| ObjectiveBy understanding the situation of hepatitis B infection in pregnant women in Chongqing,the implementation of mother-to-infant transmission interruption,and the knowledge of hepatitis B prevention and control knowledge among women of childbearing age,the problems and weaknesses in the implementation of policies were analyzed.Based on this,we will explore ways to improve the prevention and control of hepatitis B and provide targeted,actionable suggestions for government departments.Subjects and MethodsThis research is carried out by quantitative and qualitative research.Qualitative research is to conduct in-depth interviews with the target population(hospital medical staff)and related administrative personnel to understand the implementation status,appropriate interventions,and problems in the implementation of mother-to-infant blocking for hepatitis B in Chongqing.Quantitative research including questionnaire survey and expert consultation.In the questionnaire survey,multi-stage cluster sampling method was used to select the women aged 16-49 years of age in Chongqing as the object.Three districts and counties were selected from the main urban area and non-urban area of Chongqing,two streets or communities were randomly selected from the selected districts and counties.About 100 families were selected from conduct a questionnaire about the knowledge of hepatitis B prevention and control among eligible women in child-bearing age,the questionnaire contains the basic information of the surveyed object,pathway of hepatitis B transmission,knowledge of mother-to-infant transmission prevention andchannels of knowledge,1462 cases of valid questionnaires were obtained.Consultation questionnaires were send to pre-selected experts in the form of e-mails in the expert consultation,the aim is to understand the measures of mother-to-infant blocking and the tendency of the medical insurance policy.EpiData 3.0 was used to check and record the data,and SPSS 22.0 was used to describe and analyze the data.Results1.The overall infection rate of hepatitis B among pregnant women in hospital delivery was 5.35%in Chongqing from 2014 to 2016,which shows a downward trend.The infection levels in different districts and counties varied greatly,fluctuating from 2.25%to 7.55%,infection rate in main city is higher than that in non-main city(P<0.05).2.Recently,the controlling of mother-to-child transmission is carried out through the project of AIDS,syphilis and hepatitis B controlling.HBsAg test is provided free of charge for pregnant women,and hepatitis B immunoglobulin is offered to the newborns who's mother HBsAg is positive.From the clinical treatment point of view,the blocking measures is carried out from prenatal,intrapartum and postpartum stages.The most important is the combined immunization of newborns after birth,that is inoculate hepatitis B immune globulin and hepatitis B vaccine within 24 hours after birth.3.Based on existing species and blocking projects,the cost-benefit ratio of mother-to-infant blocking measures can reach 1:15 to 1:24,which is not only a low-input,high-output measure,but also can improve the quality of life and save medical costs.4.A total of 1462 women of childbearing age were investigated.The average age of respondents was(30±8)years old,mainly distribute in the range of 21-30,accounting for 50.6%;The education background ranges in high school and Bachelor above,accounting for 37.9%,38%respectively.98.5%of the respondents had heard of hepatitis B,86.7%knew that hepatitisB was an infectious disease,60.6%obtained medical knowledge through medical staff,which was the main source of knowledge.Among the transmission pathways,the highest is blood transmission and the lowest is sexually transmitted,accounting for79.62%,38.17% respectively.Awareness of pre-pregnancy examination and hepatitis B vaccine can prevent hepatitis B is higher than other knowledge.While the awareness of hepatitis B treatment,breastfeeding,and free hepatitis B immunoglobulin for HBsAg positive pregnant women is low,accounting for 23.2%,12%and24.1%respectively.The difference of knowledge awareness among age,education background were significant(P<0.05).Hepatitis B prevention literacy score of the surveyed objects was from 3 to 28,and the average scores were(17.4±4.59).Objects with hepatitis B prevention literacy were374,accounting for 14.4%.Survey shows that after controlling for the possible factors,age,education level,occupation were the impact factors of hepatitis B prevention literacy Conclusions1.Supporting measures should be consummated according to the project of AIDS,syphilis and hepatitis B controlling;broaden the scope of insurance coverage,bring the hepatitis B treatment into the medicare reimbursement2.A follow-up system should be established for HBsAg positive pregnant women and neonates3.Health education should be carried out to improve the knowledge literacy of the masses4.The government should play a leading role and attache great importance in the work of blocking mother-to-infant transmission... |
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