长沙市老年人肺炎疫苗接种率及影响因素研究
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摘要
目的了解长沙市老年人肺炎疫苗的接种率及其影响因素。方法 2017年11～12月从长沙市9个县市区中随机抽取2个县市区,每个县市区再分别随机抽取2个乡镇/街道,每个乡镇/街道各调查106名60岁以上老年人(共424人),开展问卷调查,对肺炎疫苗接种率及影响因素进行分析。结果长沙市老年人肺炎疫苗接种率为5.77%;居住地区类型、退休前职业、文化程度、个人月收入、是否知道老年人易得肺炎、是否知道肺炎疫苗、是否知晓山东疫苗事件、是否患有其他慢性病差异有统计学意义(χ~2=9.251、45.080、54.309、48.669、33.883、82.348、31.762、11.010,P<0.05)。多因素logistic回归分析显示,是否知道肺炎疫苗(OR=22.24, 95%CI:8.60～57.56)和是否患有其他慢性病(OR=0.15,95%CI:0.03～0.70)是影响肺炎疫苗接种率的主要因素(P<0.05)。结论长沙市老年人肺炎疫苗接种率低,应开展多种途经、形式多样的宣传方式,加强对肺炎及肺炎疫苗相关知识的宣传,提高肺炎疫苗认知度和接受度,接种过程中适度放宽接种禁忌证的把握,提高慢性病老年人接种率。
Objective To understand the coverage of pneumonia vaccination among the elderly in Changsha, and to analyze its influencing factors. Methods A self-designed questionnaire survey was conducted among 424 residents aged over 60 years and randomly selected from 4 towns/districts in Changsha during November and December, 2017.Chi-square test and multivariate non-conditional logistic regression model were used for data statistical analysis. Results The overall coverage rate of pneumonia vaccine among the elderly in Changsha was 5.77%, which varied significantly among the seniors with different residential area, occupation before retired, education level, monthly income, knowledge of the susceptibility of the elderly to pneumonia, knowledge of pneumonia vaccine, knowledge of Shandong vaccine incident and chronic diseases(χ~2=9.251, 45.080, 54.309, 48.669, 33.883, 82.348, 31.762, 11.010, P<0.05).Multivariate logistic regression analysis showed that the major influencing factors of the coverage of pneumonia vaccine were knowledge of pneumonia vaccine(OR=22.24, 95%CI:8.60-57.56)and having chronic diseases(OR=0.15, 95%CI: 0.03-0.70). Conclusions The coverage of pneumonia vaccine among the elderly in Changsha was relatively low.Therefore, health education related to pneumonia and pneumonia vaccine should be strengthened in order to increase the coverage of the vaccine and to decrease the incidence of pneumonia in the elderly.
Objective To understand the coverage of pneumonia vaccination among the elderly in Changsha, and to analyze its influencing factors. Methods A self-designed questionnaire survey was conducted among 424 residents aged over 60 years and randomly selected from 4 towns/districts in Changsha during November and December, 2017.Chi-square test and multivariate non-conditional logistic regression model were used for data statistical analysis. Results The overall coverage rate of pneumonia vaccine among the elderly in Changsha was 5.77%, which varied significantly among the seniors with different residential area, occupation before retired, education level, monthly income, knowledge of the susceptibility of the elderly to pneumonia, knowledge of pneumonia vaccine, knowledge of Shandong vaccine incident and chronic diseases(χ~2=9.251, 45.080, 54.309, 48.669, 33.883, 82.348, 31.762, 11.010, P<0.05).Multivariate logistic regression analysis showed that the major influencing factors of the coverage of pneumonia vaccine were knowledge of pneumonia vaccine(OR=22.24, 95%CI:8.60-57.56)and having chronic diseases(OR=0.15, 95%CI: 0.03-0.70). Conclusions The coverage of pneumonia vaccine among the elderly in Changsha was relatively low.Therefore, health education related to pneumonia and pneumonia vaccine should be strengthened in order to increase the coverage of the vaccine and to decrease the incidence of pneumonia in the elderly.
引文
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[18] 朱宝,黄蓉娜,杨汝沛,等.成都市户籍老年人肺炎疫苗接种率及影响因素调查[J].预防医学情报杂志,2017,33(1):75-80.
[19] Kohlhammer Y,Schnoor M,Schwartz M,et al.Determinants of influenza and pneumococcal vaccination in elderly people:a systematic review[J].Public Health,2007,121(10):742-751.
[20] Schneeberg A,Bettinger JA,Mcneil S,et al.Knowledge,attitudes,beliefs and behaviours of older adults about pneumococcal immunization,a Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network (PCIRN) investigation[J].BMC Public Health,2014,14(1):442.
[21] 许明红,柳赟,杨苏婉.宝鸡市城区老年人肺炎疫苗接种情况及影响因素分析[J].医学动物防制,2015,31(3):333-335.
[22] Mieczkowski TA,Wilson SA.Adult pneumococcal vaccination:a review of physician and patient barriers[J].Vaccine,2002,20(9):1383-1392.
[2] 李春颖,李泽庚,王胜,等.老年肺炎现代研究近况[J].辽宁中医药大学学报,2016,18(7):221-224.
[3] WHO.Estimates of disease burden and cost-effectiveness[R].Geneva:World Health Organization,2008.
[4] 胡晓彦,桂炳东,王伶,等.肺炎链球菌耐药性与分子流行病学研究[J].中华医院感染学杂志,2009,19(4):380-383.
[5] 陈涛.肺炎链球菌血清型分布及耐药性研究[J].中国医药导报,2017,14(23):134-136.
[6] 王华庆,安志杰.肺炎球菌性疾病免疫预防专家共识(2017版)[J].中国预防医学杂志,2018,19(3):161-191.
[7] 彭艳芹,余正,王国栋.老年人接种23价肺炎球菌多糖疫苗药物经济学研究的系统评价[J].中国药房,2015,26(36):5116-5118.
[8] 何婷.人口老龄化背景下医养结合养老模式的研究[D].衡阳:南华大学,2016.
[9] Porchia BR,Bonanni P,Bechini A,et al.Evaluating the costs and benefits of pneumococcal vaccination in adults[J].Expert Rev Vaccines,2017,16(2):93-107.
[10] 陈红英,张涛,杨来宝,等.回顾性队列研究老年人接种23价肺炎球菌多糖疫苗的保护效果[J].中国生物制品学杂志,2018,31(8):858-861.
[11] 黄瑾,张小娟,蒋懿,等.上海市闸北区老年人接种23价肺炎球菌多糖疫苗流行病学效果评价[J].中国公共卫生,2018,34(9):1-3.
[12] 梁明斌,俞敏.肺炎链球菌多糖疫苗在高风险成人中的应用[J].浙江预防医学,2015,27(2):150-153.
[13] 陆林,刘晓强.23价肺炎球菌多糖疫苗研究进展[J].中国新药杂志,2012,21(10):1099-1102.
[14] Assaad U,Elmasri I,Porhomayon J,et al.Pneumonia immunization in older adults:review of vaccine effectiveness and strategies[J].Clin Interv Aging,2012,7(8):453-461.
[15] Pauksens K,Nilsson AC,Caubet M,et al.Randomized controlled study of the safety and immunogenicity of pneumococcal vaccine formulations containing PhtD and detoxified pneumolysin with alum or adjuvant system AS02V in elderly adults[J].Clin Vaccine Immunol,2014,21(5):651-660.
[16] 中华预防医学会.肺炎链球菌性疾病相关疫苗应用技术指南(2012版)[J].中华流行病学杂志,2012,33(11):1101-1110.
[17] 陈健,许建雄,蔡衍珊,等.广州市老年人肺炎疫苗接种的影响因素分析[J].实用医学杂志,2016(16):2740-2742.
[18] 朱宝,黄蓉娜,杨汝沛,等.成都市户籍老年人肺炎疫苗接种率及影响因素调查[J].预防医学情报杂志,2017,33(1):75-80.
[19] Kohlhammer Y,Schnoor M,Schwartz M,et al.Determinants of influenza and pneumococcal vaccination in elderly people:a systematic review[J].Public Health,2007,121(10):742-751.
[20] Schneeberg A,Bettinger JA,Mcneil S,et al.Knowledge,attitudes,beliefs and behaviours of older adults about pneumococcal immunization,a Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network (PCIRN) investigation[J].BMC Public Health,2014,14(1):442.
[21] 许明红,柳赟,杨苏婉.宝鸡市城区老年人肺炎疫苗接种情况及影响因素分析[J].医学动物防制,2015,31(3):333-335.
[22] Mieczkowski TA,Wilson SA.Adult pneumococcal vaccination:a review of physician and patient barriers[J].Vaccine,2002,20(9):1383-1392.