| Background & ObjectiveHaemophilus influenzae type b (Hib) which causing invasive bacterial infection against infants and young children under 5-years-old is an important pathogen of meningitis, pneumonia, sepsis, septic arthritis disease and so on. The diseases spread throughout the world and the annual incidence rate is about 33/100000. There are three million cases occurred in each year, of which approximately 386,000 deaths. It has become one of the global public health problems. Prevention is the main method to control Hib diseases because of the difficulties in diagnosis and treatment. And Hib conjugate vaccine is an effective method to prevent Hib diseases. Many countries have adopted the vaccine into their national immunization programs. However, Hib vaccine is a second class vaccine in China and parents must pay for Hib vaccine at their own expense voluntarily so that the coverage rate is low. This paper analyzed Hib vaccination of children born from 2005 to 2009 in Hangzhou, sampled part of parents to investigate the children's situation, their parents' desire and awareness of Hib vaccination and other relevant factors, discussed factors affecting Hib vaccination and proposed some suitable strategies which will promote Hangzhou's Hib vaccination.Materials & MethodsAll vaccination information of children born from 2005 to 2009 in Hangzhou was exported from Hangzhou Children's Immunization Information Administration System into Microsoft Access. Descriptive epidemiological method was used to gather statistics description in gender, year of birth, residence, region and other aspects of children's Hib vaccination. Then the DPT vaccine, polio vaccine and varicella vaccine coverage was compared to Hib vaccine.458 parents from four districts in Hangzhou were surveyed about influencing factors of Hib vaccination including the common information of children and their parents, the parents'will of Hib vaccination and the awareness of Hib vaccine and diseases. Survey data entries were inputted into Epidata3.02 and analyzed by SPSS12.0 in single factor and Logistic regression analysis.ResultsThere were 397,304 infants born from 2005 to 2009 in Hangzhou. The coverage rates of Hib vaccine from the first to the fourth dose were 53.80%,36.76%,29.32%, 16.75%. The first dose rates of male and female children were 53.85% and 53.76% with no significant difference (χ2=0.32, P>0.05). The first three vaccination of Hib vaccine coverage of children in recent years were increased by 17.5%,28.74%,22.11%. The rate of first dose of Hib vaccine in different birth date children were significantly different (χ2=8155.73, P<0.05). Comparing multiple doses of Hib vaccine with routine immunization coverage of DPT vaccine and polio vaccine, the whole course vaccination rate was lower. As the increasing number of needle inoculation, vaccination rate has dropped obviously. The rate of first Hib vaccination of different household registration children were significantly different (χ2=3779.18, P<0.05). The lowest immunization rate was inter-provincial floating children and the highest was the inner-city's floating children. There was a difference of 19.43% between these two groups of children. The first vaccination rate of Hangzhou local household registration children (including the resident children, the county district floating children, floating children in Hangzhou) and the foreign household children (including floating children in Zhejiang province, inter-provincial movement of children, international movement of children) were 55.10% and 51.72% with significantly difference (χ2=430.83, P<0.05). Hib vaccine coverage of different districts in Hangzhou varied. The highest first vaccination rate was 85.23% (Shangcheng district). The lowest was 8% (Binjiang district). The inoculation rate of Hib in downtown (including the Shangcheng district, Xiacheng district, Jianggan district, Gongshu district and Xihu district) and in rural areas were 71.82% and 43.98% with significantly difference (χ2=28293.50, P<0.05). The varicella vaccination rate of children born in Hangzhou from 2005 to 2009 was 68.96% and the first dose rate of Hib vaccine was 53.80% with significant difference (χ2=17138.99, P<0.05) and the third dose rate of Hib vaccine was 29.32% with significant difference (χ2=125033.0, P <0.05).The survey of factors of Hib vaccination to 458 parents with children of Hib vaccine age showed Hib vaccination rate was 55.68%. To study if children inoculated Hib vaccine with factors in univariate analysis, the statistical analysis showed that the resident children, having health insurance, educated mothers, families with high income, received Hib vaccine inoculation notification, knowing that Hib could caused many diseases and knowing the effectiveness of Hib vaccine were the protective factors, while the high price of Hib vaccine was the high risk factors. Based on the univariate analysis, the result by non-condition Logistic stepwise regression showed that household registration as a resident and having received Hib vaccine notification was a protective factor. While the high price of Hib vaccine was the risk factor.ConclusionsAlthough Hangzhou children's Hib vaccine coverage was rising in recent years, the vaccination rate was still far behind the developed countries. On the purpose of Hib diseases control and prevention, the work of Hib vaccination to suitable children should be strengthened. The household register and region difference suggested that the Hib vaccine immunization work should be improved to floating children and carried out extensively in rural areas.The main factors affecting the Hib vaccination were household register, informing to parents and high price of Hib vaccine. |
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