广西2004——2012年病毒性肝炎流行特征分析

Epidemiological analysis of viral hepatitis in Guangxi, 2004-2012

目的了解广西壮族自治区(简称广西)近年病毒性肝炎的流行特征及规律,为制定预防控制策略提供科学依据。方法从国家《疾病监测信息报告管理系统》中收集2004—2012年广西病毒性肝炎疫情报告资料,病例诊断依据《病毒性肝炎防治方案》,用描述性流行病学方法进行数据分析和统计。结果广西病毒性肝炎发病率呈上升趋势,由2004年的81.82/10万升至2012年的127.64/10万,年龄高峰在20~34岁,男女之比为2.24∶1,以农民为主(57.35%)。乙型肝炎占病毒性肝炎比重最大(74.62%~82.38%),乙型肝炎的发病率上升了43.57%(67.41/10万至96.78/10万),年龄高峰在25~29岁,发病率在<20岁人群逐年下降,在20~24岁相对稳定,在≥25岁人群逐年上升,有地区差异。丙型肝炎发病率2012年比2004年上升了4.17倍(4.22/10万至21.81/10万),年龄高峰分别在0岁、25~34岁、≥80岁,在≥15岁人群逐年上升,存在城乡差异。戊型肝炎发病率上升了8.1倍(0.30/10万至2.73/10万),年龄高峰波动于60~84岁,时间高峰在3月,存在城乡差异。甲型肝炎发病明显下降(4.56/10万至1.56/10万),但学校时有暴发疫情,年龄高峰受学校暴发疫情影响而呈现双峰(7~19岁和≥50岁)或单峰(>60岁),有季节性,高峰在5月,有地区差异。结论 2004—2012年广西病毒性肝炎发病率呈上升趋势。乙型肝炎的免疫策略成效显著但仍应是病毒性肝炎防治工作的重中之重。甲型肝炎防控需针对重点地区和人群;丙型肝炎和戊型肝炎发病率持续大幅上升,城区高于农村,值得进一步研究。

Objective To understand the epidemic characteristics and regularity of viral hepatitis in Guangxi in recent years so as to provide a scientific basis for the development of prevention and control strategies. Methods The epidemic reporting data of viral hepatitis in Guangxi during 2004-2012 was collected from the 'National Disease Surveillance Information Reporting System'. The case diagnosis was based on the 'Viral Hepatitis Prevention and Treatment Programs'. Descriptive epidemiological methods were applied for data analysis and statistics. Results The incidence of viral hepatitis in Guangxi was on the rise, increased from 81.82/100 000 in 2004 to 127.64/100 000 in 2012. The peak age of onset was 20 to 34 years old and male-female ratio was 2.24∶1. Farmers were the majority of cases(57.35%). Hepatitis B accounted for the largest share of viral hepatitis(74.62%-82.38%), with incidence rose by 43.57%(from 67.41/100 000 to 96.78/100 000). The peak age of incidence was 25 to 29years old. The incidence at <20 years old decreased year after year, remained relatively stable at 20-24and rose at ≥ 25 years old, although there were regional difference. The incidence of hepatitis C rose4.17 times(from 4.22/100 000 to 21.81/100 000). The peak age was at 0,25-34 and≥ 80 years old,respectively, while the population of ≥15 years old had a yearly increased trend, although there were difference between urban and rural areas. The incidence of hepatitis E rose 8.1 times(from 0.30/100 000 to 2.73/100 000) with peak age fluctuating from 60 to 84 years old and difference between urban and rural areas. The onset peak was in March. The incidence of hepatitis A declined distinctly(from 4.56/100 000 to 1.56/100 000), though there were occasional school outbreaks, which influenced the peak age, presenting double-peak(7-19 and ≥ 50 years of age) or single peak(> 60 years old). The peak month was in May, there was regional difference. Conclusions The incidence of viral hepatitis was on the rise from 2004 to 2012 in Guangxi. Immune strategy against hepatitis B was significantly effective but should still be a top priority in the viral hepatitis prevention and control work. The prevention and control of hepatitis A should target at key areas and populations. The incidence of hepatitis C and hepatitis E continued to surge, with urban districts higher than rural areas, which is worth further study.