信息整合对改善乙型病毒性肝炎监测作用的评价

Evaluation of the role of information integration in the surveillance of viral Hepatitis B

目的评价信息整合对改善乙型病毒性肝炎监测的作用,提出改善监测建议。方法选择按现住址为章丘市的45例乙肝报告病例作为调查对象,通过调查报告医院、病人随访和采血检测3个来源的信息,按照统一病例定义,依次整合信息,对报告病例感染状态进行重新判定,评价信息整合对改善乙肝监测的作用。结果通过对医疗机构和病例随访信息的整合,判定报告病例中乙肝携带者31%,急性乙肝9%,慢性乙肝7%,重报病例4%,非急性乙肝40%(仅基于病史),不能明确病例9%;再整合采血检测信息,判定乙肝携带者33%,慢性乙肝20%,急性乙肝13%,非病毒性肝炎2%,非急性乙肝20%,不能明确病例7%。结论乙肝报告病例是多种感染状态的混合体,其中急性乙肝仅占13%。通过整合不同渠道信息,可将报告病例中的多种感染状态进行分类,从而准确掌握我国乙肝实际发病水平。

Objective The present study was designed to evaluate the role of information integration in the surveillance of viral Hepatitis B in order to find a better way of surveillance of the epidemic. Methods Forty-five reported hepatitis B cases who were currently residents in the city of Zhangqiu were selected as the subjects. Information about the epidemic from hospital reports, follow-ups and blood tests was in turn integrated based on a unified case definition with the infection status of the reported cases redetermined in order to evaluate the role of information integration in the surveillance of viral Hepatitis B. Results It was found through integration of the information from medical facilities and follow-ups that carders of hepatitis B accounted for 31% , acute hepatitis B for 9%, chronic hepatitis B for 7%,overlapping cases for 4% , non-acute hepatitis B 40% （only based on history） and indefmitive cases for 9% of the reported. And reintegration of information from blood tests revealed that carders of hepatitis B accoumed for 33% , chronic hepatitis B for 20%, acute hepatitis B for 13%, non-viral hepatitis for 2%, non-acute hepatitis B 20% and indefmitive cases for 9% of the reported. Conclusion The reported cases of hepatitis B are of mixed infections, with acute hepatitis B constituting only 13% .Integration of information from different channels contributes to the classification of mixed infections of reported cases, allowing accurate repotting of actual prevalence of hepatitis b in China.