| Objective Analysis on the epidemic characteristics of hepatitis A in Ningxia area2004-2012, and realize the prevalence of hepatitis a vaccination before and after thechange; To understand the level of anti-HAV status; Legal infectious disease in Ningxiaregion in2013reported cases of hepatitis a in network for system using case control methodto field investigation,, investigate sporadic viral hepatitis risk factors. Further grasp theepidemic features of hepatitis a, can prevent controllable risk factors, find out control strategyfor the Ningxia Hui Autonomous region of influenza a viral hepatitis, immunization programsprovide a scientific basis for the perfection of hepatitis a outbreak prediction and earlywarning.Methods The research was divided into three parts.The first part Ningxia Hui Autonomous Region Analysis2004-2012epidemic ofhepatitis A.Descriptive epidemiology research methods, nearly nine years of hepatitis A epidemicdata to be analyzed retrospectively, and a description of the distribution of the group beforeand after hepatitis A vaccination.The second part Serological survey of viral hepatitis in healthy population in Ningxiaarea.Using stratified cluster random sampling method, the first layer in the Ningxia HuiAutonomous Region5prefecture-level cities, a total of21cities and counties (area) as a sampling unit, randomly selected12counties; The second unit at the county level in the pumprandomly selected two village (neighborhood) as a three-stage sampling unit, a total of24village (neighborhood);the object of study selected meet conditions of the masses as theresearch object, according to the10age groups previously determined separately in each agegroup the positive rate IgG the general population survey of hepatitis A.The third part Investigation of sporadic hepatitis A incidence risk factors in Ningxiaarea.Reference cases of hepatitis a questionnaire compiled by the sporadic influenza a viralhepatitis pathogenesis risk factors questionnaire ", the follow-up survey in2013of directnetwork report of notifiable infectious diseases department "China Disease Prevention andControl Information System" in Yinchuan and Zhongwei all reported hepatitis A cases. A1:1matched case-control study on the follow-up to the site of all cases and controls, householdsurvey, supplemented by telephone supplement and monitoring data combined withretrospective investigation.ResultsThe first part2004-2012years Ningxia a total of8254hepatitis cases were reported,1cases of death. The incidence rate of between2.74/10million to39.24/10million, theaverage annual incidence rate of15.07/10million. Hepatitis A vaccine into the immunizationprogram before and after vaccination, the incidence of the difference was statisticallysignificant (?2=1288.806P<0.00011). Each city has the morbidity, the difference wasstatistically significant (?2=3612.87P<0.0001),2004-2007peak is mainly concentrated in the8-11month, there are obvious in autumn and winter peak. The2008-2012seasons is notobvious, throughout the year there are sporadic cases. The age of onset ranged from0to19years old of children and teenagers, accounting for66.27%, with3~9age group theincidence rate is high, the average incidence rate of each age group had significant difference(?2=7681.527P<0.0001)), immune planning before and after the0to19age group constitute declined hepatitis A vaccine into, age group of40years old rose. Male is higher than female,the difference was statistically significant (?2=305.079P<0.0001). Occupation by thestudents, farmers and scattered children were the main occupation, in the case of a total of86.87%, before and after vaccination of hepatitis A in the pathogenesis of occupation,scattered children and students the proportion has declined, but the farmers and otheroccupation after vaccination has increased the proportion of.2004-2012a public healthemergency mainly concentrated in the middle and primary schools and rural area.The second part5in the Ningxia Hui Autonomous Region city were investigated thegeneral population1209people, anti-HAV positive specimens1153, the positive rate is95.37%.There were statistically significant differences in IgG positive rate among differentethnic, occupation, area (P<0.05),there are significant different in age, gender, culture lever,area type, the positive rates of IgG residence population have no difference(P>0.05).The third part In2013the Yinchuan city and Zhongwei City, a total of47cases ofhepatitis A,40cases were followed up, the actual investigation of case40. The case groupaverage age was (44.90±20.62), control group mean age was (43.80±18.64) years old, theaverage age of the case group and the control group had no significant difference (t=0.571,P=0.452, P>0.05).Viral hepatitis prevention knowledge awareness rate was8.75%. The13variables of the study were analysed by chi square test, eating unwashed fruits, do not washtheir hands before meals and after, drinking unboiled water, eating out and poultry or petsvariables in hepatitis patient group and the control group with statistical significance (P<0.05),application of multi factor conditional Logistic regression analysis risk factors were variable,enter the model variables for eating unwashed fruits and do not wash their hands before mealsand after.Conclusion1. Ningxia Hui Autonomous Region2004-2012the incidence of hepatitis A decreasedyear by year,2012has been reduced to the lowest level since the reported incidence of hepatitis. After2008the hepatitis A vaccine into immunization programs, the incidence ofhepatitis A feature has changed, but the younger age group of children and young people andfarmers are still the main population incidence.2. Ningxia healthy population HAV antibody positive rate of95.37%, at a high level,there are some differences in the population rate of hepatitis A antibodies fivecities. Antibody levels have been reduced along with the age increased trend, after2008hepatitis A vaccine into the immunization program, the younger age group significantlyincreased antibody levels, improved immunity level of the entire population. The differenceof positive rate of anti hav between Hui and Han nationalities, among different occupationwas statistically significant. Monitoring of antibody level of hepatitis A hepatitis A epidemictrend can be predicted, which provides the basis for the prevention and control of the disease.3. The Ningxia Hui Autonomous Region sporadic viral hepatitis a risk factor surveyresults showed that incidence in Ningxia area of hepatitis A are related closely to the crowdhealth habits and public health awareness and knowledge of disease prevention of intestinalinfectious disease awareness and consciousness, found that the risk of viral hepatitis a factorhas the guiding sense to the hepatitis A control policy. |
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