| Background:Hepatitis B is a worldwide epidemic infectious disease, and a serious threat to human health. According to statistics, there are about 350 million chronic hepatitis B virus infection, and about 93 million of the HBV carriers, 25 million chronic hepatitis B patients in the world. The epidemic level of hepatitis B is not the same in different regions in our country, the national serological survey in 1992 showed that the prevalence rate of HBsAg in western region was lower than that of the eastern and central regions. With hepatitis B vaccine immunization policy implementation, the incidence of hepatitis B was decreased in our country, but the western region decreased slowly. The reported cases of hepatitis B has been the top first or second legal reported infectious disease in Tongchuan, a city in Shaanxi Province which located in the northwest, but its epidemiological features have not been in-depth study. Aims:This study is going to analyze the epidemiological features of hepatitis B from 2003 to 2014, as well as the results of three serum epidemiology surveys since 2006 in Tongchuan City, to understand the epidemic trend of hepatitis B vaccination effect, and to explore the current hepatitis B prevention and control policy. Methods:The information of hepatitis B patients who were reported from 2003 to 2014 in Tongchuan city was collected from the Epidemic Data Compilation and Chinese Disease Monitoring and Reporting System, and then the data was analyzed with descriptive epidemiological method, which included different age, gender, occupation, region, time, etc. A multi-stage cluster random sampling method was conducted in 2006. One community and three towns were selected from the Tongchuan City, and four administrative villages were randomly selected, then 964 residents aged from 1 to 59 were selected as the object of investigation in each selected village. A systematic sampling method was conducted to select four villages or towns in 2009, then 427 healthy individuals were randomly selected from each village. In 2014, a stratified two stage cluster sampling method was used to select one street and one town, and then 326 individuals aged from 1 to 29 were selected as the object of investigation. All the selected individuals were surveyed and collected peripheral blood on site. Five kinds of hepatitis B virus infection serum biomarkers were tested in laboratory. All questionnaires were recorded by double entry method in Epidata3.1, the data was analyzed by Excel 2003 and SPSS 19 software, and the comparison between different rates was analyzed by chi square test, trend chi square test and Fisher exact probability method. Results:1. There were 12,844 reported cases of hepatitis B in Tongchuan City from 2003 to 2014. The average annual reported incidence rate was 128.20 per 100000 people, and the highest year of reported incidence rate(174.29 per 100,000) was in 2004, while the lowest(85.80 per100,000) was in 2013. The number of reported hepatitis B cases has long been ranked the first in the infectious disease reporting system in Tongchuan, and it fell to the second place in 2014, and the percentage of hepatitis B accounted for legal reported infectious diseases decreased year by year.2. There is no obvious seasonal incidence increase of hepatitis B in Tongchuan City, but Wangyi District which has more floating population has the higher hepatitis B reported incidence rate than other counties and districts. The number of hepatitis B patients under the age of 10 was the least, and the report incidence rate of hepatitis B was decreased year by year, but it increased in over 60 years old group. The reported morbidity among men(143.03 per 100,000) was higher than that of women(112.28 per 100,000). The farmers and workers with hepatitis B accounted for 59.99% among all of occupations.3. The hepatitis B vaccination rate among people between 1 to 59 year old was 54.77% in Tongchuan City in 2006. HBV infection rate, HBsAg carrying rate, anti-HBs positive rate, and the negative rate of all five biomarkers of hepatitis B were 32.16%, 4.04%, 45.83%, and 47.79%, respectively. The rate of hepatitis B vaccination was 65.11% in 2009, and the positive rate of anti-HBs was 58.78, and the hepatitis B vaccine inoculation rate in the population between 1 to 29 year old was 91.41%. HBV infection rate, HBsAg carrying rate, anti-HBs positive rate and the negative rate of all five biomarkers of hepatitis B 16.02%, 3.26%, 43.86%, and 52.53% in 2014. Further analysis showed that:(1) The hepatitis B vaccination rates increased in Tongchuan City among all age groups from 1 to 29 year old, especially in 2014, and the rate of hepatitis B vaccination rate was as high as 91.41%. Compared with the survey results for the population from 1 to 29 year old in 2006, HBsAg carrying rate and the negative rate of all five biomarkers of hepatitis B increased, and HBV infection rate and anti-HBs positive rate decreased, especially the anti-HBs positive rate at 5 to 14 years old population decreased significantly. HBsAg carrying rate and the HBV infection rate in the population who had the immune history were lower than those without the history of immunization.(2) HBsAg carrying rate, HBV infection rate, anti-HBs positive rate and the negative rate of all five biomarkers of hepatitis B were not obvious difference between the male and female. HBV infection rate and the positive rate of anti-HBs at urban population were higher than that of the rural population. For the children and students, Hepatitis B vaccination rate was the highest, while the HBV infection rate and HBsAg carrying rate were the lowest. For the farmers and workers, the hepatitis B vaccination rate was lower, and the HBV infection rate and HBsAg carrying rate were higher.Conclusions:1. The reported incidence rate of hepatitis B was decreasing year by year in Tongchuan city, in particular, the decline is more obvious in young age group, and its percentage accounted for legal infectious disease reported cases also reduced, which showed that the prevention and control measures of hepatitis B vaccine achieved significant effects.2. Tongchuan is still a city with hepatitis B in middle endemic level. In recent years, hepatitis B vaccination rate continues to increase, but the survey results in 2014 showed the positive rate of anti-HBs decreased in 5 to 14 years old group, but the proportion rate of susceptible population increased. So we should pay more attention to the hepatitis B vaccination work in 5~14 years old group.3. It is suggested that the hepatitis B prevention and control strategy in Tongchuan city should change to “paying equal attention to the newborn, the adolescent and the susceptible adults” from mainly “paying attention to the immunity of the newborn”. |
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