。缅甸籍入境人群风疹抗体阳性率为84.40 %（95 % CI = 79.98 %～88.97 %），抗体几何平均浓度为33.00 IU/mL，不同国籍间人群风疹抗体阳性率和抗体几何平均浓度差异均有统计学意义（χ² = 6.72，P < 0.05；U = 2.38，P < 0.05）。常住居民3～19岁人群风疹抗体阳性率较低，3～29岁人群风疹抗体几何平均浓度较低，不同年龄组人群风疹抗体水平差异有统计学意义（χ² = 25.91，P < 0.05；H = 21.96，P < 0.05）。常住居民育龄期妇女风疹抗体阳性率为82.14 %，风疹抗体几何平均浓度为34.30 IU/mL，风疹抗体几何平均浓度与年龄呈负相关。
结论云南省中缅边境地区健康人群风疹抗体水平较低，需警惕入境风疹感染者作为传染源将风疹传入中国并造成流行；3～29岁常住居民风疹易感性较高，适时增加育龄妇女加强免疫，可降低先天性风疹综合症发生风险。

Abstract:
Objective To examine rubella antibody level and the effect of immunization among healthy Chinese residents and Burmese entering China in border regions of Yunnan province for providing evidences to rubella prevention and control in the populations.
Methods During 2018 in Yunnan province, we conducted a study including questionnaire survey and blood specimen collection. The participants of the study were 891 residents aged elder than 8 months recruited with multistage random sampling in 27 villages/towns of 3 counties in border regions and 981 people recruited among Burmese entering China for seeking medical service at hospitals in the regions with convenient sampling. The collected blood specimens were detected for rubella immunoglobulin G (IgG) antibody with enzyme-linked immunosorbent assay (ELISA). SPSS 21 software was adopted in data process and analysis.
Results Between the Chinese residents and the Burmese entering China, there were significant differences in positive rate of rubella antibody (79.35% 95% confidence interval: 72.03%, 84.94% vs. 84.40% 95% confidence interval: 79.98%, 88.97%, χ² = 6.72, P < 0.05) and geometric mean concentration of IgG (31.37 IU/ml vs. 33.00 IU/ml, U = 2.38; P < 0.05) of rubella. The rubella antibody level differed significantly among the Chinese residents of various age groups, with a lower antibody positive rate in the residents aged 3 – 19 years (χ² = 25.91, P < 0.05) and a lower geometric mean concentration of IgG in the residents aged 3 – 29 years (H = 21.96, P < 0.05). For the childbearing women in the Chinese residents, the rubella antibody positive rate was 82.14% and the geometric mean concentration of IgG was 34.30 IU/ml and reversely correlated with the age of the women.
Conclusion The blood rubella antibody is at a relatively low level among healthy populations in China-Myanmar border region of Yunnan province, suggesting that there is a risk of rubella epidemic in Chinese residents due to the infected Burmese entering China, especially in the residents aged 3 – 29 years and in the childbearing women.

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