2017—2020年大理州健康人群乙型肝炎血清学时空相关性分析

Spatiotemporal correlation analysis of serological characteristics of hepatitis B in healthy people in Dali Prefecture from 2017 to 2020

目的分析大理州健康人群乙型肝炎流行时空分布情况。方法采用分层随机抽样,按照年龄段分组,采用酶联免疫吸附试验检测样本中的乙肝表面抗原、乙肝表面抗体,通过问卷调查和查验疫苗接种证获取乙肝疫苗接种数据。结果不同年龄组间乙肝表面抗原阳性率(x^(2)=184.79,P<0.01)、乙肝表面抗体阳性率(x^(2)=3292.78,P<0.01)与乙肝疫苗接种率(x^(2)=1017.68,P<0.01)分别比较,差异均有统计学意义。时空聚集分析显示乙肝表面抗原第一聚集区在2017年,以弥渡县为中心向外辐射22.56 km,包括弥渡县、祥云县、巍山县(RR=1.73,LLR=2.20,P=0.85),差异无统计学意义;乙肝表面抗体第一聚集区在2017年,以剑川县为中心向外辐射26.93 km,包括剑川县、鹤庆县(RR=1.39,LLR=21.62,P<0.01),差异有统计学意义;乙肝疫苗接种第一聚集区在2019-2020年,以南涧县为中心向外辐射28.79 km,包括剑川县、鹤庆县(RR=1.07,LLR=2.32,P=0.88),差异无统计学意义。结论7岁以后的健康人群是大理州乙型肝炎防控的重点,及时进行乙肝疫苗接种或者加强补种。

Objective To analyze the temporal and spatial distribution of hepatitis B in healthy people in Dali Bai Autonomous Prefecture.Methods The stratified random sampling was used and the subjects were grouped by ages and counties.Enzyme-linked immunosorbent assay(ELISA)was used to detect hepatitis B surface antigen and hepatitis B surface antibody in the serum samples.Hepatitis B vaccination data were collected by questionnaire survey and checking of hepatitis B vaccination certificate.Results All the differences in the positive rates of hepatitis B surface antigen(x^(2)=184.79,P<0.01),hepatitis B surface antibody(x^(2)=3292.78,P<0.01)and hepatitis B vaccine inoculation rate(x^(2)=1017.68,P<0.01)were among different age groups were statistically significant.The spatiotemporal aggregation analysis showed that the first aggregation area of hepatitis B surface antigen in 2017 radiated 22.56 kilometers from Midu county as the center,including Midu county,Xiangyun county and Weishan county,(RR=1.73,LLR=2.20,P=0.85)and the differences were not statistically significant.In 2017,the first aggregation area of hepatitis B surface antibody was centered in Jianchuan county,with a radius of 26.93 km,including Jianchuan county and Heqing county(RR=1.39,LLR=21.62,P<0.01)and the differences were statistically significant.The first gathering area for hepatitis B vaccination was in 2019-2020,with Nanjian county as the center,radiating 28.79 kilometers outward,including Jianchuan county and Heqing count(RR=1.07,LLR=2.32,P=0.88)and the differences were not statistically significant.Conclusions The healthy people over seven years old in Dali Prefecture should be focused for hepatitis B prevention and control.Vaccination or boost vaccination against hepatitis B should be carried out.