2020年江苏省1-14岁儿童乙型肝炎血清流行率和疫苗接种率调查

Hepatitis B seroprevalence and vaccine coverage among children 1-14 years of age in Jiangsuprovince:a cross-sectional survey in 2020

目的了解江苏省儿童乙型肝炎(乙肝)血清流行率和乙肝疫苗(Hepatitis B vaccine,HepB)接种率。方法采用分层多阶段整群随机抽样,选取江苏省6个疾病监测县区1-14岁常住儿童开展问卷调查,分析HepB全程(HepB_(3))接种率和首剂(HepB1)及时接种率;检测血清乙肝表面抗原(Hepatitis B surface antigen,HBsAg)、表面抗体(Hepatitis B surface antibody,HBsAb)和核心抗体(Hepatitis B core antibody,HBcAb),分析乙肝病毒(Hepatitis B virus,HBV)标志物阳性率和HBV感染率。结果在1130名调查对象中,HBsAg阳性率、HBsAb阳性率、HBcAb阳性率、HBV感染率分别为0.27%、49.65%、0.71%、1.15%(标化率:0.28%、42.48%、0.72%、1.30%),HepB_(3)接种率、HepB1及时接种率分别为98.14%、90.88%(标化率:97.85%、91.14%)。1-4岁、5-9岁、10-14岁儿童HBsAg阳性率分别为0.22%、0.27%、0.34%,HBV感染率分别为0.66%、1.07%、2.02%。HBsAg阳性、阴性/不详母亲所生儿童的HBsAg阳性率分别为6.06%、0.09%,HBV感染率分别为9.09%、0.91%。结论江苏省2020年1-14岁儿童乙肝感染率处于较低水平,显示高水平HepB接种率对控制儿童乙肝的显著效果;需继续加强新生儿HepB常规免疫和乙肝母婴传播阻断措施。

Objective To determine hepatitis B virus(HBV)seroprevalence and hepatitis B vaccine(HepB)coverage among Jiangsu province children.Methods We used a stratified multi-stage cluster random sampling method to select local children,1-14 years of age,from 6 disease surveillance sites of Jiangsu for a questionnaire-based survey and serum sample collection.We analyzed 3-dose HepB(HepB_(3))coverage and timely first-dose HepB(HepB_(3))coverage.We tested sera for hepatitis B surface antigen(HBsAg),surface antibody(HBsAb),and core antibody(HBcAb)to determine positivity rates of these HBV markers and HBV infection rates.Results Among the 1130 children,HBsAg,HBsAb,and HBcAb positivity rates were 0.27%,49.65%,and 0.71%(adjusted:0.28%,42.48%,and 0.72%),respectively,for an HBV infection rate of 1.15%(adjusted:1.30%).HepB,and timely HepB,coverage levels were 98.14%and 90.88%(adjusted:97.85%and 91.14%).HBsAg positivity rates among 1-4-,5-9-,and 10-14-year-olds were 0.22%,0.27%,and 0.34%,with HBV infection rates of 0.66%,1.07%,and 2.02%.The HBsAg positivity rate was 6.06% among children whose mothers were HBsAg-positive and 0.09% among children whose mothers were HBsAg-negative or unknown,with HBV infection rates of 9.09%and 0.91%.Conclusions HBV seroprevalence was low among children 1-14 years of age in Jiangsu in 2020,indicating significant effectiveness of high HepB coverage for hepatitis B control in children.We should continue to strengthen routine HepB vaccination of newborns and measures for interruption of mother-to-child transmission of HBV.