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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 金傳春(Chwan-Chuen King) | |
dc.contributor.author | Chien-Yu Lin | en |
dc.contributor.author | 林倩伃 | zh_TW |
dc.date.accessioned | 2021-06-13T00:02:05Z | - |
dc.date.available | 2012-10-12 | |
dc.date.copyright | 2007-09-12 | |
dc.date.issued | 2007 | |
dc.date.submitted | 2007-07-30 | |
dc.identifier.citation | Elveback L.R., Fox J.P., et al. (1976). “An influenza simulation model for immunization studies.” Am J Epidemiol 103:152-65.
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/28172 | - |
dc.description.abstract | 學童感染流感病毒時,有較長的病毒傳播期與高度傳染力,所以為流感爆發時的重要傳播者,然而,甚少研究使用血清學研究評估實際的流感病毒的感染情況。本研究是以社區健康學童為研究對象的血清流行病學追蹤研究,主要的目的有二:(一)明瞭於2005-2006流感流行季時,人流感病毒((H3N2, H1N1與B)在台灣北(台北)、中(彰化)、東(宜蘭)及離島(金門)不同地區學童的感染盛行率、發生率以及血清抗體幾何平均效價是否有所不同,及(二)、探查造成學童此年度流感感染的相關危險/保護因子。
為著手前瞻性流行病學追蹤研究,本研究在2005-2006年流感流行季前(2005年11-12月)與流行季後(2006年4-5月),共收集了五所小學1104位學童的成對血清。另外,我們利用問卷收集感染流感相關的危險/保護因子。實驗方法為以人類O型紅血球,利用血球凝集抑制試驗,檢視A/H1N1, A/H3N2及B型三種流感病毒血球凝集素為4單位(HA=4 units)時,測試學童的血清所含2005~06年當季世衛組織對北半球建議的流感三疫苗株[A/New Caledonia/20/99-like (H1N1), A/California/7/2004 (H3N2)-like and B/Shanghai/361-2002-like]之抗體效價;並以單變項與多變項分析H1N1與H3N2兩重要亞型流感病毒的血清保護(血球凝集抑制(HI)抗體效價≧40)與新感染(在第二次抽血時流感病毒的HI抗體效價較第一次抽血時上升至少4倍以上)之相關因子。 結果顯示,學童流感病毒的總新感染比例為25.36%,且在不同地區流行的幅度與主要的流行型別有些微不同。在2005-2006年流感流行季,台灣地區的流行是以A/H1N1亞型為主,台北、宜蘭、金門也是以A /H1N1亞型為主,然而彰化地區卻是A/H1N1與H3N2兩亞型共同流行,且是以流行H3N2為主。此外,不同年齡層學童的流感感染率也不同,年紀越小者,其感染率越高(p <0.0001)。A/H1N1與H3N2兩亞型的不顯性感染比例也略有不同,H1N1有較高的不顯性感染比例而感染H3N2的學童產生「類流感」症狀的人會比感染H1N1的人多。曾打過流感疫苗者其得「類流感」症狀或流感病毒的新感染也較少,但樣本數太少而難下確切結論。 本研究是台灣第一個以不同風險度社區健康學童為對象的世代研究,同時度量學童血清對人流感病毒抗體H1N1與H3N2兩亞型的盛行率及發生率,以供未來台灣擬定學童施打疫苗政策的參考[註:我國衛生單位已決定自2007年起全面免費為國小一、二年級學童接種人流感疫苗]。在面對未來可能流感流行的公共衛生挑戰,必須更努力推動在金門與台灣本島禽流感病毒常活躍地之人流感病毒抗體偵測及其效價變化。 | zh_TW |
dc.description.abstract | Schoolchildren are important community-based influenza epidemic alerting group because they have longer shedding periods and higher transmissibility. However, few studies used serology to evaluate their impact of influenza virus infection. In this community-based seroepidemiological cohort study, the specific aims were: (1) to understand the differences and similarities of the sero-incidence and the sero-prevalence rates of human influenza virus infection, and their distributions of the geometric mean of sero-titers (GMTs) against the three types/subtypes of human influenza viruses (H3N2, H1N1 and B) among schoolchildren in different geographical areas [northern (Taipei), central (Changhwa) and eastern (Ilan) Taiwan plus one off-shore isolated island (Kinmen)] during the 2005-2006 epidemic season, and (2) to investigate the possible risk/protection factors associated with the human influenza virus infections and their sero-titer changes during the 2005-2006 influenza epidemic season.
We initiated a prospective cohort study by collecting the 1104 paired children’s serum samples of the five elementary schools at both pre- and post-2005~2006 influenza epidemic season in November-December, 2005 and April-May, 2006, respectively. Additionally, the questionnaire information on risk/protection factors that might be related to sero-protection, sero-incidence and sero-titer changes was also obtained for analysis. Haemagglutination- Inhibition (HI) test using human type O erythrocytes and 4 hemagglutination antigen (HA) units of the H1N1, H3N2 and B viruses were employed to screen the presence of HI antibody and their serotiters against the three 2005~2006 influenza virus vaccine-like strains [A/New Caledonia/20/99-like (H1N1), A/California/7/2004 (H3N2)-like and B/Shanghai/361-2002-like] implemented in the Northern Hemisphere recommended by WHO. Both univariate and multivariate logistic regression analyses were used to investigate factors associated with sero-protection (HI sero-titer >40) and sero-incidence (≧4-fold sero-titer rise) of the two important subtypes of H1N1 and H3N2. The results showed that the overall new infection rate of human influenza viruses among Taiwan’s schoolchildren during 2005-06 was approximately 25.36% of the tested schoolchildren, with geographical variations in the subtypes of human influenza A viruses and the magnitude of the infection. H1N1, which was dominant among the schoolchildren in Taipei, Kinmen and Ilan, was also the dominant subtype in whole Taiwan area during 2005-06; whereas both H1N1 and H3N2 subtypes were co-circulated with more predominance of H3N2 subtype in Changhwa. Moreover, grade was a strong risk factor in acquiring the infection of human influenza viruses and the younger schoolchildren had statistically higher rates of the newly infections (p <0.0001). Pediatric infection of H1N1 virus showed higher asymptomatic ratio than H3N2 whereas children infected with H3N2 showed more symptoms of influenza-like illness (ILI) than those infected with H1N1. Furthermore, children who received influenza vaccine also had less chance to develop ILI or acquiring the new infection of influenza during the study period but without statistical significance, possibly due to small sample size. This is the first community-based study to simultaneously measure prevalence of incidence rates against human influenza H1N1 and H3N2 viruses among children at schools in areas with different risk levels in Taiwan for formulating better vaccination policy (ps: mass-vaccination program of human influenza will be implemented on grade 1 and grade 2 elementary schoolchildren, starting from 2007 by the Department of Health in Taiwan.). In facing possible future public health challenges of influenza epidemics, more efforts are needed to conduct serological surveillance and to monitor possible changing patterns of human influenza virus antibodies in Kinmen versus different parts of Taiwan where avian influenza viruses are frequently circulating. | en |
dc.description.provenance | Made available in DSpace on 2021-06-13T00:02:05Z (GMT). No. of bitstreams: 1 ntu-96-R94842018-1.pdf: 569902 bytes, checksum: ce82b83d12f04012d84070c60c5fde24 (MD5) Previous issue date: 2007 | en |
dc.description.tableofcontents | Chinese Acknowledgements (致謝)…………………………..........................………....ii
English Abstract……………………....………………….….…….….............................vi Chinese Abstract (中文摘要)…………………………………………….......................ix Table Contents………...……………………………………..….....................................xi Figure Contents……………………………………………….…...................................xv Chapter 1. Introduction…………...........................................…1 Chapter 2. Literature Review………………………………….2 2.1. Introduction of Human Influenza Viruses…………………………2 2.2 Public Health Impact of Influenza in Children and Transmission of Human Influenza Viruses………………………………………….3 2.3. Influenza Vaccination in Schoolchildren …………………………5 2.4. Review of Serological Studies on Human influenza virus………...7 Chapter 3. Objectives, Specific Aims and Hypotheses..…...…8 3.1. Objective…………………………………………………………..8 3.2. Specific Aims……………………………………………………...8 3.3. Hypotheses………………………………………………………...9 Chapter 4. Materials and Methods…………………………...10 4.1. Study Design and Study Populations…………………………….10 4.2. Data Collection…………………………………………………...11 4.3. Laboratory Methods……………………………………………...12 4.4. Outcome Measures……………………………………………….17 4.5. Statistics…………………………………………………………..17 Chapter 5 . Results………………………..…………………...19 5.1. Characteristics of the Study Cohort in Taiwan…………………..19 5.2. Sero-prevalence Rates and Seroprotection Rates………………...21 5.3. Geometric Mean Sero-titers of HI Antibodies against the Three Human Influenza Viruses and Sero-protection Rates……………21 5.4. Sero-incidence and Sero-conversion Rates during 2005~2006..…28 5.5.. Asymptomatic ratios…………………………………………..…32 5.6. Risk Factors Analysis………………………………………….…33 Chapter 6. Discussion………………………………………...35 6.1. Measurements of Sero-protection and Sero-conversion Rates among Schoolchildren in Taiwan …………………………..…35 6.2. Risk Factor Analysis…………………………………………..…39 6.3. Limitations………..........................................................................40 6.4. Future Directions…........................................................................41 Chapter 7. References…............................................................43 Tables……………………………………..………………........................47 Figures…………………………………….….………………..................71 | |
dc.language.iso | en | |
dc.title | 2005-2006年流感流行季台灣地區國小學童人流感病毒血清學偵測 | zh_TW |
dc.title | Serological Surveillance of Human Influenza Viruses among Elementary Schoolchildren in Taiwan during the 2005-2006 Influenza Season | en |
dc.type | Thesis | |
dc.date.schoolyear | 95-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 何美鄉(Mei-Shang Ho),李文宗(Wen-Chung Lee),方啟泰(Chi-Tai Fang),李秉穎(Ping-Ing Lee),謝英恆(Ying-Hen Hsieh),高全良(Chuan-Liang Kao) | |
dc.subject.keyword | 流感病毒,學童,血清流行病學,流感發生率,疫苗政策,台灣, | zh_TW |
dc.subject.keyword | Influenza virus,Schoolchildren,Seroepidemiology,Influenza,Seroincidence Rate,Vaccine Policy,Taiwan, | en |
dc.relation.page | 74 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2007-07-31 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 流行病學研究所 | zh_TW |
顯示於系所單位: | 流行病學與預防醫學研究所 |
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