河南省1~74岁人群乙型病毒性肝炎血清流行病学调查

Seroepidemiological survey of hepatitis B virus infection among people aged 1-74 in Henan Province

目的了解河南省城乡1~74岁人群乙型肝炎病毒(hepatitis B virus,HBV)血清标志物的流行状况,评价乙型肝炎(hepatitis B)防控效果,为河南省疾病预防控制部门未来制定防治策略提供依据。方法采用多阶段随机抽样方法,在全省随机抽取30个县区中60个居委会/行政村。根据乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)感染率估算预期调查人数为30300人(实际调查人数32077人);采用流行病学调查方法,使用ELISA对HBV血清标志物进行检验;采用EPIdate 3.1软件建立数据库,用SPSS 13.0统计软件进行数据的统计分析。结果全省1~74岁人群HBsAg、HBsAb和HBcAb流行率分别为3.26%、46.56%和21.75%。HBsAg流行率1~4岁最低为0.35%,1~24岁人群流行率随年龄增加,不同年龄组差异有统计学意义(χ^(2)=308.540,P<0.05)。HBsAb流行率不同年龄组差异有统计学意义(χ^(2)=114.887,P<0.05)。HBcAb流行率1~4岁组最低为2.22%,不同年龄组差异有统计学意义(χ^(2)=2993.071,P<0.05)。城市人群HBsAg流行率为2.70%,农村为3.62%,城市低于农村,差异有统计学意义(χ^(2)=22.404,P<0.05);城市人群HBsAb流行率为49.08%,农村为44.98%,城市高于农村,差异有统计学意义(χ^(2)=55.606,P<0.05);城市人群HBcAb流行率为20.21%,农村为23.11%,城市低于农村,差异有统计学意义(χ^(2)=48.248,P<0.05)。男女性别分布,男女HBsAg流行率分别为4.03%、2.64%,男性高于女性,差异有统计学意义(χ^(2)=17.082,P<0.05)。职业情况,农民HBsAg阳性率最高为4.35%,医护人员最低为2.21%。文化程度,小学以下的HBsAg阳性率最高为5.29%,本科及以上学历人员最低为2.04%。结论河南省乙肝防控成就显著,乙肝病毒感染率显著降低,特别是保护了小年龄组人群免受乙肝病毒的危害。保持新生儿乙肝疫苗首针、及时接种率和全程接种率;加大在农村、偏远等重点地区乙肝疫苗接种的防控工作及知识宣传;加强农民、工人等重点人群的及时接种、补种是今后乙肝防控的工作重点。

Objective To understand the prevalence of serological markers of hepatitis B virus(HBV)infection among people aged 1-74 years in urban and rural areas of Henan Province,and to evaluate hepatitis B prevention and control effects for further provision of theoretical support for formulating prevention and control strategies in the future.Methods Multi-stage random sampling method was used to randomly select 60 neighborhood committees/administrative villages from 30 counties in the whole province.Based on the HBsAg infection rate,the expected number of people to be investigated was 30300,while the actual number was 32077.The serological indexes of HBV infection were detected by ELISA including HBsAg,HBsAb and HBcAb.The data were collected and stored in EPIdate 3.1 database and analyzed by SPSS 13.0 statistical software.Results The prevalences of HBsAg,HBsAb and HBcAb among people aged 1-74 years in Henan Province were 3.26%,46.56%,21.75%,respectively.The lowest prevalence of HBsAg was in group of 1-4 years old(0.35%),and the rate increased with age and reached the peak at the age of 24.The prevalence of HBsAg was significantly different in different age groups(χ^(2)=308.540,P<0.05),so was HBsAb(χ^(2)=114.887,P<0.05).The lowest prevalence of HBcAb was in group aged 1-4(2.22%),and there had a significant difference among different age groups(χ^(2)=2993.071,P<0.05).The prevalence of HBsAg was 2.70%in urban population and 3.62%in rural population,which was lower in urban area than in rural area(χ^(2)=22.404,P<0.05).The prevalence of HBsAb in urban population was 49.08%,and that in rural population was 44.98%,indicating a higher prevalence of HBsAb in urban population(χ^(2)=55.606,P<0.05).The prevalence of HBcAb in urban area was 20.21%,while that in rural area was 23.11%,indicating the prevalence of HBcAb in urban area was lower than in rural area(χ^(2)=48.248,P<0.05).The prevalence of HBsAg was 4.03%in men and 2.64%in women,indicating a higher prevalence in men than in women(χ^(2)=17.082,P<0.05).As for the occupational distribution,the prevalence of HBsAg was the highest in farmers(4.35%),and the lowest in medical staffs(2.21%).According to the educational background,the prevalence of HBsAg was the highest among those illiterates(5.29%),and the lowest among those undergraduates and above(2.04%).Conclusion With vaccination as the main strategy,the comprehensive prevention and control measures of hepatitis B in Henan Province have made great achievements in significantly reducing the infection rate of HBV and especially protecting younger age group from the harm of HBV.Along with the prevention and treatment of hepatitis B in urban areas at the moment,increasing education on prevention and control of hepatitis B in rural areas,increasing the first and timely vaccination rate of newborns,increasing the whole process vaccination rate,and raising the vaccination rate of hepatitis B for the high-risk population would still be the focused point on the prevention and control of hepatitis B.