文章摘要
王焱焱,张卫,张政,马建新,于海燕,邵华,廖巍,张彪,庞星火,廖苏苏.基于社区的北京市朝阳区成年人乙型肝炎流行病学调查[J].中华流行病学杂志,2015,36(10):1104-1108
基于社区的北京市朝阳区成年人乙型肝炎流行病学调查
A community-based seroepidemiological survey of hepatitis B among adults in Chaoyang district,Beijing
收稿日期:2015-04-03  出版日期:2015-10-14
DOI:10.3760/cma.j.issn.0254-6450.2015.10.015
中文关键词: 乙型肝炎表面抗原;乙型肝炎表面抗体;社区成年人乙肝流行率;血清流行病学
英文关键词: Hepatitis B surface antigens;Hepatitis B surface antibodies;Community-based prevalence of HBsAg;Seroepidemiology
基金项目:国家科技重大专项(2012ZX10004-904,2012ZX10002001-003);中国医学科学院基础医学研究所公共卫生专业学位培训基地建设项目
作者单位E-mail
王焱焱 100005 北京, 中国医学科学院基础医学研究所北京协和医学院基础学院流行病学和卫生统计学系  
张卫 北京市疾病预防控制中心  
张政 朝阳区疾病预防控制中心  
马建新 朝阳区疾病预防控制中心  
于海燕 将台社区卫生服务中心  
邵华 将台社区卫生服务中心  
廖巍 100005 北京, 中国医学科学院基础医学研究所北京协和医学院基础学院流行病学和卫生统计学系  
张彪 100005 北京, 中国医学科学院基础医学研究所北京协和医学院基础学院流行病学和卫生统计学系  
庞星火 北京市疾病预防控制中心 pxh17@sina.com 
廖苏苏 100005 北京, 中国医学科学院基础医学研究所北京协和医学院基础学院流行病学和卫生统计学系 susuliao@cei.gov.cn 
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中文摘要:
      目的 了解北京市朝阳区≥18岁社区成年人HBsAg和抗-HBs流行状况。方法 2014年北京市疾病预防控制中心(CDC)和朝阳区CDC在朝阳区42个社区进行慢病社区诊断调查,并采血检测HBsAg和抗-HBs,各社区按性别、年龄构成抽样3 000人。本研究对完成乙肝血清学检测1 000人(≥18岁)以上的35个社区数据进行分析。结果 35个社区共调查78 100人,HBsAg粗阳性率为2.24%(95%CI:2.13%~2.34%),其中40~44岁组阳性率最高(3.00%,95%CI:2.56%~3.44%),18~24岁组最低(1.69%,95%CI:1.29%~2.09%);男性HBsAg阳性率高于女性(2.45% vs. 2.07%, P<0.01);北京户籍(京籍)者HBsAg阳性率低于外地户籍(非京籍)者(1.97% vs. 2.98%,P<0.01);各社区HBsAg阳性率差距较大,最高为10.68%(95%CI:9.43%~11.94%),最低为0.24%(95%CI:0.13%~0.38%)。将年龄、性别、职业、户籍和社区5个因素纳入logistic多元回归模型,调整后5个因素与HBsAg阳性率的关联有统计学意义(P<0.01)。人群抗-HBs粗阳性率为30.85%(95%CI:30.53%~31.18%),阳性率最高和最低的年龄分别是18~24岁(38.10%,95%CI:36.58%~39.61%)和75~岁(28.88%,95%CI:27.62%~30.15%);HBsAg、抗-HBs双阴率为67.02%(95%CI:66.69%~67.35%);抗-HBs水平以及HBsAg、抗-HBs双阴率社区间差异很大。结论 朝阳区HBsAg流行率处在中度偏低水平,但中青年和非京籍人群HBsAg感染率相对较高,因此朝阳区乙肝防控的重点应为这两类人群;各社区HBsAg、抗-HBs阳性率差距较大,原因有待进一步探讨。
英文摘要:
      Objective To understand the positive rates of hepatitis B surface antigen(HBsAg) and surface antibody(anti-HBs) among adults aged ≥18 years in communities in Chaoyang district,Beijing. Methods HBsAg and anti-HBs were tested with ELISA reagents for participants in the Community Diagnosis Survey(3 000 person were sampled in each community according to the age and sex distribution of the residents) in all 42 communities in Chaoyang district by Beijing Center for Disease Control and Prevention (CDC) and Chaoyang CDC. The data of 35 communities in which at least 1 000 adults were tested were analyzed. Results A total of 78 100 adults were tested for HBsAg and anti-HBs in the 35 communities. The crude positive rate of HBsAg was 2.24%(95%CI:2.13%-2.34%). The highest age-specific HBsAg positive rate was 3.00%(95%CI:2.56%-3.44%) for those aged 40-44 years and the lowest age-specific HBsAg positive rate was 1.69%(95%CI:1.29%-2.09%) for those aged 18-24 years,respectively. A obvious difference in community-based HBsAg positive rate was founded with the highest of 10.68%(95%CI:9.43%-11.94%) and lowest of 0.24%(95%CI:0.13%-0.38%). HBsAg positive rate was significantly lower in local residents than in participants with household registered in other provinces(1.97% vs. 2.98%,P<0.01),but the sex specific difference in HBsAg positive rate was relatively smaller(2.45% in males and 2.07% in females,P<0.01). The multivariate logistic regression analysis showed that age,community,occupation,residence status and sex were all associated with positive rate of HBsAg(P<0.01). The overall positive rate of anti-HBs was 30.85%(95%CI:30.53%-31.18%),and the highest was 38.10% in age group 18-24 years (95%CI:36.58%-39.61%) and the lowest was 28.88% in age group 75-years(95%CI:27.62%-30.15%),respectively. Up to 67.02% of the subjects were both HBsAg and anti-HBs negative(95%CI:66.69%-67.35%),and the age specific difference was not significant. But significant differences in anti-HBs positive rate and the negative rate of both HBsAg and anti-HBs were found across communities. Conclusion The overall positive rate of HBsAg was at a moderate low level among adults in Chaoyang,but the age specific positive rate was high in the middle-aged and the population specific positive rate was high in participants with household registered in other provinces,therefore,the prevention and control of hepatitis B in Chaoyang should be focused on the middle aged people and participants with household registered in other provinces. The community specific differences in the positive rate of HBsAg and anti-HBs across communities need to be further studied.
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