文章摘要
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
投稿时间:2018-03-27  
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)
作者单位E-mail
孙校金 100050 北京, 中国疾病预防控制中心免疫规划中心  
王富珍 100050 北京, 中国疾病预防控制中心免疫规划中心  
郑徽 100050 北京, 中国疾病预防控制中心免疫规划中心  
缪宁 100050 北京, 中国疾病预防控制中心免疫规划中心  
王华庆 100050 北京, 中国疾病预防控制中心免疫规划中心  
尹遵栋 100050 北京, 中国疾病预防控制中心免疫规划中心  
张国民 100050 北京, 中国疾病预防控制中心免疫规划中心 zhanggm@chinacdc.cn 
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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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