Park Sağlık Ocağı bölgesinde 6-60 ay arası çocuklarda Hemofilus İnfluenza Tip B'ye karşı doğal bağışıklık düzeyinin saptanması ve değerlendirilmesi

Hemofilus influenza tip b(Hib) bes yasin altindaki cocuklarda morbidite ve mortalitesi yuksek enfeksiyon hastaliklarina neden olmaktadir. Bu arastirma, Hib'e karsi dogal bagisiklik duzeyini saptamak ve etkili faktorleri degerlendirmek amaciyla Park Saglik Ocagi bolgesinde yasayan 6-60 aylik cocuklarda yurutulmustur. Park Saglik Ocagi bolgesinde yasayan 6-60 aylik cocuklardan, saglik evlerine ve yasa gore tabakali rasgele ornekleme yoluyla 270 cocuk secilmis ve bunlardan 242'si arastirmaya katilmistir. Katilim orani % 89.6'dir. Arastirma kapsamina giren cocuklarin, ebeveynleri ile gorusulerek anket formu uygulanmis ve cocuklardan kan ornekleri alinmistir. Serumlarda Anti- Hemofilus influenza IgG EIA kiti ile Anti-Hib IgG antikor duzeyi belirlenmis ve 0.15 ug/ml. ve uzerindeki degerler dogal bagisiklik olarak degerlendirilmistir. Arastirmadaki cocuklarin %65.3'unde dogal bagisiklik saptanmis olup, cok erken aylarda bile yuksek antikor duzeyleri tespit edilmistir. Istatistiksel degerlendirmeler sonucunda, olasi Hib etkenli hastaliklardan birini gecirme durumunda(p<0.01) ve ust solunum yolu enfeksiyonlarini sik gecirme durumunda(p<0.05) dogal bagisiklik anlamli olcude yuksek bulunmustur. Lojistik regresyon analizinde ise olasi Hib etkenli hastalik gecirme durumu ile dogal bagisiklik arasinda iliski saptanmistir. Arastirmada bolgemizdeki cocuklarin Hib ile karsilasma oranlari yuksek olarak degerlendirilmis ve gecirilen hastaliklarla iliskisi nedeniyle Hib'in cocukluk caginin onemli bir enfeksiyon etkeni oldugu sonucuna varilmistir. Hib ile karsilasma cok erken aylarda baslamaktadir ve bu aylardan itibaren korunmanin saglanmis olmasi gerekli gorunmektedir. Gelismis ulkelerde konjuge Hib asilari rutin bagisiklama programina dahil edilmis ve Hib cocuklar icin bir risk olmaktan cikmistir. Ulkemizde de Hib ile ilgili cok yonlu 89calismalarin yurutulmesi ve cocuklarimizin bu etkenle karsilasma ve hastalik gecirme riskinin azaltilmasi icin konjuge Hib asilarinin rutin bagisiklama programina dahil edilmesi gerekmektedir. AbstractHaemophilus influenzae type b(Hib) causes infection diseases which have high mortality and morbidity under five years old children. This study was carried out in the region of Park Health Center to determine natural immunity level of children who are in between 6 months and 60 months old and to evaluate important factors. 270 children of Park Health Center region who are in between 6-60 months old were selected according to health unit and age by using stratified random sampling method and 242 of them had joined the study. The participation ratio is 89.6 %. Parents of children were interviewed and blood samples were taken from children. Anti-Hib antibody level was determined by using a Haemophilus influenzae IgG EIA kits and 0.15 ug/ml. or higher antibody level was accepted as natural immunity. Natural immunity was detected in 65.3% of children and high antibody level was determined even in early months. Result of statistical analysis pointed out that natural immunity was found significant high when child had possible Hib agent disease(p<0.01) and with frequency of upper airway tract infections(p<0.05). A relation was detected between natural immunity and possible Hib agent disease history in logistic regression analyse. This study showed that the ratio of exposure to Hib is high for children who live in our region and Hib was found as an important infection agent of childhood duration because of relation with disease passed. Children who are early ages have been exposed to Hib and immunisation must be started at these ages. Conjugate Hib vaccines are added to the routine immunization programme in developed countries and now Hib is not a risk. In Turkey, further studies related to Hib disease have to be carried out and to decrease exposure to Hib and risk of Hib diseases, conjugate vaccines must be added routine immunisation programme.