| 孙校金,王富珍,郑徽,缪宁,王华庆,尹遵栋,张国民.中国2004-2015年不同预防接种阶段甲型肝炎和戊型肝炎流行病学特征比较[J].中华流行病学杂志,2018,39(10):1351-1355 |
| 中国2004-2015年不同预防接种阶段甲型肝炎和戊型肝炎流行病学特征比较 |
| Epidemiological characteristics of hepatitis A and hepatitis E in different periods of vaccination in China, 2004-2015 |
| 收稿日期:2018-03-27 出版日期:2018-10-23 |
| DOI：10.3760/cma.j.issn.0254-6450.2018.10.012 |
| 中文关键词: 甲型肝炎 戊型肝炎 预防接种 流行病学特征 |
| 英文关键词: Hepatitis A Hepatitis E Vaccination Epidemiological characteristics |
| 基金项目:中国疾病预防控制中心公共卫生应急反应机制的运行（131031001000150001） |
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| 中文摘要: |
| 目的 比较甲型肝炎（甲肝）和戊型肝炎（戊肝）在不同预防接种阶段的流行病学特征，并结合疫苗使用情况，为优化戊肝疫苗使用建议提供参考。方法 将2004-2015年分为2004-2007、2008-2011和2012-2015年3个阶段，年龄划分为0~、20~、30~和≥ 40岁组，比较不同时段、不同年龄组报告发病率的差异；同时描述疫苗批签发及甲肝疫苗使用情况。结果 2004-2015年，中国甲肝报告发病率呈逐渐下降趋势（t=-12.15，P<0.001），戊肝报告发病率呈逐渐升高趋势（t=6.63，P<0.001）。甲肝和戊肝月均报告发病数分别由2004-2007年的6 515、1 491例变化为2012-2015年的1 986、2 277例，戊肝每年3月出现发病峰值且持续出现。东、中、西部地区甲肝报告发病率均下降明显，但西部（3.46/10万）仍明显高于东部（1.13/10万）和中部（1.14/10万）（χ2=32 630，P<0.01）；中、西部地区戊肝上升明显，东部地区较为平稳（2.66/10万），但仍高于中部（1.74/10万）和西部（1.58/10万）（χ2=6 009，P<0.01）。甲肝0~19岁人群下降84.36%；戊肝≥ 20岁人群报告发病率逐渐上升，且年龄越高、报告发病率越高。甲肝疫苗接种率由62.05%提高到93.54%，接种率与甲肝报告发病率呈负相关（F=10.69，χ2<0.05）。结论 2004-2015年中国甲肝发病快速下降，戊肝发病仍在上升，应推动戊肝疫苗在人群中的使用。 |
| 英文摘要: |
| Objective Through analyzing the epidemiological characteristics of hepatitis A and E and the situation of vaccination, to promote the recommendation profile on Hepatitis E vaccination program, in China. Methods Three phases of time span were divided as 2004-2007, 2008-2011 and 2012-2015, with age groups divided as <20, 20-29, 30-39 and ≥ 40. Incidence rates in both different phases and age groups were compared. Numbers of Hepatitis A and E vaccines released and used, were described. Results Between 2004 and 2015, a declining trend in the reported incidence of hepatitis A (t=-12.15, P<0.001), but an increasing trend in hepatitis E (t=6.63, P<0.001) were noticed. The mean number of hepatitis A cases declined from 6 515 to 1 986 between 2004 and 2007 while the number of hepatitis E cases increased from 1 491 to 2 277 between 2012 and 2015. The peaks of hepatitis E appeared persistent annually, in March. The incidence of hepatitis A declined in three regions, with the western region (3.46/100 000) much higher than the eastern (1.13/100 000) or central regions (1.14/100 000) (χ2=32 630, P<0.01). The incidence of hepatitis E increased both in the central (1.74/100 000) and western regions (1.58/100 000), but more in the eastern region (2.66/100 000) (χ2=6 009, P<0.01). Incidence of hepatitis A declined in all age groups and declined by 84.36% among the 0-19 group. However, the incidence of hepatitis E showed an increasing trend among the ≥ 20 group. Incidence rates appeared higher in the older age groups. The coverage of hepatitis A vaccine increased from 62.05% to 93.54%, but with a negative association seen between the coverage of Hepatitis A vaccine and the incidence (F=10.69, χ2<0.05). Conclusion The incidence of Hepatitis A declined sharply in China while hepatitis E was still increasing from 2004 to 2015, calling for the expansion on the coverage of Hepatitis E vaccine in the whole population. |
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