| 张冬娟,洪荣涛,黄丽芳,吴瑞红.福建省乙型肝炎疫苗免疫效果的大型队列研究[J].Chinese journal of Epidemiology,2018,39(8):1091-1095 |
| 福建省乙型肝炎疫苗免疫效果的大型队列研究 |
| A large scale cohort study on the immunization effect of hepatitis B vaccine in Fujian province |
| Received:February 13, 2018 |
| DOI：10.3760/cma.j.issn.0254-6450.2018.08.015 |
| KeyWord: 乙型肝炎 队列研究 发病密度 |
| English Key Word: Hepatitis B Cohort study Incidence density |
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| Abstract: |
| 目的 评价福建省乙型肝炎（乙肝）疫苗免疫接种效果。方法 根据我国乙肝免疫策略与队列研究设计要求，将福建省人群分为1992年之前出生的自然暴露队列和1992年之后出生的免疫接种队列（含自愿接种队列、规范接种队列），通过网络直报疫情个案数据库清洗，观察2004-2017年急性乙肝发病及其死亡结局，分析、评价不同队列人群乙肝发病率与免疫接种效果。结果 在观察期间，福建省全人群乙肝发病率为44.594/10万，死亡率为0.010/10万。自然暴露队列发病率为56.885/10万，自愿接种队列发病率为14.502/10万，与自愿接种队列相比，自然暴露队列乙肝发病的风险增高（RR=3.923），差异有统计学意义（P=0.000 7），归因危险度为42.383/10万，归因危险度百分比为74.507%，人群归因危险度为35.448/10万，人群归因危险度百分比为70.967%。其中2002年以后出生的规范接种队列发病率为2.336/10万，自然暴露队列与规范接种队列相比，RR值为24.347（P=0.000 0），归因危险度为54.549/10万，归因危险度百分比为95.893%，人群归因危险度为47.371/10万，人群归因危险度百分比为95.300%。结论 福建省1992年以来乙肝免疫规划管理成效显著，新时期对乙肝疫苗免疫持久性问题、成年人乙肝免疫公共卫生意义等有待专题研究。 |
| English Abstract: |
| Objective To evaluate the effectiveness of hepatitis B vaccination in Fujian province. Methods Based on the hepatitis B immunization strategy of China, a cohort study was designed, involving the population in Fujian province. The population under study was divided into natural exposure birth cohort before 1992 and the immunization birth cohort after 1992 (including voluntary vaccination cohort and standardized vaccination cohort). By cleaning the database of hepatitis B cases which directly reported through network and looked into the incidence and related death outcomes of acute hepatitis B from 2004 to 2017, the incidence levels of hepatitis B and immunization effects were analyzed and evaluated among different birth cohorts. Results During the observation period, the overall prevalence of hepatitis B in Fujian province was 44.594 per 100 000, with mortality rate as 0.010 per 100 000. The incidence of natural exposure cohort of birth was 56.885 per 100 000. The incidence of voluntary vaccination cohort of birth was 14.502 per 100 000. Compared with the voluntary vaccination cohort, the risk of hepatitis B increased significantly in the natural exposed cohort (RR=3.923), and the difference was statistically significant (P=0.000 7), with attributable risk as 42.383 per 100 000. The attributable risk ratio was 74.507. The population attributable risk ratio was 70.967%. The population attributable risk was 35.448 per 100 000. The attributable rate in standardized vaccination cohorts born after 2002 was 2.336 per 100 000. Compared with the cohorts born before 1992, the RR was 24.347 (P=0.000 0), the attributable risk was 54.549 per 100 000, and the attributable risk ratio was 95.893%, the population attributable risk ratio was 95.300%, the population attributable risk was 47.371 per 100 000, comparing to the natural exposed population. Conclusions The effectiveness of hepatitis B immunization program had been remarkable in Fujian province since 1992. However, further studies on the persistency of hepatitis B vaccine immunization and its public health significance still needed to be carried out. |
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