不安全注射在广西壮族自治区乙型肝炎病毒传播途径中程度估测的初步研究

A Preliminary Estimation on Extent of Transmission of Hepatitis B Virus by Unsafe Injection in Guangxi Zhuangzu Autonomous Region

广西壮族自治区于 1992年按多层整群抽样方法在疾病监测点进行病毒性肝炎血清流行病学调查 ,对 12个村 (街 ) 6 2 4户 1～ 5 9岁居民 1882人采样检测。用放射免疫 (RIA)法检测乙型肝炎 (乙肝 )病毒表面抗原 (HBsAg)与抗体 (抗 HBs)、乙肝病毒核心抗体 (抗 HBc) ,用酶联免疫吸附试验 (ELISA)检测乙肝病毒e抗原 (HBeAg)。结果显示 :乙肝病毒 (HBV)感染流行率为 76 2 % ,男女性相似 ,但男性HBsAg阳性率 (2 3 4 % )是女性 (13 8% )的 1 7倍 ;已婚人群HBV感染流行率比未婚人群高 6 8个百分点 ,0～ 2 0岁暴露于不安全注射人群的HBsAg阳性率比未有机会暴露人群高 12 2个百分点。母亲HBsAg阳性家庭其子女HBsAg阳性率为 6 4 3% ,父亲HBsAg阳性而母亲阴性的家庭其子女HBsAg阳性率为 2 9 4 % ,双亲HBsAg均阴性家庭其子女HBsAg阳性率 15 5 %。研究结果提示 :HBV在广西壮族自治区通过不安全注射传播的可能性至少为 12 2 % ,通过出生时产道传播的可能性至少为35 3% ,通过家庭成员生活接触传播的可能性至少为 13 9% ,通过家庭外生活接触传播的可能性至少为 3 3% ,通过性传播的可能性至少为 6 8%。 1～ 9岁HBsAg阳性儿童 5 5 %来自不安全注射 ,17%来自家庭内生活接触 ,15 %来自家庭外生活接触 ,13%来自母婴垂?

A sero-epidemiological survey on HBV infection was carried out with stratified multistage random cluster sampling method in Guangxi Zhuangzu Autonomous Region in 1992.1882 people of 1～59 years old were selected from 624 families of 12 villages(streets). HBsAg,anti-HBc were tested by RIA,and HBeAg by ELISA. The results showed that the HBV cumulative(past or current)infection rate was 76.2%,being similar in both sexes. But the HBsAg positive rate was higher in males(23.4%)than in females(13.8%). The infection rate was higher by 6.8% in the married group than that in unmarried group,reflecting a higher rate for married males. The HBsAg positive rate of a 0～20 year old population with exposure to medication injections was 12.2%,higher than a group without that exposure. We attribute the risk difference to unsafe injections. The children's HBsAg positive rate in families with a HBsAg positive mother was 64.3%,in families with only a positive father was 29.4%,and in families with both parents negative was 15.5%. We conclude that HBsAg transmission risks in Guangxi,China,was at least 12.2% for unsafe injections,35.3% for perinatal exposure,13.9% for inside-household contacts,3.3% for outside-household contacts and 6.8% for sexual contacts. Of 1-9 year old HBsAg positive children,55% attributed to unsafe injection,17% to inside-house- hold,15% to outside-household and 13% to perinatal transmission.The preventive strategy for HBV infection is to emphasize immunizing newhorn,children and teenagers as early as possible,strengthening the syringe sterilization,implementing one needle-one syringe-one person for medication and vaccination injections.Further stress of injection practices in China is needed,aiming to reduce the unsafe injection risk to the minimum.