福建省乙型肝炎疫苗免疫效果类实验流行病研究  

Quasi-experimental epidemiological study on immune effect of hepatitis B vaccine in Fujian Province,China

作　　者：张冬娟[1] 黄荣东 林光灿[1] ZHANG Dong-juan;HUANG Rong-dong;LIN Guang-can(Fujian Provincial Center for Disease Control and Prevention,Fuzhou 350001,Fujian Province,China)

机构地区：[1]福建省疾病预防控制中心疫苗管理办,福建福州350001

出　　处：《中国生物制品学杂志》2021年第8期974-978,983,共6页Chinese Journal of Biologicals

基　　金：福建省科技计划项目-软科学项目(2015R0025)。

摘　　要：目的评价福建省乙型肝炎疫苗免疫效果,揭示不同干预人群乙型肝炎流行特征及保护水平。方法采用类实验流行病研究设计,按我国不同时期乙型肝炎疫苗免疫策略,将研究目标人群分为干预组(1992年后出生队列;其中干预A组:2002年后出生队列,干预B组:1992—2001年出生队列)和对照组(1992年前出生队列),通过网络直报疫情个案数据库清洗,观察2004—2019年目标人群乙肝发病及死亡结局,分析评价不同干预人群乙肝流行特征及保护水平。结果研究目标人群人年发病率为37.687/10万,死亡率为0.009/10万。其中干预A组人年发病率为1.899/10万,保护率(protection rate,PR)为96.107%(95%CI:96.105%~96.108%),效果指数(efficiency index,EI)为25.687;干预B组人年发病率为12.487/10万,PR为74.404%(95%CI:74.403%~74.405%),EI为3.907;干预两组人年死亡率均为0.001/10万。对照组人年发病率、死亡率分别为48.786/10万和0.012/10万,干预A组人年发病率仅为对照组的1/26,死亡数仅为对照组的1/51,自2014年以来人年发病率均控制在1/10以下。结论福建省2002年以来乙肝免疫规划成效显著,基本消除了地区差异和性别差异大等特征。新时期成年免疫与慢性乙型肝炎规范治疗管理的公共卫生意义有待专题研究。Objective To evaluate the immune effect of hepatitis B(HB)vaccine in Fujian Province,China and reveal the epidemic characteristics and protection level of HB in various intervention populations.Methods A quasiexperimental epidemiology design was adopted.According to the HB immunization strategies in different periods in China,the target populations were divided into intervention(born in and after 1992,among whom the cohort born after 2002 was served as intervention group A,and the cohort born from 1992 to 2001 as intervention group B)and control(born before1992)groups.The morbidity and mortality of HB in target populations from 2004 to 2019 were observed,and the epidemic characteristics and protection levels of HB in different intervention populations were analyzed and evaluated,through China Information System of Disease Prevention and Control.Results The person-year morbidity and mortality of target population were 37.687/100000 and 0.009/100000 respectively.The person-year morbidity in intervention group A was 1.899/100000,with a protection rate(PR)of 96.107%(95%CI:96.105%~96.108%)and an effectiveness index(EI)of 25.687.The person-year morbidity in intervention group B was 12.487/100000,with a PR of 74.404%(95%CI:74.403%~74.405%)and an EI of 3.907.Both the mortalities in two intervention groups were0.001/100000.The person-year morbidity and mortality in control group were 48.786/100000 and 0.012/100000 respectively.The person-year morbidity in intervention group A was only 1/26,while the case number of deaths was only 1/51,of those in control group.The person-year morbidities in various counties(cities/districts)were less than 1/100000 since 2014.Conclusion The HB immunization program in Fujian province has achieved remarkable results since 2002,of which the differences in regions and genders were basically eliminated.However,the public health significance of adult immunization and chronic hepatitis B management in the new era remains to be studied.

关 键 词：类实验流行病研究 乙型肝炎疫苗免疫 保护率 效果指数 

分 类 号：R181.2[医药卫生—流行病学]