甘孜州卫生学校与康定中学学生乙肝流行动态及应对策略

Prevalence of Hepatitis B Dynamics in Students in Sichuan Ganzi Health School and Kangding Middle School and Coping Strategies

目的分析甘孜州在校中学生(含中专学生)乙型肝炎流行特征及动态,为制定有效防制对策提供科学依据。方法对2013-2015级初、高中阶段学生问卷调查和每年同期体检乙肝报告进行动态分析。结果 5 126名中学生中抗-HBs阳性2 367人(46.18%),HBV感染301人(5.87%),HBsAg阳性144人(2.81%),近期HBsAg阳性19人(77.30/万)。HBV感染:高中(6.99%)高于初中(3.15%),农村(6.99%)高于城市(3.69%),彝族(17.78%),藏族(5.46%),其他民族(4.63%),汉族(3.26%),其差异均有统计学意义。近期HBV感染:彝族(5.39%),其他民族(1.82%),藏族(1.18%),汉族(1.14%),近期接种Hep B,HBsAb阳性者,无HBV感染;反之,HBV感染率为1.87%,其差异也均有统计学意义。结论学校建立健康档案,加强传染源和学生宿舍管理,进行预防接种,普及健康知识,增强防病意识,并由学校向家庭社区覆盖。

Objective To study and analyze the dynamic and epidemic characteristics of hepatitis B in middle school students（ including secondary specialized school students） in ethnic minority areas of Ganzi Tibetan Autonomous Prefecture,and to provide a scientific basis for effective prevention and control. Methods A dynamic analysis was conducted on the questionnaires of junior and senior middle school students in grade2013,2014 and 2015,and the annual reports of the hepatitis B examination. Results Among the 5 126 middle school students,2 367（ 46. 18%） were anti-HBspositive,301（ 5. 8%） were HBV-infected,144（ 2. 81%） were HBsAg-positive,19（ 77. 30/104） were recently HBsAg-positive. The HBV infection rate was higher in senior middle school students（ 6. 99%） than in junior middle school students（ 3. 15%） and higher in rural areas（ 6. 99%） than in urban areas（ 3. 69%）. The infection rate was the highest in Yi people（ 17. 78%）, followed by those in Tibetans（ 5. 46%）, other ethnic groups（ 4. 63%） and Han people（ 3. 26%）; the differences were all statistically significant. The recent HBV infection rate was the highest in Yi people（ 5. 39%）,followed by those in other ethnic groups（ 1. 82%）,Tibetans（ 1. 18%） and Han people（ 1. 14%）. HBsAb-positive studies with recent Hep B immunization were not HBV-infected,while the HBV infection rate in those no immunized was 1. 8%; the difference was statistically significant. Conclusion Schools should establish health records, strengthen management of sources of infection and student dormitories, conduct vaccination and popularize health knowledge,enhance students＇ awareness of disease prevention,and gradually include family communities into the program.