2004—2017年中国戊型肝炎流行特征分析

Epidemiological analysis of viral hepatitis E in China,2004-2017

目的分析中国戊型肝炎流行病学特征,为防控戊型肝炎提供参考。方法2004—2017年戊型肝炎发病数据来源于中国疾病预防控制中心“传染病报告信息管理系统”,不含中国香港、澳门、台湾数据,按照发病日期下载数据。戊型肝炎突发公共卫生事件来源于“突发公共卫生事件管理信息系统”,报告标准依据《国家突发公共卫生事件相关信息报告管理工作规范(2006版试行)》。将发病数据分为2004—2007、2008—2011和2012—2017年3个时段,分别代表戊型肝炎疫苗上市前8年、疫苗上市前4年和疫苗上市后。采用线性回归对发病率进行趋势性分析,采用改良的集中度M值分析法分析季节性特征,计算集中度M值。结果2004—2017年,中国累计报告329519例戊型肝炎病例,报告发病率由1.27/10万上升至2.10/10万,呈逐渐上升趋势(t=6.87,P<0.001)。2004—2007、2008—2011、2012—2017年戊型肝炎集中度M值分别为17.43、16.06、11.17,季节性较弱。江苏、广东和浙江报告发病数占全国病例数的31.54%。东部报告发病率为2.67/10万,高于中部(1.45/10万)、西部(1.11/10万),但中部、西部报告发病率持续升高。报告发病率随年龄增长而升高(t=7.85,P<0.001),≥40岁人群报告发病率>2/10万,65~69岁最高(5.22/10万)。农民、离退休人员、家政/家务及待业报告病例数占总报告病例数的67.46%。戊型肝炎突发公共卫生事件共报告7起,其中敬老院报告3起。结论中国中部、西部戊型肝炎报告发病率持续升高,需加强中、西部地区戊型肝炎监测;中老年人群、农民及敬老院等集体单位发病风险高。

Objective To analyze the changing epidemiological characteristics of hepatitis E cases in China,in order to promote in preventing and controlling hepatitis E.Methods Data of hepatitis E and outbreaks reported through national notifiable diseases reporting system were analyzed from 2004 to 2017,but data of Hongkong,Macao and Taiwan were not included.Data of hepatitis E were divided into three phases as 2004-2007,2008-2011 and 2012-2017,representing eight years before,four years before and years after the postmarketing of hepatitis E vaccine.Linear regression was used for analyzing the trend of hepatitis E,improved muster method was used for analyzing the seasonal intensity.Results From 2004 to 2017,329 519 hepatitis E cases were reported and the annual incidence were increasing from 1.27/100 000 to 2.10/100 000(t=6.87,P<0.001).The concentrations of hepatitis E during 2004-2007,2008-2011 and 2012-2017 were 17.43,16.06,11.17,respectively,with low seasonal intensity.Number of cases reported by Jiangsu,Guangdong and Zhejiang accounted for 31.54%of national cases.The incidence were lower in central(1.45/100 000)and western(1.11/100 000)region than that in eastern region(2.67/100 000),but were increasing continuously.There was an increasing trend of incidence with growing ages(t=7.85,P<0.001).The incidence was higher than 2/100 000 among cases aged≥40,and was the highest(5.22/100 000)in the age group of 65-69 years old.Farmers,retired persons,houseworkers and unemployees accounted for 67.46%of total cases.A total of 7 outbreaks were reported,among which 3 were in nursing homes.Conclusion The incidence of hepatitis E in central and western regions were increasing continuously and the surveillance should be strengthened.There was higher risk among middle-aged population,farmers and nursing homes,so strategy for immunization among those population was in great need.