西藏自治区2014年和2020年1~69岁人群乙型肝炎血清流行病学调查分析

田甜; 顿珠多吉; 旦增贡嘎; 胡永红; 赵伟栋; 次仁德吉; 琼珍; 晋美

Abstract

田甜,顿珠多吉,旦增贡嘎,胡永红,赵伟栋,次仁德吉,琼珍,晋美.西藏自治区2014年和2020年1~69岁人群乙型肝炎血清流行病学调查分析[J].Chinese journal of Epidemiology,2023,44(10):1604-1609

西藏自治区2014年和2020年1~69岁人群乙型肝炎血清流行病学调查分析

Comparative analysis of seroepidemiological survey results of hepatitis B among people aged 1-69 years in Tibet Autonomous Region in 2014 and 2020

Received:March 27, 2023

DOI：10.3760/cma.j.cn112338-20230327-00184

KeyWord: 乙型肝炎流行病学调查阳性率

English Key Word: Hepatitis B Epidemiological investigation Prevalence

FundProject:中国乙肝防控科研基金（YGFK20210139）

Author Name	Affiliation	E-mail
Tian Tian	Institute of Immunization Programme, Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850000, China	314893032@qq.com
Dunzhu Duoji	Institute of Sanitary Inspection, Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850000, China
Danzeng Gongga	Institute of Immunization Programme, Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850000, China
Hu Yonghong	Institute of Immunization Programme, Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850000, China
Zhao Weidong	Institute of Immunization Programme, Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850000, China
Ciren Deji	Institute of Immunization Programme, Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850000, China
Qiong Zhen	Institute of Immunization Programme, Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850000, China
Jin Mei	Institute of Immunization Programme, Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850000, China

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Abstract:

目的对比2014年和2020年西藏自治区（西藏）两次乙型肝炎（乙肝）血清流行病学调查结果，评价西藏乙肝防控效果。方法两次调查均以1~、5~、15~、30~69岁常住人口HBsAg阳性率估计值计算所需样本量，2014年和2020年所需样本量分别为7 163和4 802人。采用多阶段分层整群随机抽样方法抽取调查对象，开展问卷调查并对每名调查对象采集5 ml静脉血，检测HBsAg、抗-HBs、抗-HBc，对HBsAg阳性标本进行复核。使用SPSS 22.0软件对调查结果进行分析，计算各指标阳性率及其95%CI。结果 2014年共调查7 069人，2020年共调查4 913人。2020年HBsAg、抗-HBs和抗-HBc阳性率分别为9.20%（452/4 913）、37.11%（1 823/4 913）和32.75%（1 609/4 913），较2014年分别下降22.95%、15.54%、1.92%。1~、5~、15~、30~69岁人群HBsAg阳性率分别为2.23%（8/358）、2.85%（20/701）、6.86%（69/1 006）和12.46%（355/2 848），较2014年分别下降61.82%、62.75%、54.81%和24.21%。1~4岁人群抗-HBs阳性率为52.79%（189/358），较2014年上升10.30%，5~、15~和30~69岁人群分别为32.67%（229/701）、37.67%（379/1 006）、36.03%（1 026/2 848），较2014年分别下降20.84%、14.13%和16.52%。1~、5~、15~、30~69岁人群抗-HBc阳性率分别为4.19%（15/358）、6.42%（45/701）、21.07%（212/1 006）、46.95%（1 337/2 848），较2014年分别下降59.63%、58.93%、50.49%、12.10%。结论西藏乙肝防控工作取得一定成效，1~69岁人群HBsAg阳性率2020年较2014年有所下降，但现阶段仍处于高流行水平。1~69岁人群抗-HBs水平较低，HBV感染风险较大，需进一步加强乙肝疫苗接种工作，有效落实HBV母婴阻断策略。

English Abstract:

Objective To evaluate the effectiveness of hepatitis B prevention and control in Tibet Autonomous Region by comparative analysis of the results of seroepidemiological surveys of hepatitis B in 2014 and 2020. Methods The required sample size was calculated based on the estimated HBsAg positivity rates of permanent residents aged 1-4, 5-14, 15-29, and 30-69 years. A total of 7 163 people and 4 802 people were required in 2014 and 2020, respectively. The subjects were selected by stratified multistage cluster random sampling method, using questionnaires to obtain basic information, and 5 ml of venous blood was collected from each subject to detect HBsAg, anti-HBs, and anti-HBc, and rechecked the HBsAg positive samples. SPSS 22.0 software was used to analyze the survey results, calculate the positive rate and 95% confidence interval. Results A total of 7 069 people were investigated in 2014 and 4 913 people in 2020. In 2020, the positive rate of HBsAg, anti-HBs, and anti-HBc was 9.20% (452/4 913), 37.11% (1 823/4 913), and 32.75% (1 609/4 913), respectively, and decreased by 22.95%, 15.54%, and 1.92% as compared with the rate in 2014. The positive rate of HBsAg of people aged 1-, 5-, 15- and 30-69 years in 2020 was 2.23% (8/358), 2.85% (20/701), 6.86% (69/1 006) and 12.46%(355/2 848), respectively, decreased by 61.82%, 62.75%, 54.81% and 24.21% as compared with the rate in 2014. The positive rate of anti-HBs of people aged 1-4 years was 52.79% (189/358), 10.30% increased compared with 2014; for people aged 5-, 15-, and 30-69 years was 32.67% (229/701), 37.67% (379/1 006) and 36.03%(1 026/2 848), respectively, decreased by 20.84%, 14.13% and 16.52% as compared with the rate in 2014. The positive rate of anti-HBc of people aged 1-, 5-, 15-, 30-69 years was 4.19% (15/358), 6.42%(45/701), 21.07% (212/1 006), and 46.95% (1 337/2 848), respectively, decreased by 59.63%, 58.93%, 50.49%, and 12.10% as compared with the rate in 2014. Conclusions The prevention and control of hepatitis B in Tibet have made partial achievements. The prevalence of HBsAg among people aged 1-69 years in 2020 had declined compared with 2014, but it is still at a high epidemic level. People have a high risk of HBV infection for a low level of anti-HBs. It is necessary to strengthen the vaccination of hepatitis B further and effectively implement the strategy of blocking mothers and children of the hepatitis B virus.

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