2015年山东省社区人群甲型肝炎抗体水平调查

Prevalence of hepatitis A antibody among population covered by different hepatitis A immunization strategies in Shandong Province,2015,China

目的 分析山东省社区人群甲型肝炎抗体（抗-HAV IgG）水平.方法 于2015年10月,根据山东省地理位置,采用分层抽样方法将17个设区的市分层后,采用随机数字表法进行抽样.首先,选择2个东部市（青岛、日照）,2个西部市（聊城、枣庄）和3个中部市（济南、淄博、莱芜）;其次,每市抽取1个县,每县抽取2个乡镇;最后,以所有乡镇中≤7岁（甲型肝炎疫苗免费接种儿童）、8~11岁（甲型肝炎疫苗自费接种儿童）、12~24岁（甲型肝炎疫苗查漏补种人群）、25~34岁（甲型肝炎疫苗使用前出生人群）和≥35岁（甲型肝炎疫苗使用前出生人群）人群为调查对象,共调查了1654名.调查年龄、性别、家庭住址等基本信息后,采集其血清标本.采用ELISA方法检测血清抗-HAV IgG.采用2015年山东省统计年鉴数据以及2010年全国人口普查数据进行标化后,计算抗-HAV IgG阳性标化率（标化率）与95%CI值.结果 1654名调查对象中,男性856名（51.75%）,女性798名（48.25%）,年龄为（13.44＆#177;13.06）岁.抗-HAV IgG阳性率为91.41%（1512例）,标化率为90.93%（95%CI：90.92%~90.94%）;≤7岁组标化率最高（95.90%,95%CI：95.88%~95.91%）,25~34岁组最低（83.23%,95%CI：83.21%~83.25%）;东部地区标化率（96.79%,95%CI：96.78%~96.80%）高于中部（86.66%,95%CI：86.65%~86.67%）和西部（91.96%,95%CI：91.95%~91.97%）.结论 山东省人群抗-HAV IgG阳性率水平较高,但青壮年偏低.建议在做好儿童甲型肝炎疫苗接种的同时,加强青壮年特别是中部和西部地区青壮年人群甲型肝炎防制工作.

Objective To evaluate prevalence of hepatitis A antibody （anti-HAV IgG） among population covered by different hepatitis A vaccine immunization strategies in Shandong Province in 2015. Methods In October 2015, according to the geographical location of Shandong Province, the stratified random sampling method was used to stratify the 17 municipal distrcts, and the random number table method was used for sampling, First, two eastern cites （Qingdao, Rizhao）, two western cities （Liaocheng, Zaozhuang） and three central cities （Jinan, Zibo and Laiwu） were selected; secondly, one county was drawn from each city. Finally, the participants were divided into five age groups including ≤7 years （age group covered by free hepatitis A vaccination strategy）, 8-11 years （age group who receive hepatitis A vaccination at their own charge）, 12-24 years （age group covered by catch-up vaccination of hepatitis A）, 25-34 years （age group born before hepatitis A vaccine was used） and ≥35 years （age group born before hepatitis A vaccine was used）. After all the paticipants or their guardians asked and registered basic information such as age, gender, home address, blood samples were collected from them and anti-HAV IgG was detected by ELISA method. The positive rate of anti-HAV IgG and 95%CI were calculated. Results A total of 1654 participants were involved in the final analysis, including 856 males （51.75%） and 798 females （48.25%） whose mean age was（13.44＆#177;13.06）years .The crude positive rate of anti-HAV IgG was 91.41% （1512/1654, 95%CI： 89.96%-92.72%） and the age-adjusted rate was 90.93% （95%CI： 90.92%-90.94%）. The positive rates of anti-HAV IgG was at the highest level in the age group of ≤7 years （95.90%,95%CI： 95.88%-95.91%） and was at the lowest level in the age group of 25-34 years （83.23%,95%CI： 83.21%-83.25%）. The age-specific positive rates of anti-HAV IgG in eastern areas （96.79%,95%CI： 96.78%-96.80%） were higher than those in both middle areas （86.66%,95%CI： 86.65%-86.67%） and western areas （91.96%,95%CI： 91.95%-91.97%）. Conclusion The positive rate of anti-HAV IgG was high among the general population in Shandong Province, but relatively low among young and middle-aged adults. Besides the routine immunization of hepatitis A among the children, more efforts should be taken for the prevention and control of hepatitis A among young and middle-aged adults in Shandong Province, especially in central and western areas.