大理州乙肝疫苗接种和乙肝病毒流行现状分析OACSTPCD
Hepatitis B vaccination status and its prevalence in Dali Prefecture
背景 乙型肝炎病毒(hepatitis B virus,HBV)感染是一种公共卫生威胁,世界卫生组织提出了 2030年全球消除病毒性肝炎的目标.云南省于2016-2020年开展了乙肝表面抗原(HBV surface antigen,HBsAg)和乙肝表面抗体(HBV surface antibody,HBsAb)监测工作,大理州作为调查现场参与其中.目的 了解大理州HBV感染和HBsAb阳性率的关联因素.方法 本研究为横断面调查研究,采用分层整群抽样,于 2016-2020年对大理州 6个年龄组的 18 904人开展问卷调查和血清采集,应用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测血清HBsAg、HBsAb和乙肝核心抗体(HBV core antibody,HBcAb).运用广义线性混合模型(generalized linear mixed model,GLMM)分析 HBV感染率和HBsAb阳性率的关联因素.结果 大理州标化HBV感染率为 33.88%,乙肝疫苗接种率为 24.42%,及时接种率为 16.37%,全程接种率为 23.90%,标化HBsAg、HBsAb和HBcAb阳性率分别为 2.32%、39.95%和 18.57%.GLMM分析显示,男性感染风险低于女性,OR值为 0.889(95%CI:0.811～0.974).相比 0～1岁组,≥60岁年龄组感染率更高(且为所有年龄组中最高),OR值为 9.223(95%CI:5.440～15.636).及时接种人群和全程接种人群感染率低于未及时接种人群和未全程接种人群,OR值分别为 0.670(95%CI:0.514～0.875)和 0.072(95%CI:0.055～0.094).男性 HBsAb阳性率高于女性,OR值为0.922(95%CI:0.862～0.987).相比 0～1岁组,12～18岁年龄组HBsAb阳性率更低(且为所有年龄组中最低),OR值为0.032(95%CI:0.026～0.040).全程接种人群HBsAb阳性率高于未全程接种人群,OR值为 1.161(95%CI:1.391～1.872).结论 大理州HBsAg阳性率低于流行水平,但青少年和成人HBsAb阳性率较低,应做好基础免疫和查漏补种,提高全人群免疫水平.
Background Hepatitis B virus(HBV)is a public health threat with a global strategic goal to achieve total elimination by 2030.The monitoring of HBV surface antigen(HBsAg)and HBV surface antibody(HBsAb)has been carried out in Yunnan Province from 2016 to 2020,and Dali Prefecture participates in this work as the investigation site.Objective To investigate the status of HBV infection and the associated factors of HBsAb positive rate in Dali.Methods Stratified cluster sampling was used to conduct questionnaire survey and serum collection in 18 904 people of 6 age groups in Dali Prefecture from 2016 to 2020.Enzyme linked immunosorbent assay was applied.Serum HBsAg,HBsAb and HBV core antibody(HBcAb)were detected by ELISA.Generalized Linear Mixed Models(GLMM)were used to analyze the factors associated with HBV infection rate and positive rate of HBsAb.Results The standard HBV infection rate was 33.88%,the vaccination rate of hepatitis B vaccine(HepB)was 24.42%,the timely vaccination rate was 16.37%,and the full vaccination rate was 23.90%.The positive rates of standardized HBsAg,HBsAb and HBcAb were 2.32%,39.95%and 18.57%,respectively.GLMM analysis showed a lower risk of infection in men than that in women(OR=0.889,95%CI:0.811-0.974).Compared with the 0-1 year age group,the infection rate was highest in the≥60 year age group(OR=9.223,95%CI:5.440-15.636).The infection rate of the timely vaccinated group and the whole vaccinated group was lower than that of the non-timely vaccinated group and the incomplete vaccinated group,and the OR values were 0.670(95%CI:0.514-0.875)and 0.072(95%CI:0.055-0.094),respectively.The positive rate of HBsAb in male was higher than that in female(OR=0.922,95%CI:0.862-0.987).Compared with 0-1 year old group,HBsAb positive rate in 12-18 years old group was the lowest(OR=0.032,95%CI:0.026-0.040),and HBsAb positive rate in the whole vaccination group was higher than that in the whole vaccination group(OR=1.161,95%CI:1.391-1.872).Conclusion The positive rate of HBsAg in Dali is lower than the epidemic level,and the positive rate of HBsAb in adolescents and adults is lower.Basic immunization and reseeding should be done to improve the immunity level of the whole population.
刘彦君;赵红梅;杨晓炜;谢潇潇;管芳
大理州疾病预防控制中心,云南大理 671000
预防医学
乙型肝炎广义线性混合模型乙肝感染影响因素乙肝表面抗体流行病学
hepatitis Bgeneralized linear mixed modelinfluencing factors of hepatitis B infectionhepatitis B surface anti-bodyepidemiology
《解放军医学院学报》 2024 (003)
256-260 / 5
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