1992－2022年浙江省宁波市奉化区乙型肝炎流行病学分析

吴珏静; 董维波; 夏颖苹; 傅叁君; 冯伟; 周洋

doi:10.3784/jbjc.202305080205

摘要:

目的分析1992—2022年浙江省宁波市奉化区乙型肝炎（乙肝）流行病学特征。

方法收集1992—2022年奉化区乙肝病例报告数据，其中1992—2004年数据通过传染病年报收集，2005—2022年数据通过中国疾病预防控制信息系统收集，根据免疫策略调整分1992—2001年、2002—2011年、2012—2022年3个阶段进行描述流行病学分析。

结果 1992—2022 年奉化区共报告乙肝7 950例，年均报告发病率为51.04/10万。奉化区自2010年起无未分类乙肝病例报告，其中报告慢性乙肝病例占93.90%。 3个阶段全人群的年均乙肝报告发病率分别为54.57/10万、46.51/10万、52.04/10万。其中，0～14和15～29岁年龄组呈下降趋势，60岁以上年龄组呈上升趋势（0～14岁年龄组：趋势χ²=10.040，P=0.002；15～29岁年龄组：趋势χ²=19.960，P<0.001；60岁以上年龄组：趋势χ²=16.44，P<0.001）。 1992—2022年男性年均报告发病率（73.35/10万），显著高于女性（27.92/10万）（χ²=51.000，P<0.001）。 1992—2022年奉化区0～14岁年龄组乙肝标化报告发病率的平均年度变化百分比（AAPC）为−10.92%［95%置信区间（CI）：−13.35%～−8.43%，P＜0.001］，15～29岁年龄组乙肝标化报告发病率的年度变化百分比（APC）为−4.13%（95%CI：−5.57%～−2.66%，P＜0.001）。 1992—2022年奉化区乙肝疫苗全程接种率为99.20%。

结论 1992—2022年浙江省宁波市奉化区总体乙肝报告发病率处于较高水平，2010—2022年报告以慢性乙肝为主，急性乙肝呈下降趋势。自乙肝疫苗免疫策略实施以来出生的人群，乙肝报告发病率明显下降。提示需要继续保持较高的乙肝接种率，加强成年人乙肝防控工作。

Abstract:

Objective To analyze the epidemiological characteristics of hepatitis B in Fenghua district of Ningbo, Zhejiang province, from 1992 to 2022.

Methods The incidence data of hepatitis B reported in Fenghua from 1992 to 2004 were collected through the local annual report of infectious diseases and the incidence data of hepatitis B reported in Fenghua from 2005 to 2022 were collected through China Disease Prevention and Control Information System. Due to the adjustment of immunization strategies, descriptive epidemiological analyses on the incidence of hepatitis B in Fenghua during 1992−2001, 2002−2011 and 2012−2022 were carried out.

Results From 1992 to 2022, a total of 7 950 cases of hepatitis B were reported in Fenghua, with an average annual reported incidence rate of 51.04/100 000. Since 2010, no unclassified hepatitis B cases have been reported in Fenghua, in the reported cases, chronic hepatitis B cases accounted for 93.90%. The average annual incidence rates of hepatitis B in Fenghua during the three periods were 54.57/100 000, 46.51/100 000 and 52.04/100 000, respectively. The incidence rate showed downward trends in age groups 0–14 years and 15–29 years (Trend χ²=10.040, P=0.002; Trend χ²=19.960, P<0.001), while showed an upward trend in age group ≥60 years (Trend χ²=16.440, P<0.001). From 1992 to 2022, the average annual reported incidence rate of hepatitis B was significantly higher in men (73.35/100 000) than in women (27.92/100 000) (χ²=51.000, P<0.001). From 1992 to 2022, the average annual percentage change (AAPC) of standardized incidence rate of hepatitis B in age group 0–14 years was −10.92% (95%CI: −13.35% – −8.43%, P<0.001), and the average percentage change (APC) of standardized incidence rate of hepatitis B in age group 15–29 years was −4.13% (95%CI: −5.57% – −2.66%, P<0.001). The overall coverage rate of hepatitis B vaccine was 99.20% from 1992 to 2022.

Conclusion The reported incidence of hepatitis B was at a relatively high level in Fenghua from 1992 to 2022. From 2010 to 2020, the incidence of acute hepatitis B showed a downward trend, the majority of the hepatitis B cases were chronic ones. The reported incidence of hepatitis B dropped significantly in the population born after the implementation of the hepatitis B immunization strategy. It is necessary to maintain a high hepatitis B vaccination coverage rate and strengthen the prevention and control of hepatitis B in adults.

1992－2022年浙江省宁波市奉化区乙型肝炎流行病学分析

Epidemiology of hepatitis B in Fenghua district, Ningbo, Zhejiang, 1992−2022