| 杨琼英,黄勇,王雯,张春焕,许建雄,张周斌.2008年和2018年广州市乙型肝炎流行病学特征比较[J].中华流行病学杂志,2021,42(6):1061-1066 |
| 2008年和2018年广州市乙型肝炎流行病学特征比较 |
| Comparative analysis on seroprevalence of hepatitis B in Guangzhou in 2008 and 2018 |
| 收稿日期:2020-09-28 出版日期:2021-06-29 |
| DOI：10.3760/cma.j.cn112338-20200928-01195 |
| 中文关键词: 乙型肝炎 血清流行病学 免疫接种 抗体 抗原 |
| 英文关键词: Hepatitis B Seroepidemiology Vaccination Antibody Antigen |
| 基金项目:广州市医学重点学科（2021-2023-11）；广州市卫生健康科技项目（20201A011056） |
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| 中文摘要: |
| 目的 比较2008年和2018年广州市1~59岁人群乙型肝炎（乙肝）血清流行病学调查结果。方法 采用二阶段整群抽样法，于2008年和2018年在广州市随机抽取1~59岁常住人口进行乙肝血清流行病学调查。结果 2008年调查1~59岁人群4 989名，2018年3 980名。2018年1~59岁人群HBsAg阳性率为9.50%（95%CI：7.34%~11.66%），较2008年（12.45%，95%CI：10.58%~14.33%）略有下降，差异无统计学意义（χ2=18.302，P=0.075）；下降主要为7~16岁人群，2018年HBsAg阳性率为0.88%（95%CI：0.35%~1.42%），较2008年（4.54%，95%CI：2.71%~6.36%）下降80.62%，差异有统计学意义（χ2=34.144，P=0.000）。2018年1~59岁人群抗-HBs阳性率为72.30%（95%CI：69.56%~75.04%），较2008年（64.93%，95%CI：61.65%~68.22%）升高11.35%，差异有统计学意义（χ2=51.618，P=0.001）；升高主要为17~59岁人群，2018年抗-HBs阳性率为71.93%（95%CI：68.90%~74.96%），较2008年（63.77%，95%CI：60.16%~67.37%）升高12.80%，差异有统计学意义（χ2=28.422，P=0.001）。2018年1~59岁人群HBV感染率为48.10%（95%CI：43.20%~53.00%），较2008年（62.27%，95%CI：59.11%~65.44%）下降22.76%，差异有统计学意义（χ2=167.138，P=0.000）；其中1~、7~和17~59岁人群HBV感染率分别为4.58%、5.13%和56.56%（降幅分别为81.83%、85.91%和18.47%），高流行区域人群HBV感染率为48.87%（降幅24.70%），有乙肝疫苗接种史人群HBV感染率为28.81%（降幅38.75%）。结论 自2008年以来，广州市乙肝防控效果显著，儿童HBV感染率达到WHO消除乙肝2020年的目标，但仍属于高流行区，降低乙肝死亡率的目标任务相当艰巨，需继续做好新生儿乙肝疫苗接种工作和成年人的监测筛查工作。 |
| 英文摘要: |
| Objective To compare the seroprevalence of hepatitis B in Guangzhou in 2008 and 2018. Methods According to the proportion of Guangzhou population size, two-stage cluster sampling was used to select the residents aged 1-59 years in the two surveys. Results 4 989 and 3 980 people aged 1-59 years were involved in 2008 and 2018, respectively. HBsAg prevalence was 9.50% (95%CI:7.34%-11.66%) in 2018 and 12.45% (95%CI:10.58%-14.33%) in 2008 among the people aged 1-59 years, with no significant difference statistically (χ2=18.302, P=0.075). The decrease of HBsAg prevalence was mainly in the population aged 7-16 years. For the people aged 7-16 years, the HBsAg prevalence was 0.88% (95%CI:0.35%-1.42%) in 2018 and decreased by 80.62% as compared with the rate 4.54% (95%CI:2.71%-6.36%) in 2008, with statistically significant difference (χ2=34.144,P=0.000). Anti-HBs prevalence was 72.30% (95%CI:69.56%-75.04%) in 2018 and ascended by 11.35% as compared with the rate of 64.93% (95%CI:61.65%-68.22%) in 2008 among the people aged 1-59 years, with statistically significant difference (χ2=51.618, P=0.001). The rise of anti-HBs prevalence was mainly in the population aged 17-59 years. For the people aged 17-59 years, the anti-HBs prevalence was 71.93% (95%CI:68.90%-74.96%) and risen by 12.80% as compared with the rate of 63.77% (95%CI:60.16%-67.37%) in 2008, with a statistically significant difference (χ2=28.422, P=0.001). HBV infection rate was 48.10% (95%CI:43.20%-53.00%) in 2018 and decreased by 22.76% as compared with the rate of 62.27% (95%CI:59.11%-65.44%) in 2008, with statistically significant difference (χ2=167.138, P=0.000). The HBV infection rates in the population aged 1-6 years, 7-16 years, and 17-59 years were 4.58%, 5.13%, and 56.56% (a decrease of 81.83%, 85.91%, and 18.47%), respectively. The infection rate of HBV was 48.87% (a decrease of 24.70%) in high epidemic areas and 28.81% (a decrease of 38.75%) in people with a history of hepatitis B immunization.Conclusion The prevention and control of hepatitis B in Guangzhou have achieved remarkable results it already reached the national goal of reducing HBsAg prevalence to less than 1% among children under five years since 2008. However, the target goal of reducing the hepatitis B mortality rate is quite demanding. The neonatal hepatitis B vaccination and monitoring and screening in adults are still needed. |
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