2005-2022年江苏省甲型肝炎流行病学特征

Epidemiological characteristics of hepatitis A in Jiangsu,2005−2022

目的分析2005-2022年江苏省甲型肝炎(甲肝)疫苗免疫规划接种前后甲肝的流行趋势和变化特征以及探寻甲肝可能的时空聚集区,为制定防治甲肝科学有效的预防措施提供依据。方法通过中国疾病预防控制信息系统收集2005-2022年甲肝的报告发病资料,利用描述性流行病学方法进行分析,使用SPSS 17软件对不同时期、不同性别的发病情况进行差异性检验;运用Joinpont 4.8.0.1软件对发病率随时间的变化趋势进行检验;运用Arcgis 10.3软件绘制甲肝发病率县(市、区)分布图;采用SaTScan 9.7软件进行回顾性时空扫描分析。结果2005-2022年江苏省共报告甲肝病例18862例,年均发病率为1.31/10万,从2005-2007年的3.14/10万下降至2020-2022年的0.59/10万(平均年度变化百分比=-9.10%,95%置信区间=-12.20%~-6.00%)。从时间分布上来看,甲肝免疫规划前期以春季高发,到免疫规划时期季节性逐渐丧失。从性别发病分布上来看,男女发病之比从免疫规划前期的2.30∶1到免疫规划时期(2020—2022年)的0.97∶1;从年龄分布来看,各时期45~55岁年龄段居多;从职业分布来看,以农民、工人、家务待业以及退休人员为主。从地区分布来看,甲肝发病主要分布在临海或河系较多的区域如:紧邻太湖的虎丘区,紧邻微山湖的贾汪区,紧邻高邮湖的兴化市、江都区;2005-2022年时空扫描探测出一个甲肝发病聚集区,主要集中在江苏省东南临江沿海地区。结论2005-2022年甲肝报告发病率呈下降趋势,人群性别分布逐渐稳定,存在地区差异性分布,应继续加强甲肝发病监测,对重点人群、重点地区指定针对性的防控措施。

Objective To analyze the epidemiological characteristics and possible spatiotemporal incidence clustering of viral hepatitis A in Jiangsu province during 2005−2022,and provide evidence for the effective prevention and control of hepatitis A.Methods The incidence data of hepatitis A in Jiangsu during 2005−2022 were collected from China Disease and Prevention Information System for a descriptive epidemiological analysis.Software SPSS 17 was used for the evaluation of the time and gender specific differences in the incidence.Software Joinpont 4.8.0.1 was used to analyze the change trend of the incidence over time.Software Arcgis 10.3 was used to visualize the area distribution of hepatitis A incidence.Software SaTScan9.7 was used for a retrospective spatiotemporal scanning analysis.Results A total of 18862 cases of hepatitis A were reported in Jiangsu during 2005−2022,with an average annual incidence rate of 1.31 per 100000.The incidence rate decreased from 3.14 per 100000 during 2005−2007 to 0.59 per 100000 during 2020−2022(average annual percentage change=−9.10%,95%confidence interval:−12.20%–−6.00%).Hepatitis mainly occurred in spring during 2005−2007(shortly after hepatitis A vaccination was included in national immunization program),but the incidence seasonality has gradually disappeared by now.The male to female ratio of hepatitis A cases was 2.30∶1 during 2005−2007,but 0.97∶1 during 2020−2022.The cases were mainly distributed in age group 45−55 years.Farmers,workers,the jobless or unemployed and retirees were the mostly affected.The incidences of hepatitis A were high in coastal areas and river net areas,such a:Huqiu near Taihu lake,Jiawang near Weishanhu lake,Xinghua and Jiangdu near Gaoyou lake.During 2005−2022,spatiotemporal scanning detected a incidence clustering area in coastal area in southeastern Jiangsu.Conclusion The reported incidence of hepatitis A in Jiangsu during 2005−2022 showed a downward trend,the effect of hepatitis A immunization was obvious,and the population distribution was gradually stable,but area specific difference was observed.It is necessary to strengthen the surveillance for hepatitis A and conduct targeted prevention and control of hepatitis A in key populations and areas.