台灣南部成年人麻疹血清抗體流行病學之研究－以年度勞工健康檢查資料爲例

Study of Seroepidemiology of Measles among Adult Population in Southern Taiwan: A Review of Data from Annual Employee Health Exam Results

張仁鴻(Jen-Hung Chang) ； 黃建元(Chien-Yuan Huang) ； 王建楠(Jian-Nan Wang) ； 蘇世斌(Shih-Bin Su) ； 陳俊達(Chun-Ta Chen)

《中華職業醫學雜誌》 18卷2期 (2011/04) Pp. 115-124

https://doi.org/10.30027/CJOM.201104.0007

摘要

Purpose: Ever since universal measles vaccination program in Taiwan in 1978, no measles outbreak had occurred since 1989. Immunity to measles in most adults is mainly from routine childhood immunizations. However, measles vaccine may reduce its protective effect gradually with time. We designed this study to review the epidemiology of measles among adult workers in the Tainan Science-based Industrial Park.Material and methods: We carried out a retrospective, cross-sectional study by reviewing annual employee health exam results, collected from medical records in Tainan Science-based Industrial Park clinic from July 2007 to February 2008. The study sample was divided into two groups: those born before and after 1978, when the universal measles vaccination program was implemented, and we then compared the seropositivity rates for measles antibody (Ab) in them.Result: A total of 970 subjects (323 female; 647 male) were recruited and overall seropositivity rate of measles Ab was 89.2%. The seropositivity rate of measles Ab in male is higher than that in female (90.9%:85.8%, p=0.016); the seropositivity rate of measles Ab in subjects born before 1978 is higher than that in subjects born after 1978 (88.6%:82.7%). The median of optical density of measles Ab in subjects born before 1978 is higher than that in subjects born after 1978 (0.7:0.45, p＜0.001). The seropositivity rate of measles Ab in male who revealed abnormality of cholesterol-low density lipoprotein level is more than seronegativity rate of measles Ab in male (p=0.009). The seropositivity rate of measles Ab in male and in female who revealed abnormality of total-cholesterol level is more than seronegativity rate of measles Ab in male and in female (p=0.017; p=0.032). Univariate logistic regression analysis revealed that odds ratio of seropositivity rate of measles Ab in male competed with that in female is 1.66 (p=0.016); odds ratio of seropositivity rate of measles Ab in subjects born after 1978 competed with that in subjects born before 1978 is 0.63 (p=0.033). The seropositivity rate of measles Ab was 100% in subjects who were born before 1967, 85.9%-98.1% in those born between 1968 and 1977, 86.2%-94.6% in those born between 1978 and 1983, 70% in those born in 1984, and 66.7% in those born in 1985.Conclusions: This study revealed that the seropositivity rate of measles Ab in subjects born before 1978 is higher than that in subjects born after 1978; the seropositivity rate of measles Ab in male and in female who revealed abnormality of total-cholesterol level is more than seronegativity rate of measles Ab in male and in female; the seropositivity rate of measles Ab in male and in subjects born before 1978 that were higher than that in female and in subjects born after 1978.

關鍵字

血清麻疹抗體 ； 流行病學 ； 麻疹疫苗 ； 疫苗失敗 ； 群體免疫

並列摘要

Purpose: Ever since universal measles vaccination program in Taiwan in 1978, no measles outbreak had occurred since 1989. Immunity to measles in most adults is mainly from routine childhood immunizations. However, measles vaccine may reduce its protective effect gradually with time. We designed this study to review the epidemiology of measles among adult workers in the Tainan Science-based Industrial Park.Material and methods: We carried out a retrospective, cross-sectional study by reviewing annual employee health exam results, collected from medical records in Tainan Science-based Industrial Park clinic from July 2007 to February 2008. The study sample was divided into two groups: those born before and after 1978, when the universal measles vaccination program was implemented, and we then compared the seropositivity rates for measles antibody (Ab) in them.Result: A total of 970 subjects (323 female; 647 male) were recruited and overall seropositivity rate of measles Ab was 89.2%. The seropositivity rate of measles Ab in male is higher than that in female (90.9%:85.8%, p=0.016); the seropositivity rate of measles Ab in subjects born before 1978 is higher than that in subjects born after 1978 (88.6%:82.7%). The median of optical density of measles Ab in subjects born before 1978 is higher than that in subjects born after 1978 (0.7:0.45, p＜0.001). The seropositivity rate of measles Ab in male who revealed abnormality of cholesterol-low density lipoprotein level is more than seronegativity rate of measles Ab in male (p=0.009). The seropositivity rate of measles Ab in male and in female who revealed abnormality of total-cholesterol level is more than seronegativity rate of measles Ab in male and in female (p=0.017; p=0.032). Univariate logistic regression analysis revealed that odds ratio of seropositivity rate of measles Ab in male competed with that in female is 1.66 (p=0.016); odds ratio of seropositivity rate of measles Ab in subjects born after 1978 competed with that in subjects born before 1978 is 0.63 (p=0.033). The seropositivity rate of measles Ab was 100% in subjects who were born before 1967, 85.9%-98.1% in those born between 1968 and 1977, 86.2%-94.6% in those born between 1978 and 1983, 70% in those born in 1984, and 66.7% in those born in 1985.Conclusions: This study revealed that the seropositivity rate of measles Ab in subjects born before 1978 is higher than that in subjects born after 1978; the seropositivity rate of measles Ab in male and in female who revealed abnormality of total-cholesterol level is more than seronegativity rate of measles Ab in male and in female; the seropositivity rate of measles Ab in male and in subjects born before 1978 that were higher than that in female and in subjects born after 1978.

並列關鍵字

serum measles antibody ； seroepidemiology ； measles vaccine ； vaccine failure ； herd immunity