中国2019年乙型肝炎监测试点报告病例分析

孟彤彤; 缪宁; 王富珍; 郑徽; 尹遵栋; 梁晓峰; 张国民

Abstract

孟彤彤,缪宁,王富珍,郑徽,尹遵栋,梁晓峰,张国民.中国2019年乙型肝炎监测试点报告病例分析[J].Chinese journal of Epidemiology,2021,42(9):1532-1536

中国2019年乙型肝炎监测试点报告病例分析

Analysis on hepatitis B cases reported from surveillance points in China, 2019

Received:March 19, 2021

DOI：10.3760/cma.j.cn112338-20210319-00233

KeyWord: 乙型肝炎监测临床类型

English Key Word: Hepatitis B Surveillance Clinical type

FundProject:中国成人高危人群和社区人群乙肝疫苗优化免疫策略研究（2018ZX10721202）；中国慢性病毒性肝炎流行现状研究（2017ZX10105015）；2021年公共卫生应急反应机制的运行-计划免疫项目（131031001000200001）

Author Name	Affiliation	E-mail
Meng Tongtong	Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Miao Ning	Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Wang Fuzhen	Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Zheng Hui	Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Yin Zundong	Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Liang Xiaofeng	School of Medicine, Jinan University, Guangzhou 510632, China
Zhang Guomin	Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China	zhanggm@chinacdc.cn

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Abstract:

目的分析2019年全国法定传染病报告系统（NNDRS）乙型肝炎（乙肝）报告情况和质量。方法下载2019年全国200个乙肝监测试点NNDRS报告的乙肝个案调查表和附卡，计算附卡有效填写率；根据附卡信息，按照乙肝诊断标准（WS 299-2008）对报告乙肝进行复核，用Kappa检验评价报告与复核分类的一致性；分析导致分类不一致的原因。结果 2019年NNDRS中200个乙肝监测点共报告乙肝64 686例，急性、慢性和未分类乙肝分别为5.8%、92.4%和1.8%。报告乙肝总发病率为56.7/10万，其中急性乙肝报告发病率为3.3/10万，慢性乙肝报告发病率为52.4/10万。报告病例平均年龄为47（47±15）岁，64.4%为男性。ALT平均水平为214.2（214.2±1 253.4）U/L。报告病例中50.6%（32 722）为农、林、牧、渔和水利业生产人员。东、中、西部地区报告乙肝发病人数的比例分别为42.5%（27 501）、22.1%（14 315）和35.4%（22 870）。报告乙肝复核分类总一致率为58.8%，Kappa=0.15；对于能够明确乙肝分类的39 271例急性和慢性乙肝，复核分类总一致率为96.9%，Kappa=0.73。病例分类不一致的原因中附卡信息缺失占94.5%（24 267/25 681）。结论监测地区乙肝分类诊断能力提高，但NNDRS中乙肝病例报告卡附卡有效填写率有待提高。

English Abstract:

Objective To understand the characteristics of hepatitis B cases reported through the National Notifiable Disease Reported System (NNDRS) of China in 2019, analyze the quality of hepatitis B reporting. Methods The survey forms and reporting cards of hepatitis B cases in 200 surveillance points in China in 2019 were collected from NNDRS, the completeness rate of the reporting card was calculated, and the reported hepatitis B cases were verified based on the diagnostic criteria (WS 299-2008). The clinical types of the cases after verification were compared with the reported ones, the consistency was evaluated with Kappa test. The reasons for the inconsistent clinical types of the cases were analyzed. Results In 2019, a total of 64 686 hepatitis B cases were reported through NNDRS. Acute, chronic and unclassified hepatitis B cases accounted for 5.8%, 92.4% and 1.8%, respectively. The average age of reported cases was 47 (47±15) years, and males accounted for 64.4%. The average level of alanine aminotransferase was 214.2 (214.2±1 253.4) U/L. The reported cases mainly worked in agriculture, forestry, animal husbandry, fishery, and water conservancy (50.6%, 32 722). The proportions of cases reported from the eastern, western and central regions were 42.5% (27 501),22.1% (14 315) and 35.4% (22 870), respectively. The consistent rate of the clinical types between the reported cases and the verified cases was 58.8%, with a Kappa value of 0.15. For the 39 271 cases confirmed as acute and chronic hepatitis B cases in the reporting cards, the consistent rate of the clinical types between the reported cases and the verified cases was 96.9%, with a Kappa value of 0.73. In 94.5% (24 267/25 681) of the cases with inconsistent clinical types, the reporting card information were incomplete. Conclusion The diagnosis of hepatitis B has been improved in the hepatitis B surveillance in China, but it is necessary to improve the completeness of the reporting cards of hepatitis B cases to NNDRS.

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