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目的了解海南省人群乙型肝炎病毒(HBV)感染现状,评价乙肝疫苗纳入儿童免疫策略后的效果。方法采取整群抽样方法,按照经济水平、民族、地理位置,选择被调查市县。在被选市县中随机抽取2个乡镇,每个乡镇随机抽取1个村,以家庭为单位对全部人群采集静脉血用ELISA检测HBsAg、抗-HBs和抗-HBc,并完成个案调查。结果共采集3945人血清进行检测,人群中HBsAg阳性率为13.18%、抗-HBs阳性率为52.72%、HBV流行率为56.96%。HBsAg阳性率最高年龄组为20~29岁组(21.52%),最低为0~4岁组(4.02%),10岁以下儿童为6.21%;HBV流行率最高为50~59岁组(83.43%),最低是0~4岁(29.99%),10岁以下组为30.69%。HBsAg阳性率和HBV流行率:城市低于农村,差异有非常显著性(χ2=13.66,P<0.01;χ2=12.56,P<0.01)。富裕地区、经济欠发达地区、贫困地区三者间比较,差异也存在显著性(χ2=50.13,P<0.01;χ2=13.17,P<0.01)。HBsAg阳性率,男性高于女性(χ2=11.97,P<0.01);HBV流行率男性低于女性(χ2=7.74,P<0.01),差异均存在显著性。结论海南省人群HBV流行率是高的,人群HBsAg携带率仍远高于全国平均水平,但人群中乙肝流行病学特征已发生了改变,乙肝疫苗纳入儿童免疫规划后效果显著,降低了人群HBsAg携带率和HBV流行率,特别是10岁以下儿童下降幅度更为明显。
Objective To understand the status of hepatitis B virus (HBV) infection in Hainan population and evaluate the effect of hepatitis B vaccine in children immunization strategy. Methods A cluster sampling method was adopted to select the cities and counties under investigation according to the economic level, ethnicity and geographical location. In selected cities and counties, 2 townships were randomly selected, and 1 village was randomly selected from each township. Venous blood was collected from all the population by family as the ELISA to detect HBsAg, anti-HBs and anti-HBc by ELISA and case investigation was completed. Results A total of 3945 serum samples were collected for detection. The positive rate of HBsAg in the population was 13.18%, the positive rate of anti-HBs was 52.72%, and the prevalence of HBV was 56.96%. The highest positive rate of HBsAg was in 20-29 years old group (21.52%), the lowest was 0-4 years old group (4.02%), children under 10 years old was 6.21%, and the highest HBV prevalence was in 50-59 years old group (83.43% ), The lowest is 0 ~ 4 years old (29.99%), 30.69% under 10 years old. The prevalence of HBsAg and the prevalence of HBV were lower in urban than in rural areas (χ2 = 13.66, P <0.01; χ2 = 12.56, P <0.01). There were also significant differences among rich areas, underdeveloped areas and impoverished areas (χ2 = 50.13, P <0.01; χ2 = 13.17, P <0.01). The positive rate of HBsAg was higher in males than in females (χ2 = 11.97, P <0.01). The prevalence of HBV in males was lower than females (χ2 = 7.74, P <0.01). Conclusions The prevalence of HBV in Hainan population is high. The population carrying rate of HBsAg is still far above the national average. However, the epidemiological characteristics of hepatitis B in population have changed. The effect of hepatitis B vaccine in children’s immunization program is significant, reducing the population HBsAg Carrier rates and prevalence of HBV, especially for children under 10, have been more pronounced.