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題名 | 臺灣北中南東四區山地和平地鄉3-6歲兒童日本腦炎病毒感染的血清流行病學研究=Seroepidemiology of Japanese Encephalitis Viral Infection among 3-6 Years Old Children from Mountainous and Plains Townships Located in the Northern, Central, Southern and Eastern Taiwan |
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作者 | 許麗卿; 吳盈昌; 林雪蓉; 金傳春; 何美鄉; 盧志崶; 許須美; 陳國東; 洪其璧; | 書刊名 | 中華民國微生物及免疫學雜誌 |
卷期 | 30:3 1997.08[民86.08] |
頁次 | 頁194-206 |
分類號 | 414.84 |
關鍵詞 | 臺灣; 山地; 平地鄉; 兒童; 日本腦炎病毒感染; 血清流行病學; Japanese; Encephalitis; JE; Plaque reduction neutralization test; PRNT; Nakayama vaccine; Beijing-1 vaccine; Aborigines; Nonaborigines; |
語文 | 中文(Chinese) |
中文摘要 | 為明瞭台灣鄉村地區學齡前兒童日本腦炎病毒中和抗體分佈情形,本研究於民國82年選擇新竹、台中、屏東及花蓮四縣3-6歲兒童為研究對象,以中山株(Nakayama-NIH)為抗原的溶斑減少中和抗體試驗法(Plaque Reduction Neutralizati,n Test; PRNT),進行 清流行病學調查。中和抗體陽性以1:10以上抗體效價及50%病毒溶斑數降低為準則。在2281名兒童中,日本腦炎中山株病毒的中和抗體總陽性率為67%(1520/2281)。在完成三劑日本腦炎疫苗接種後,四縣市中和抗體陽性牽以四歲為最低,分別是新竹縣45%(56/125)、台中縣52%(57/110)、屏車縣30%(39/128)及花蓮縣66%(67/102),明顯低於同縣不同年齡層幼童(P<0.0001,Chi-square test)。五歲以後中和抗體陽性率均逐年上升,六歲達最高,介於82-91%之間。又47名未接種疫苗兒童的中和抗體陽性率也有隨著年齡增加而逐年上升,故這些地區日本腦炎病毒自然感染普遍存在。 完成三劑疫苗接種者的中山株中和抗體陽性率為67%(1122/16664),接種二劑者為66%(65/97),僅接種一劑為33%(4/12),而未接種痠苗兒童為40%(19/47),後面三者均顯著地低於已完成三劑疫苗接種者(P<0.0001,Chi-square test for trend),顯示自然感染率雖高,但接受二劑以上疫苗接種者仍具有較高的保護力,即疫苗在現階段日本腦炎防治上扮演著相當重要的角色。又比較平地鄉和山地鄉,僅新竹及台中兩縣平地鄉的日本腦炎病毒中和抗體陽性率較山地鄉高,達統計顯著差異(P=0.04,Chi-square test),而花蓮縣及屏東縣 無此現象,顯示有地理上的差異。此外四縣中接種三劑北京株疫苗後對日本腦炎病毒中和抗體陽性率(87%)明顯地高於接種三劑中山株者(39%)(Chi-square test),顯示接種三劑北京 疫苗確實優於三劑中山株疫苗。 |
英文摘要 | In order to evaluate the Japanese encephalitis virus (JEV) vaccination program in rural Taiwan, we conducted a seroepidemiological survey of JEV among rural children 3 to 6 years of age in Taiwan. The children were selected through a systemic sampling following stratification by age of children in 4 selected aboriginal villages and 4 adjacent nonaboriginal villages. The overall vaccine coverage rate for the primary (2 doses) dose was 81.2% (1853/2281) with higher rates (87.7%87.9%) found among the more recent birth cohort of 3 to 4 years of age. The neutralizing antibody (NT) against JEV was measured with plaque reduction neutralization test (PRNT) using Nakayama strain as the virus. With a positive NT anti body defined as ≧ 1:10 dilution of serum yielding more than 50% plaque reduction, the overall JEV NT antibody positive rate among children receiving 3 doses of vaccine was 67%. However, the age -specific positive rates varied significantly with varying ages; the lowest of 47% being among children 4 years of age which was lower than the rates of 68%, 76% and 87% among children of 3, 5 and 6 years of age, respectively. This trend of rising seropositive rates of JEV antibody with increasing age among 4 and 6 years of age was also noted among children who had received no vaccine, suggesting the importance of natural infection among rural Taiwanese children. Despite the high frequency of natural infection, the seropositive rates of JEV antibody still correlated well with the dose of vaccine received, i.e., 67% (1122/1664), 66% (65/97), 33% (4/12) and 40% (19/47) for children receiving 3, 2, 1, and 0 dose of JE vaccines, respectively (P<0.0001 Chi-square for trend test). When stratified analysis by dose and by type of vaccines was conducted, a significantly higher seropositive rate of JEV NT antibody was noted among children receiving JE vaccine of Beijing type (87%) than children receiving Nakayama type (39%) (p<0.0001, Chi -square test). Our data indicated that the JEV vaccination, in conjunction with JEV natural infection, has maintained high JEV NT antibody level among rural children of Taiwan. |
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