目的 探讨2015-2019年湖北省孕产妇艾滋病、梅毒、乙型病毒性肝炎(乙肝)的检测、感染及干预情况,为制定下一阶段的防治措施提供参考.方法 利用国家预防艾滋病、梅毒及乙肝母婴传播管理信息系统,收集2015-2019年湖北省孕产妇预防母婴传播项目月报表及相关数据,分析孕产妇艾滋病、梅毒、乙肝不同时期检测率及年度变化趋势以及感染孕产妇所娩儿童的干预情况.结果2015-2019年湖北省孕产妇艾滋病、梅毒及乙肝检测率分别为99.66％、99.36％及99.45％,孕期检测率为85.56％、85.16％及85.29％,5年间3种疾病的检测率和孕期检测率均呈逐年上升的趋势,差异有统计学意义(P＜0.05);孕期艾滋病、梅毒及乙肝的阳性检出率分别为1.33(％)、1.30(％)及5.45％,其中,艾滋病和梅毒的孕期阳性检出率逐年上升,仅产时的阳性检出率分别为1.47(％)、2.13(％)及8.19％,3种疾病仅产时的阳性检出率逐年上升;艾滋病感染孕产妇所娩儿童用药率在91.67％～95.74％之间波动,梅毒感染孕产妇所娩儿童的预防性治疗率和乙肝表面抗原阳性产妇所娩儿童的免疫球蛋白注射率逐年上升.结论 在维持湖北省孕产妇艾滋病、梅毒及乙肝检测率较高水平的情况下,建议进一步提高孕期检测比例、提升产时检测和结果反馈效率、加强对目标人群的健康教育力度以及规范艾滋病、梅毒感染孕产妇及所娩儿童的综合性干预.

目的 了解HIV感染孕产妇所娩婴儿的母婴传播情况,探讨影响母婴传播的因素,为提高湖北省预防艾滋病母婴传播项目实施效果提供参考依据.方法 收集2011年1月1日至2020年12月31日湖北省预防艾滋病母婴传播管理信息系统报告的已分娩的HIV感染孕产妇的相关信息,回顾性分析其人口学特征、孕产史、ART、丈夫/性伴情况和暴露儿童接受预防母婴传播服务等因素,比较不同组间的母婴传播率,采用Logistic回归模型分析其相关影响因素.结果 497例研究对象中,HIV感染孕产妇和暴露儿童的平均ART用药比例分别为77.46％(385/497)和85.11％(423/497),10.66％(53/497)的暴露儿童为非人工喂养,HIV感染孕产妇开始ART的时间[M(P25,P75)]为16(9,29)周,暴露儿童早期诊断的确诊时间为98(96,205)天,2011-2020年母婴传播率为4.63％,总体呈逐年下降的趋势(x2趋势=16.946,P=0.001).多因素分析结果显示,分娩年份2016-2020年(OR=0.163,95％CI:0.047～0.570)、孕产妇联合用药方案(OR=0.272,95％CI:0.096～0.771)、暴露儿童抗病毒治疗(OR=0.253,95％CI:0.103～0.621)、择期剖宫产(OR=0.167,95％CI:0.035～0.802)、人工喂养(OR=0.201,95％CI:0.103～0.621)是影响艾滋病母婴传播的独立因素(P＜0.05).结论 湖北省艾滋病母婴传播情况的总体趋势向好,提高抗病毒药物应用率、推广安全人工喂养可有效降低母婴传播的风险;分娩方式对母婴传播的影响需进一步研究.

Objective To investigate the prevalence of hepatitis B (HB) vaccination, causes of without the vaccination and their influencing factors among 15 – 59 years old residents in Xiangyang and Xiaogan city of Hubei province, and to provide evidences for developing strategies on HB prevention and control in the population. MethodsUsing a self-designed questionnaire, we conducted a voluntary survey among 1 398 permanent residents aged 15 – 59 years recruited with multistage random sampling in urban and rural regions of Xiangyang and Xiaogan city during March – November, 2020. Chi-square test and binary logistic regression were used to analyze the data collected. ResultsOf all the participants, 65.38% (914) reported having HB vaccination and 37.7% (527) reported full-does HB vaccination. Among the participants never having HB vaccination, 308 (63.64%) reported the willingness to have the vaccination; while, the main reason for being unwilling to have the vaccination was considering that the vaccination is unnecessary due to self-perceived good health. Multivariate logistic analysis indicated that occupation, education, monthly income, and whether with HB patients around were significant influential factors of HB vaccination. ConclusionFor adult residents in Xiangyang and Xiaogan city, being a farmer, with lower education and having high income are risk factors for without HB vaccination and the residents with HB patients around could pay attention to HB vaccination.

目的 了解湖北省HIV感染孕产妇早产的流行情况,探讨其相关影响因素,为制定预防HIV感染孕产妇早产的策略和措施提供参考依据.方法 收集2004-2020年全国预防艾滋病母婴传播管理信息系统中湖北地区报告的已分娩的HIV感染孕产妇相关流行病学调查资料,采用单因素x2检验和Poisson回归模型,分析HIV感染孕产妇早产情况及其影响因素.结果 湖北省HIV感染孕产妇早产率为10.70％(66/617),呈逐年上升趋势(x2趋势=4.942,P=0.026),不同地区间HIV感染孕产妇早产率的差异无统计学意义.Poisson回归模型分析结果显示,年龄(35～49)岁(RR=2.080,95％CI:1.177～3.678)、注射毒品感染 HIV(RR=2.899,95％CI:1.540～5.456)、孕期末次病毒载量≥1 000 拷贝/mm3(RR=4.567,95％CI:1.984～10.516)、胎膜早破(RR=2.395,95％CI:1.063～5.393)、妊娠合并肝病(RR=2.268,95％CI:1.154～4.455)和妊娠期高血压(RR=3.540,95％CI:2.063～6.075)是影响HIV感染孕产妇早产的危险因素(P＜0.05),不含蛋白酶抑制剂(PI)的三联用药方式(RR=0.461,95％CI:0.231～0.917)是影响HIV感染孕产妇早产的保护性因素(P＜0.05).结论 对于HIV感染孕产妇而言,加强围产期保健,采用不含PI的三联抗病毒治疗方案,控制孕期病毒载量水平、妊娠高血压疾病、妊娠合并肝病、胎膜早破等风险因素是降低其早产发生率的重要措施.

目的 了解湖北省梅毒感染孕产妇的流行病学特征及所娩儿童先天梅毒的患病情况，探讨发生先天梅毒的相关影响因素。方法 收集2015年1月1日―2020年12月31日湖北省预防艾滋病、梅毒和乙型肝炎（简称乙肝）母婴传播管理信息系统中报告的梅毒感染孕产妇的个案信息，对其人口学特征、梅毒的检测治疗情况和所娩儿童先天梅毒的患病情况进行分析。采用多因素logistic回归分析模型分析发生先天梅毒的影响因素。结果 3 467例梅毒感染孕产妇的年龄为（29.79±5.43）岁，母婴传播率为3.17%（110例）,接受过驱梅治疗的比例为73.35%（2 543例）,规范治疗的比例为49.21%（1 706例）,接受预防性治疗的梅毒暴露儿童占74.82%（2 594例）。多因素分析结果显示，产时/产后确诊梅毒感染（OR=1.879, 95%CI:1.237～2.853）、丈夫/性伴感染梅毒（OR=3.762, 95%CI:1.473～9.608）、妊娠末次非梅毒螺旋体血清学试验（简称非梅试验）效价≥1∶8（OR=8.908, 95%CI:1.840～43.131）、未进行治疗（OR=6.360, 95%CI:3.316～12.199）、进行一般治疗（OR=4.714, 95%CI:2.385～9.320）、暴露儿童接受预防性治疗（OR=0.559, 95%CI:0.369～0.846）和足月产（OR=0.496, 95%CI:0.300～0.821）是影响先天梅毒发病的独立因素（均有P＜0.05）。结论 梅毒感染孕产妇的确诊时期、妊娠末次非梅试验效价、治疗情况、分娩孕周、丈夫/性伴梅毒感染状况和暴露儿童预防性治疗情况与先天梅毒的发生密切相关。早期明确诊断并规范开展驱梅治疗和暴露儿童预防性治疗有助于降低先天梅毒的发生。

目的 了解湖北省15-59岁居民乙型肝炎(乙肝)防治知识、态度和行为.方法 采用多阶段随机抽样在湖北省2个地市6个县区抽取15-59岁居民进行现场问卷调查,分析乙肝防治知识、态度和行为平均得分、知晓率或比例.结果 共纳入调查对象1 398名,乙肝防治知识、态度、行为平均得分分别为15.12(±4.99)分(满分23分)、2.57(±2.20)分(满分8分)、10.55(±2.14)分(满分15分),各项知识知晓率、正确态度比例、正确行为比例分别在16.45％-89.77％、10.23％-78.18％、22.17％-97.42％之间.Logistic回归分析显示,地区、职业、文化程度、月收入、周围有无乙肝感染者显著影响调查对象乙肝防治知识得分.乙肝防治知识和态度得分均与行为得分呈正相关(r=0.27,P＜0.05;r=0.19,P＜0.05).结论 调查地区15-59岁居民乙肝防治知识水平总体偏低;应开展针对性的乙肝防治知识宣传,引导正确的乙肝防治态度和行为.

目的 分析湖北省2015-2019年孕产妇HIV感染的流行病学特征及母婴阻断情况,为制定预防和控制HIV母婴传播策略提供科学依据.方法 对湖北省2015年1月至2019年12月在预防艾滋病、梅毒和乙肝母婴传播管理信息系统中上报的HIV阳性孕产妇病例进行回顾性研究,分析其特征和母婴阻断情况.结果 2015-2019年湖北省孕产妇的HIV阳性检出率为1.28/万;孕产妇的HIV检测率呈逐年上升趋势(x2趋势=6 015.10,P＜0.05),阳性检出率总体呈上升趋势(x2趋势=9.633,P＜0.05);382例HIV阳性孕产妇中,20～34岁占比80.37％(307例),汉族占比86.65％(331例),初中文化占比48.43％(185例),家务及待业占比40.05％(153例),本县区户籍人口占比80.37％(307例).191例(50.00％)HIV阳性孕产妇感染途径为性传播,187例(48.95％)在孕期保健时被检出确认为感染者,259例(67.80％)在孕期接受预防母婴传播干预服务;HIV阳性孕产妇的分布呈现出地域差异,恩施州地区阳性检出率3.10/万(53/171 071);245例HIV阳性产妇及所生儿童年度抗病毒用药率均＞90％;2015-2019年湖北省HIV的母婴传播率在1.76％～5.27％之间波动.结论 湖北省孕产妇HIV感染率处于较低水平,但艾滋病母婴传播率未达到国际消除HIV认证标准,建议今后的项目管理过程中,突出重点人群、重点市州,采取针对性的综合干预措施.

目的 评估家长对入托入学儿童预防接种证查验工作的认知和影响因素.方法 采用分层整群抽样方法在湖北省4个县18所幼儿园和小学选择新人学儿童的家长开展问卷调查,分析家长对接种证查验工作的态度、知晓率及其影响因素.结果 在1 900名儿童家长中,认为疫苗安全、疫苗有效、接种证查验必要、接种犹豫的家长比例分别为81.9％、77.4％、96.8％、14.4％.家长对接种证查验、疫苗补种工作的知晓率分别为99.2％、97.2％.Logistic回归分析显示,地区、与儿童关系、疫苗安全性认知、疫苗有效性认知显著影响家长知晓率;学校类型、疫苗安全性认知显著影响家长对接种证查验必要性的态度.结论 儿童家长对入托入学儿童预防接种证查验工作的认知度较高;需针对性地加强接种证查验工作和预防接种知识宣传.

Objective To examine the status and influence factors of mental health among rural left-behind school children.Methods With convenience sampling,1 925 pupils of grade 6,junior and high school students were recruited from 6 primary and high schools at two towns of Macheng municipality of Hubei province and were self-administered anonymously with a general questionnaire,Health Kids Resilience Assessment (HKRA),and Mental Health Inventory of Middle-School Students (MMHI-60) in September 2012.Results The total MMHI-60 score was 128.58 ± 39.25 for the 725 (37.66％ of all students surveyed) left-behind school children and 127.76 ±37.2 for the 1 200 (62.34％) non-leftbehind school children,without significant difference.The left-behind school children identified with mental health problems showed significantly lower MMHI-60 total score and domain scores than the non-left-behind school children (P ≤0.05 for all),except for scores of social ability and goal and ambition domain.Among the left-behind school children,those not missing their parents had a lower mental health status,with the highest MMHI-60 total score (153.58 ±44.88),and those presenting positive attitude towards their parents' migrant working had a better mental health status,with the lowest MMHI-60 total score (121.18 ± 38.04).The MMHI-60 total score differed among the left-behind school children with different amount of monthly pocket money and those with the monthly pocket money of less than 50 RMB yuan had the lowest MMHI-60 total score (125.53 ± 41.19),suggesting that they had a better mental health status.Multivariate analyses showed that grade of study,the attitude towards their parents' migrant working,and psychological resilience were major influencing factors for mental health among the left-behind school children.Conclusion Psychological resilience is a protective factor for mental health;whereas,being at higher grade of study and negative attitude towards their parents' migrant working are risk factors for mental health among rural left-behind school children.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的了解湖北省武汉市青少年抑郁和早期应激现状,探讨早期应激与抑郁的关系。方法整群抽样选取武汉市6所中小学校共2 888名学生,利用自编一般情况问卷、儿童抑郁症状量表（CDI）和儿童期虐待自评量表（PRCA）进行调查。结果武汉市青少年抑郁检出率为14.3%,性别和年级间抑郁检出率差异无统计学意义,父亲和母亲文化程度较低以及有抑郁家族史青少年抑郁的检出率较高;早期应激总检出率为51.9%,男生（56.6%）高于女生（46.1%）,差异有统计学意义（χ²=31.416,P&lt;0.01）;除忽视外,男生在躯体虐待（64.4%）、情感虐待（57.6%）、性虐待（72.3%）的检出率均高于女生的35.7%、42.4%、27.7%（χ²=42.493、6.430、10.537,均P&lt;0.01）;抑郁组早期应激检出率为83.0%,高于非抑郁组的63.4%（χ²=54.46,P&lt;0.01,OR=2.277,95%CI=1.822².845）;非条件多因素logistic逐步回归控制人口学特征因素后分析显示,影响抑郁的因素以及与抑郁关联强度由大到小依次为父亲文化程度为小学（OR=2.429,95%CI=1.384⁴.265）、忽视（OR=1.911,95%CI=1.468².488）、情感虐待（OR=1.742,95%CI=1.325².291）、躯体虐待（OR=1.443,95%CI=1.117¹.839）。结论早期应激与青少年抑郁密切相关,躯体虐待、情感虐待和忽视是青少年抑郁的危险因素。</span>

目的:了解留守特征及相关因素对农村留守儿童心理健康的影响.方法:整群抽取湖北省麻城市两个乡镇的小学(6年级)、初中、高中各1所的学生进行调查,以1031名留守儿童为研究对象,进行包括自编一般情况问卷(含留守情况)以及《中国中小学生心理健康量表》问卷调查,采用t检验、多元线性回归进行数据分析.结果:留守儿童心理问题检出率为54.12％,留守高中生心理健康量表总得分高于留守小学生和初中生,差异有统计学意义(P＜0.05);农村留守儿童心理健康水平在外出务工人员、务工时间、看护方式、对父母的想念及父母外出务工的态度上差异均有统计学意义(P＜0.05),多元线性逐步回归分析发现留守儿童对外出务工父/母的想念对其心理健康量表总得分的影响最大(标准化β=0.12,P＜0.01).结论:留守特征及相关因素对留守儿童心理健康有重要影响.

OBJECTIVE:To understand the status of mental health among left-behind children in rural area and to explore its relationship with social capital.METHODS:A sample of 1 031 left behind children, aged 10-18 years, was randomly selected from six schools of two townships in Macheng city of Hubei province where large number of rural parents were working in the urban area. Data from a cross-sectional survey was collected among the sampled students from primary, middle and high schools, using self-designed questionnaires which targeting the 'left-behind' condition and social capital Mental Health Inventory of Middle-School Students (MMHI-60). Chi-square test was used to compare the differences in mental health among different groups. Spearman correlation and logistical regression analysis were applied to assess the relationship between social capital and mental health.RESULTS:The prevalence of mental problems was 54.12%. Results from linear χ² test indicated that the detection rates of mental problems were parallel with the monthly pocket money and the reduction in the frequency of contacting migrant father/mother (P < 0.01). Results from the multiple logistic regression analysis indicated that students who were senior(OR = 2.410-2.682, P < 0.001), and who reported not caring about their parents (OR = 2.048-2.420, P < 0.001)were at increased risks for mental health problems. After controlling the demographic characteristics and conditions of staying relevant factors, family social capital(OR = 0.845, 95%CI:0.801-0.891), neighborhood social capital (OR = 0.867, 95%CI:0.826-0.910)and school social capital(OR = 0.893, 95%CI:0.863-0.923) were all associated with declined risks of mental health problems, in which the family social capital was the most important one.CONCLUSION:The prevalence of mental health problems was high among the left-behind children in rural area. Much attention should be paid to assist these children in improving their mental health status. One promising approach appeared to be improving social capitals which would include family social capital, neighborhood social capital, and school social capital to assist these children from avoiding mental health problems.

中学生正处于青春发育期,性生理迅猛发育,第二性征更加显著,由此带来了性意识的觉醒和发展.在社会上、媒体中各种性信息杂呈下,青春躁动期的中学生的性心理、性行为直接影响他们身心健康.为了解中学生的性行为特点,笔者对武汉市某区中学生进行了调查,为开展青少年性健康教育提供参考.

目的:研究武汉地区6～17岁儿童青少年身高、体重及体质指数的分布特征.方法:采用整群系统抽样的方法抽取武汉市区及周边农村中小学学生共4 153名,测量身高体重并计算体质指数,分析一般身体形态生长各项指标的年龄性别分布特点,通过两样本t检验分析各年龄组身体形态生长各项指标的性别和城乡差异.结果:武汉地区6～17岁儿童青少年生长发育符合一般规律,身体形态各项指标均值随年龄的增长而增长,城乡和性别之间差异性显著(P＜0.05).女生相对于男生,城市学生相对于农村学生,青春期有提前和缩短的趋势.结论:基于不同年龄组学生身高、体重和体质指数男女及城乡差异,教育工作者应把重点放在青春期和农村.