宜昌区域病毒性甲型肝炎流行病学特征分析  

Epidemiological characteristics of viral hepatitis A,Yichang area

作　　者：徐英[1] 徐勇[1] 宋秀芬[1] 张皓[1] 蒋尉[1] 贺圆圆[1] XU Ying XU Yong SONG Xiu - fen ZHANG Hao JIANG Wei HE Yuan - yuan(Yichang Centre for Disease Control and Prevention, Yichang ,Hubei 443005, Chin)

机构地区：[1]宜昌市疾病预防控制中心,湖北宜昌443005

出　　处：《现代预防医学》2017年第15期2692-2695,2699,共5页Modern Preventive Medicine

基　　金：湖北省自然科学基金课题;乙肝病毒性肝炎家庭中学龄前儿童免疫效应研究(2013CFC128)

摘　　要：目的分析宜昌市2001-2015年病毒性甲型肝炎发病特征及流行趋势,为本区域甲肝防治提供科学依据。方法收集全市甲肝疫情资料进行三间分布描述,用ELISA法查甲肝抗体阳转率,发病率比较采用卡方检验。结果 2001-2015年宜昌市甲肝发病率总体呈现下降趋势,病例呈现散发,未出现暴发疫情。发病率由2001年9.91/10万降低至2015年2.00/10万,下降了79.82%。累计报告死亡病例5例,年均死亡率为0.01/10万。实施扩大免疫规划前甲肝年均发病率(7.11/10万)高于实施后发病率(2.43/10万)(P<0.01)。发病地区为市郊农村,发病高峰年龄后移、人群以农民为主,无发病季节性特征。开展15岁以下儿童甲肝疫苗接种363628人,累计接种率为80.58%。疫苗接种率与发病率间存在负相关(P<0.05)。结论宜昌市病毒性甲肝发病模式已由高地方流行向中低地方流行转变,青壮年农民是发病重点人群,调整免疫策略增强针对性干预,有效控制本区域甲肝流行。Objective To analyze the characteristics and epidemic trend of hepatitis A in 15 years of a national program on immunization in Yichang City, and to provide a scientific basis for prevention and treatment of hepatitis A. Methods The data of epidemic situation of hepatitis A were collected. The hepatitis A IgG antibody level was tested using enzyme - linked immunosorbent assay （ELISA）. The incidences of inter -regional hepatitis A were compared with chi - square test. Results During the 2001 -2015 immunization program, the incidence of hepatitis A in our city showed a decreasing trend, and the cases were distributed and no outbreaks occurred. The incidence rate decreased from 9.91/100 000 in 2001 to 2.00/100 000 in 2015 ,with a decrease of 79.82%. 5 cases of deaths happened, and the average annual mortality rate was 0.01/100 000. The average annual incidence of hepatitis A （7.11/100 000） before EPI was higher than that （2.43/100 000） after EPI （P 〈 0. O1 ）. The mainly epidemic area were the suburbs of rural areas,the peak age of cases backwards shift,peasants occupied most of the cases, and no seasonal characteristics appeared. 363 628 children received hepatitis A vaccination, with the cumulative vaccination rate of 80. 58%. There was a negative correlation between vaccination rate and incidence rate （ P 〈 O. 05 ）. Conclusion The pattern of hepatitis An infection in our city has changed from high infection area to middle or low infection area. Young peasants are the key people who are likely to infect hepatitis A, and immunization strategy should be adopted to enhance the targeted intervention and effectively control the epidemic of hepatitis A in the region.

关 键 词：免疫规划 病毒性甲型肝炎 流行趋势 防制效果 

分 类 号：R181.23[医药卫生—流行病学]