2016-2020年重庆市乙型肝炎时空流行特征分析

Epidemiological characteristics and spatiotemporal distribution of hepatitis B in Chongqing, 2016–2020

目的 分析2016—2020年重庆市乙型肝炎(乙肝)流行特征,探讨乙肝发病的时空分布特点,为采取有针对性的防控措施提供参考依据。方法 通过传染病报告管理系统获取重庆市2016年1月1日至2020年12月31日乙肝发病数据,采用描述流行病学的方法分析乙肝流行病学特征,利用GeoDa 1.14、SatScan 9.6空间统计分析软件,进行乙肝发病的热(冷)点地区探测及时空聚集性分析。结果 2016—2020年重庆市共报告乙肝73 847例,年平均报告发病率为48.26/10万,发病率从2016年67.54/10万逐年下降至2020年27.56/10万。男女比例为1.96∶1,年龄41~60岁组的病例占44.53%,职业为农民的比例占51.07%。乙肝发病分布存在明显的空间聚集性,探测到热点区域主要集中在渝东南和渝东北地区。通过时空扫描确定3个乙肝聚集区,其中最大可能聚集区集中在渝东南地区,覆盖8个区(县),聚集时间为2016—2017年。结论 2016—2020年重庆市乙肝发病高风险人群是农村地区41~60岁男性人群。乙肝发病存在时空聚集性,防控的重点是渝东南和渝东北地区。建议在今后防控工作中应加强该地区高风险人群的乙肝疫苗接种、宣传教育等防控措施。

Objective To describe the epidemiological characteristics and spatiotemporal distributions of hepatitis B in Chongqing from 2009 to 2016, and provide information and evidence for guiding public health response and intervention.Methods We retrieved the hepatitis B surveillance data during January 2016 to December 2020 from “National Disease Reporting Information System”. Descriptive analysis was conducted to evaluate the epidemiological characteristics of hepatitis B in Chongqing. The spatial autocorrelation analysis was carried out by software GeoDa 1.14, and the spatiotemporal scan statistics were performed by software SaTScan 9.6. Results A total of 73 847 cases of hepatitis B were reported in Chongqing during 2016–2020. The average annual incidence rate was 48.26/100 000, which decreased from 67.54/100 000 in2016 to 27.56/100 000 in 2020. The male-to-female ratio of the cases was 1.96∶1. In the reported cases, 44.53% were aged41–60 years and 51.07% were farmers. High-incidence clustering areas were identified in southeastern and northeastern Chongqing. Three statically significant hepatitis B clustering areas were identified by the spatiotemporal scan, and most of these clustering areas were in southeastern Chongqing during 2016–2017. Conclusion The incidence of hepatitis B decreased gradually in Chongqing from 2012 to 2020. Men aged 41–60 years in rural area were most affected by hepatitis B. The distribution of hepatitis B in Chongqing showed spatiotemporal clustering. It is necessary to strengthen the prevention and control of hepatitis B in southeastern and northeastern Chongqing to reduce the disease burden. It suggested to strengthen the hepatitis B vaccination and health education in population at high risk in these areas.