天津市2000-2011年甲型肝炎免疫控制效果评价

Evaluation on the hepatitis A vaccine in preventing hepatitis A infection in Tianjin, from 2000 to 2011

目的评价2000--2011年天津市甲型肝炎（甲肝）免疫控制策略实施效果。方法采用描述性方法分析天津市2000—2011年甲肝疫情，评价疫情报告和诊断的可靠性。统计甲肝免疫目标人群接种率，并以血清流行病学方法调查1999、2005和2010年健康人群甲肝抗体水平，评价免疫屏障状况。采用多重曲线模型分析天津市甲肝与其他肠道传染病的流行趋势。结果天津市历经11年在特定人群1岁幼儿、小学一年级、初中一年级学生和高危人群中实施甲肝疫苗免疫预防策略，有效控制了甲肝流行。甲肝发病率从2000年的2．89／10万降至2011年的0．12／10万；甲肝在病毒性肝炎中的比例从2000年的8．02％降到2011年的0．48％。全市甲肝抗体水平呈现随时间推移增高的趋势。结论天津市实施的甲肝疫苗免疫策略控制了甲肝流行。

Objective Hepatitis A immunization strategies were carried out in 2001 in Tianjin. We wanted to evaluate the effectiveness of the strategies related to hepatitis A control programs and to provide the basis for fiarther modification of the strategies. Methods Descriptive epidemiology study was used to analyze the hepatitis A epidemic situation in 2000-2011 in Tianjin and to evaluate the disease reporting system. Hepatitis A vaccine coverage of target population and serum epidemiological study were carried out in 1999, 2005 and 2010 to check on the hepatitis A antibody levels so as to evaluate the immuno-barrier condition in the normal population. Cox-Stuart test was used to analyze the epidemic trend of hepatitis A and other intestinal infectious diseases in Tianjin. Results The incidence rate of hepatitis A decreased from 2.89/100 000 in 2000 to 0.12/ 100 000 in 2011, and the percentage of hepatitis A in all types of viral hepatitis decreased from 8.02% in 2000 to 0.48% in 2011 in Tianjin. The positive rates of hepatitis A antibody also increased in the residents. Conclusion The hepatitis A vaccination program was successful in the programs on prevention and control of hepatitis A in Tianjin, China.