Study On Family Aggregation And Epidemic Status Of Hepatitis B Among Minority Population In Guizhou

Objective : To understand the current status of hepatitis B Virus(HBV) infection, analyze the HBV infection epidemiological characteristics and discuss the family aggregation with HBV infection and its associate factors among minority population in Guizhou Province in order to provide clues and scientific evidence for the strategies of HBV prevention and control. Methods: With multistage cluster random sampling method,1629 permanent residents were recruited from eight villages in two counties among minority autonomous prefectures in Guizhou Province. They were surveyed by questionnaires and collected blood samples in November and December, 2013. The questionnaire included demographic feature,history of personal lifestyle behaviors, history of hepatitis B immunization and history of hepatitis B exposure and so on. Hepatitis B virus surface antigen(HBs Ag),hepatitis B virus surface antibody( HBs Ab), hepatitis B virus core antibody(HBc Ab),hepatitis Be antigen( HBe Ag) and hepatitis Be antibody(HBe Ab) in blood serun were detected with time-resolved fluorescence immunoassay(TRFIA) method. Stata9.0 software was uterlized to calculat the probability function of the binomial distribution. The binomial distribution chi-square test was used to analyze the family aggregation with HBV infection. SPSS 13.0 software was used for single-factor and multi-factor logistic regression analysis of the influence factors of the family aggregation. Results: Among 1629 subjects, the overall HBV infection rate was50.6%. The positive rate of HBs Ag, HBs Ab, HBc Ab, HBe Ag and HBe Ab was8.3%,31.9%, 28.4%, 1.0% and 21.2%, respectively. The serological markers negative for all of the five accounted for 45.9%. The hepatitis B vaccine inoculation rate was 8.2%. The characteristics of hepatitis B epidemiological distribution: the HBV infection rate among <20 and ≥60 years old groups were higher than the others.The positive rate of HBs Ag with high peak was focus on 50~59 age group. There were significant differences in the HBV infection rate and positive rate of HBs Ag,HBs Ab, HBc Ab between different nationality. The positive rate of HBs Ab was a certain high among the residents of <20 years old group, male, student, higher education level and unmarried, while the married has higher HBc Ab positive rate.Thirteen kinds of serological markers model were detected in the survey, which was divided into three categories prevalence model. Susceptible model was in the most common and immune model and infection model with the proportion of 45.9%,31.9% and 22.2%, respectively. HBV infection has the trend of family aggregation among family members more than 2(2c=14.409, P<0.05) by the analysis of family aggregation of hepatitis B.There was no significant difference(2c=2.598,P=0.627) in the HBV infection rate between the family members grouped by various family relations. The result of multivariate non-conditional logistic regression analysis showed that HBV vaccination history(OR=0.385, 95%CI:0.175~0.846)and with higher total family income of last year( OR=0.789, 95%CI :0.660~0.942) were protective factors,whereas, big family size( OR=2.899,95%CI:2.223~3.779),ever migrant work(OR=1.541, 95%CI:1.057~2.246) and family members of positive HBs Ag(OR=6.060, 95%CI:3.909~9.395) were risk factors of family aggregation with HBV infection.The attributable fraction of population(AFp) was 0.1442,0.1343 and 0.4590, respectively. Conclusion: The population of minority in Guizhou Province is at the high prevalence area with HBV infection, so the situation of prevention and control is severe. The proportion of susceptible model population was higher in minority areas, hepatitis B vaccination and health education should be strengthened to improve immunity level. To maintained immune barrier of the immune model population is important strategy of hepatitis B prevention and control. The HBV infection of minority population in Guizhou Province showed family aggregation, which may be related to close contact in the family. The hepatitis B screening should be strengthened to family members who live together with HBV infection and timely hepatitis B vaccination should be administered. Meanwhile, health education should be enhanced within family in order to reduce the formation of family aggregation with HBV infection caused by dailylife contact transmission.