中国东部儿童家长对EV71疫苗接受率的Meta分析
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摘要
目的分析中国东部儿童家长对肠道病毒71型(EV71)疫苗的接种意愿。方法检索中国期刊全文数据库、维普数据库和万方全文数据库、PubMed、Embase、Web of Science数据库,收集2016年1月-2018年5月公开发表的关于我国儿童家长对EV71疫苗接种意愿的相关文献,对符合纳入标准的文献提取数据纳入分析。运用R-3.5.0统计分析软件的Meta分析方法对效应量进行合并。通过亚组分析和敏感性分析探索异质性来源,采用Begg和Egger法评价纳入文献的发表偏倚。结果共19篇文献纳入研究,我国儿童家长EV71疫苗合并接受率为68.79%(95%CI:60.74%～75.84%),事件前后合并接受率分别为75.97%和67.07%,大样本和小样本组合并接受率分别为70.27%、67.60%,亚组间差异无统计学意义。纳入文献的异质性较大,I2值为99.4%,通过亚组分析和敏感性分析I2值并无明显下降,故不能确定异质性的来源。Begg和Egger法检验发表偏倚,P值分别为0.17和0.38,尚不能认为纳入文献存在发表偏倚。结论中国儿童家长对EV71疫苗的接受率较高,但实际接种率较低,应加大对疫苗的推广力度和获得政策支持,以达到形成免疫屏障的目的。
Objective To analyse the willingness of EV71 vaccine among Chinese children.s parents in the east.Methods The Chinese Journal Full-text Database,VIP Database and Wanfang Full-text Database,PubMed,Embase,and Web of Science Database were searched.The relevant literature on the willingness of EV71 vaccines among Chinese children.s parents published from Jan,2016 to May,2018 were collected.The extracted data of the literatures that meet the inclusion criteria were included in the analysis.The amount effect was combined using the meta-analysis method of R-3.5.0 statistical analysis software.Heterogeneity sources were explored by subgroup analysis and sensitivity analysis,and the publication bias of the included literature was evaluated using the Begg and Egger methods.ResultsA total of 19 articles were included in the study.The combined acceptance rate of EV71 vaccine in Chinese children.s parents was 68.79%(95%CI:60.74%～75.84%);the combined acceptance rates before and after the event were 75.97%and 67.07%,respectively;the combined acceptance rates for the large sample group and the small sample group were 70.27%and 67.60%,respectively,and there was no statistical significance between subgroups.The heterogeneity of the literature included was larger;the value of99.4%,and the value ofnot decrease obviously through subgroup analysis and sensibility analysis,so the source of heterogeneity could not be determined.The P values of the publicatyion bias of the Begg and the Egger methods were 0.17 and 0.38,respectively,which could not be considered as publication bias in the literature included.Conclusion The acceptance rate of EV71 vaccine in Chinese children’s parents is high,but the actual vaccination rate is low.Therefore,we should increase the promotion of the vaccine and obtain policy support to achieve the goal of forming immune barrier.
Objective To analyse the willingness of EV71 vaccine among Chinese children.s parents in the east.Methods The Chinese Journal Full-text Database,VIP Database and Wanfang Full-text Database,PubMed,Embase,and Web of Science Database were searched.The relevant literature on the willingness of EV71 vaccines among Chinese children.s parents published from Jan,2016 to May,2018 were collected.The extracted data of the literatures that meet the inclusion criteria were included in the analysis.The amount effect was combined using the meta-analysis method of R-3.5.0 statistical analysis software.Heterogeneity sources were explored by subgroup analysis and sensitivity analysis,and the publication bias of the included literature was evaluated using the Begg and Egger methods.ResultsA total of 19 articles were included in the study.The combined acceptance rate of EV71 vaccine in Chinese children.s parents was 68.79%(95%CI:60.74%～75.84%);the combined acceptance rates before and after the event were 75.97%and 67.07%,respectively;the combined acceptance rates for the large sample group and the small sample group were 70.27%and 67.60%,respectively,and there was no statistical significance between subgroups.The heterogeneity of the literature included was larger;the value of99.4%,and the value ofnot decrease obviously through subgroup analysis and sensibility analysis,so the source of heterogeneity could not be determined.The P values of the publicatyion bias of the Begg and the Egger methods were 0.17 and 0.38,respectively,which could not be considered as publication bias in the literature included.Conclusion The acceptance rate of EV71 vaccine in Chinese children’s parents is high,but the actual vaccination rate is low.Therefore,we should increase the promotion of the vaccine and obtain policy support to achieve the goal of forming immune barrier.
引文
[1]杨芳,于石成,张菊英,等. 2008-2011年我国大陆地区重症手足口病流行特征分析[J].疾病监测,2013,28(11):888-893.
[2]王坚英,朱火明,陈亚琴,等.浙江省仙居县589例小儿手足口病流行病学分析[J].中华流行病学杂志,2014,35(6):708-709.
[3]李红霞,张文增,陈东妮,等.北京市顺义区5岁以下婴幼儿家长手足口病认知情况与EV71疫苗接种意愿调查[J].公共卫生与预防医学,2016,27(5):25-28.
[4]姚慧临,王瑞平,龙云,等.上海松江区儿童家长对手足口病疫苗接种意愿的电话调查[J].现代预防医学,2016,43(2):274-277.
[5]马涛,申涛,林丹,等.某区5岁及以下儿童家长手足口病认知和EV71疫苗接种意愿调查[J].现代预防医学,2016,43(23):4310-4313,4318.
[6]杭惠,刘成,覃江纯.苏州市5岁以下儿童家长手足口病认知与EV71疫苗接种意愿调查[J].现代预防医学,2017,44(24):4442-4446.
[7]唐田,杨团团,王中战,等.北京市丰台区3岁以下儿童家长对手足口病的知晓情况和EV71疫苗的接种意愿[J].职业与健康,2017,33(13):1780-1783,1788.
[8]高丽,陈爱女,赖耀荣,等. 2016年浙江省象山县5岁及以下幼儿家长手足口病认知和EV71疫苗接种意愿调查[J].实用预防医学,2018,25(4):474-477.
[9]向伦辉,李晓军,金凯,等.上海市宝山区5岁及以下儿童家长对肠道病毒71型灭活疫苗接种意愿调查[J].疾病监测,2017,32(12):944-947.
[10]丁克琴,易波,陈奕,等.宁波市儿童家长EV71疫苗接种认知、态度及影响因素[J].预防医学,2017,29(8):850-854.
[11]梅茂冬.江苏省滨海县幼儿家长对手足口病疫苗的可接受性及其影响因素分析[J].现代医学,2016,44(1):47-51.
[12]谢仕兰,王开亮,黄振豪,等.平湖街道托幼机构儿童家长手足口病知晓情况与EV 71疫苗接种意愿调查[J].医学动物防制,2017,33(12):1293-1297.
[13]陆瑾,陈慧,穆利群,等.上海市黄浦区儿童家长EV71疫苗知晓率和接种意愿调查[J].职业与健康,2017,33(16):2239-2242.
[14] Li T,Wang H,Lu Y,et al. Willingness and influential factors of parents to vaccinate their children with novel inactivated enterovirus 71 vaccines in Guangzhou,China[J]. Vaccine,2018,36(26):3772-3778.
[15]杨波,王军,郭钜旋,等. EV71疫苗接种意愿与接种行为差异分析[J].中国公共卫生,2017,33(6):861-866.
[16]罗国良.儿童肠道病毒71型疫苗接种意愿与行为的调查研究[J].现代实用医学,2017,29(11):1516-1518.
[17]叶新,何剑峰,孙立梅,等.广州市3岁及以下儿童监护人肠道病毒71型认知及其灭活疫苗自费接种意愿调查[J].疾病监测,2017,32(3):252-257.
[18]刘新迪.宁海县跃龙街道6月龄至5周岁婴幼儿家长手足口病认知情况与EV71疫苗接种意愿调查[J].世界最新医学信息文摘,2017,17(82):177,179.
[19]朱祺,沈金花,陈文花,等.上海松江区≤6岁儿童家长对EV71疫苗接种态度及影响因素[J].中国公共卫生,2016,32(7):885-888.
[20]姜璎慈,王思源,李颖.上海长宁区0~6岁儿童家长对EV71疫苗接种态度及影响因素分析[J].中国健康教育,2018,34(3):246-249,287.
[21]丁春喜,田敏,曹纳新.浙江省嘉善县儿童监护人肠道病毒71型疫苗接种意愿及影响因素的调查分析[J].国际流行病学传染病学杂志,2017,44(3):183-186.
[22]陈惠欢,麦炜,周跃华,等. 2011-2013年肇庆市手足口病重症病例流行特征分析[J].热带医学杂志,2015,15(5):705-707.
[23]方巧云,琚雄飞,许岸高.惠州市重症手足口病病原谱及EV71型VP1区基因特征分析[J].热带医学杂志,2014,14(2):172-175,210.
[24]张赫.手足口病疫苗接种率不高[N].健康时报,2018-04-24.
[25]罗美玲,谭红专,周权,等.在R软件中实现单个率的Meta分析[J].循证医学,2013,13(3):181-184,188.
[26]于兆佳,陈禹存,张丹丹,等.我国人乳头瘤状病毒疫苗认知率与接受率的meta分析[J].中国卫生统计,2017,34(4):578-582.
[27]孙文喜,董成龙,袁颖,等. Rutter儿童行为问卷调查的中国普通学龄儿童行为问题发生率meta分析[J].中国心理卫生杂志,2018,32(9):744-752.
[28]刘安平,孙婷婷.中国儿童水痘疫苗接种率Meta分析[J].中国疫苗和免疫,2017,23(6):698-704.
[29]龙遗芳,李胜峰,谢莘,等.广东省2017年肠道病毒71型灭活疫苗接种现况分析[J].华南预防医学,2018,44(4):349-351.
[30]高志英,乔学农. 2017年北京市西城区什刹海社区卫生服务中心接种门诊肠道病毒EV71型疫苗接种率及其影响因素分析[J].实用预防医学,2018,25(5):600-603.
[2]王坚英,朱火明,陈亚琴,等.浙江省仙居县589例小儿手足口病流行病学分析[J].中华流行病学杂志,2014,35(6):708-709.
[3]李红霞,张文增,陈东妮,等.北京市顺义区5岁以下婴幼儿家长手足口病认知情况与EV71疫苗接种意愿调查[J].公共卫生与预防医学,2016,27(5):25-28.
[4]姚慧临,王瑞平,龙云,等.上海松江区儿童家长对手足口病疫苗接种意愿的电话调查[J].现代预防医学,2016,43(2):274-277.
[5]马涛,申涛,林丹,等.某区5岁及以下儿童家长手足口病认知和EV71疫苗接种意愿调查[J].现代预防医学,2016,43(23):4310-4313,4318.
[6]杭惠,刘成,覃江纯.苏州市5岁以下儿童家长手足口病认知与EV71疫苗接种意愿调查[J].现代预防医学,2017,44(24):4442-4446.
[7]唐田,杨团团,王中战,等.北京市丰台区3岁以下儿童家长对手足口病的知晓情况和EV71疫苗的接种意愿[J].职业与健康,2017,33(13):1780-1783,1788.
[8]高丽,陈爱女,赖耀荣,等. 2016年浙江省象山县5岁及以下幼儿家长手足口病认知和EV71疫苗接种意愿调查[J].实用预防医学,2018,25(4):474-477.
[9]向伦辉,李晓军,金凯,等.上海市宝山区5岁及以下儿童家长对肠道病毒71型灭活疫苗接种意愿调查[J].疾病监测,2017,32(12):944-947.
[10]丁克琴,易波,陈奕,等.宁波市儿童家长EV71疫苗接种认知、态度及影响因素[J].预防医学,2017,29(8):850-854.
[11]梅茂冬.江苏省滨海县幼儿家长对手足口病疫苗的可接受性及其影响因素分析[J].现代医学,2016,44(1):47-51.
[12]谢仕兰,王开亮,黄振豪,等.平湖街道托幼机构儿童家长手足口病知晓情况与EV 71疫苗接种意愿调查[J].医学动物防制,2017,33(12):1293-1297.
[13]陆瑾,陈慧,穆利群,等.上海市黄浦区儿童家长EV71疫苗知晓率和接种意愿调查[J].职业与健康,2017,33(16):2239-2242.
[14] Li T,Wang H,Lu Y,et al. Willingness and influential factors of parents to vaccinate their children with novel inactivated enterovirus 71 vaccines in Guangzhou,China[J]. Vaccine,2018,36(26):3772-3778.
[15]杨波,王军,郭钜旋,等. EV71疫苗接种意愿与接种行为差异分析[J].中国公共卫生,2017,33(6):861-866.
[16]罗国良.儿童肠道病毒71型疫苗接种意愿与行为的调查研究[J].现代实用医学,2017,29(11):1516-1518.
[17]叶新,何剑峰,孙立梅,等.广州市3岁及以下儿童监护人肠道病毒71型认知及其灭活疫苗自费接种意愿调查[J].疾病监测,2017,32(3):252-257.
[18]刘新迪.宁海县跃龙街道6月龄至5周岁婴幼儿家长手足口病认知情况与EV71疫苗接种意愿调查[J].世界最新医学信息文摘,2017,17(82):177,179.
[19]朱祺,沈金花,陈文花,等.上海松江区≤6岁儿童家长对EV71疫苗接种态度及影响因素[J].中国公共卫生,2016,32(7):885-888.
[20]姜璎慈,王思源,李颖.上海长宁区0~6岁儿童家长对EV71疫苗接种态度及影响因素分析[J].中国健康教育,2018,34(3):246-249,287.
[21]丁春喜,田敏,曹纳新.浙江省嘉善县儿童监护人肠道病毒71型疫苗接种意愿及影响因素的调查分析[J].国际流行病学传染病学杂志,2017,44(3):183-186.
[22]陈惠欢,麦炜,周跃华,等. 2011-2013年肇庆市手足口病重症病例流行特征分析[J].热带医学杂志,2015,15(5):705-707.
[23]方巧云,琚雄飞,许岸高.惠州市重症手足口病病原谱及EV71型VP1区基因特征分析[J].热带医学杂志,2014,14(2):172-175,210.
[24]张赫.手足口病疫苗接种率不高[N].健康时报,2018-04-24.
[25]罗美玲,谭红专,周权,等.在R软件中实现单个率的Meta分析[J].循证医学,2013,13(3):181-184,188.
[26]于兆佳,陈禹存,张丹丹,等.我国人乳头瘤状病毒疫苗认知率与接受率的meta分析[J].中国卫生统计,2017,34(4):578-582.
[27]孙文喜,董成龙,袁颖,等. Rutter儿童行为问卷调查的中国普通学龄儿童行为问题发生率meta分析[J].中国心理卫生杂志,2018,32(9):744-752.
[28]刘安平,孙婷婷.中国儿童水痘疫苗接种率Meta分析[J].中国疫苗和免疫,2017,23(6):698-704.
[29]龙遗芳,李胜峰,谢莘,等.广东省2017年肠道病毒71型灭活疫苗接种现况分析[J].华南预防医学,2018,44(4):349-351.
[30]高志英,乔学农. 2017年北京市西城区什刹海社区卫生服务中心接种门诊肠道病毒EV71型疫苗接种率及其影响因素分析[J].实用预防医学,2018,25(5):600-603.