Analysis Of The Epidemiological Characteristics From 2004 To 2016 And Prediction Of Hepatitis A In Jilin Province

Objectives:Hepatitis A?HA?is an acute digestive tract infection caused by Hepatitis A virus?HAV?.It major harm to the human body is damage to the liver.The main transmission route of hepatitis A is fecal-oral transmission,which is affected by the transmission route.The onset of hepatitis A has seasonal characteristics and can cause outbreaks and epidemics.Since the viral hepatitis classification report in 1990,the incidence of hepatitis A?hepatitis A?has declined year by year.Hepatitis A cases are distributed throughout the world.According to data released by the World Health Organization in 2000,there are about 1.5 million cases of hepatitis A in the world each year.The prevalence of hepatitis A in China is relatively serious and belongs to the middle-high endemic area.Before the hepatitis A vaccine was inoculated in 1991,the number of hepatitis A patients in China was approximately 630,000.National monitoring data for 2008 showed that the incidence of hepatitis A fell from 55.69 per100 000 in 1990 to 4.24 per 100 000.The epidemiological study of hepatitis A in Jilin province is relatively rare.At present,only the epidemiological investigation of hepatitis A in Baicheng District of Baicheng City after the floods in 1998 has been conducted.The results show that the prevalence of hepatitis A in flood areas is higher than that in non-disaster areas,and it also shows that regionally uniform HAV spread throughout the year.In recent years,Jilin Province has attached great importance to the prevention and treatment of hepatitis A,increased publicity and implementation of the hepatitis A control strategy to expand the national immunization program since 2009,and the incidence of hepatitis A has plummeted and the epidemic has been gradually controlled.The purpose of this study is to explore the trends of the hepatitis A epidemic in Jilin Province from 2004 to 2016,and to explore its epidemic patterns and characteristics,in order to better formulate corresponding control policies and provide scientific basis for controlling the prevalence of hepatitis A in the province.MethodThe case data of hepatitis A virus in Jilin Province from 2004 to 2016 are from the cases reported by the“Infectious Disease Reporting Information Management System”.According to the time of onset and the number of cases of places of residence,after deleting the same cases with basic information,there were 7036 cases of hepatitis A cases.Demographic data comes from Jilin Statistical Yearbook?2004²016?.All data were uniformly screened and tested using Excel 2016 to ensure data accuracy.The description of the distribution time,area and population of hepatitis A in Jilin Province from 2004 to 2016 was carried out,and the differences in the incidence of hepatitis A before and after the expansion of the national immunization program in 2009 were analyzed.The ARIMA time series model was used to predict the future incidence of hepatitis A in Jilin Province.Data analysis was performed using SPSS 20.0 software.Statistical analysis was used to describe the count data using the rate and composition ratio.The?² test was used to compare the count data.The statistical data were described by means of the mean and standard deviation.The comparison between groups was analyzed by variance and the ARIMA model of R language was used to analyze the incidence.Prediction,statistical level is 0.05.ResultJilin Province has implemented online direct reporting of viral hepatitis A since2004.From 2004 to 2016,Jilin Province reported a total of 7036 cases of hepatitis A and 2 cases of death.The average annual incidence rate was 2.58 per 100,000 and the mortality rate was 0.28‰.The incidence of hepatitis A in 2004²013 showed a decreasing trend,reaching a minimum level of 0.60 per 100,000 in 2013,and the incidence increased slowly from 2013 to 2016.From 2004 to 2016,there were reports of hepatitis A cases in Jilin Province.The cumulative number of cases was 7036 cases,10 cases were excluded from the region,and the number of cumulative cases was 3445 in Jilin City,1455 cases in Changchun City and 871 cases in Siping City.It accounted for 67.8%of all cases.The annual average incidence rate was 1.50 per 100,000 in Changchun,4.22 per 100,000 in Jilin,1.98 per 100,000 in Siping,3.26 per 100,000 in Liaoyuan,1.20 per 100,000 in Tonghua,1.20 per 100,000 in Baishan,and 1.81 in Songyuan.100,000,Baicheng1.04/lakh,and Yanbian Prefecture 0.93/lakh.The highest reported incidence rate was in Jilin City,followed by Liaoyuan City,and the lowest incidence was in Yanbian Prefecture.Hepatitis A affects the whole year of Jilin Province from 2004 to 2016.The monthly incidence of the disease was 9.35%,8.00%,10.56%,9.42%,10.16%,8.67%,8.70%,9.03%,7.48%,6.79%.,6.54%,5.30%,the highest incidence of the composition of the number is from 3 to 5 months,10 to 12 months the number of the composition of the least.There were 4771 males and 2263 females,with a sex ratio of 2.11:1.Male incidence is significantly higher than women.Moreover,the proportion of males and females from 2004 to 2016 showed a decreasing trend.In 2005,the sex ratio was the highest 2.5:1.The incidence of sex ratio in 2015 was the lowest 1.20:1.From the age of onset,there were episodes in all age groups.The incidence of the 30⁵5 age group is the highest?3937 cases,55.96%?,the peak incidence of men is 30 to 50 years?2776cases,58.17%?,the peak incidence of women is 30 to 55 years old?1161 cases,51.28%The lowest incidence was found in the low age group?<5 years old?and the high age group?>80 years old?.Among the cases of hepatitis A reported from 2004 to2016,325 cases of unspecified occupational diseases were excluded.The incidence of hepatitis A in Jilin Province was mainly concentrated in farmers?2,778 cases?,housekeeping,domestic and unemployed people?1065 cases?,and workers?887cases?.In the occupational composition ratio of cases,they accounted for 39.48%,15.14%,and 12.61%respectively.The number of cases in these three occupations accounted for 67.23%of the total cases.In 2009,hepatitis A vaccine was included in the expansion of the national immunization program.Compared with the prevalence of hepatitis A before and after the expansion of the immunization program,the incidence of hepatitis A in2004²008 was 1.50 per 100 000,and the incidence of hepatitis A in 2009²016 was0.93 per 100 000,before the immunization program.The morbidity rate decreased by38%.After chi-square test,there was a statistically significant difference in the incidence of hepatitis A before and after the national immunization program was x²=3237.824,P<0.001?.The time,area,and population distribution after the expansion of immunization programs were changed before the expansion of immunization programs.The results of the ARIMA time series model show that the most models are ARIMA?0,1,1??1,0,1?₁₂,AIC=-549.7,AICC=-548.5,BIC=-522.31.Conclusion1.The incidence of hepatitis A in Jilin Province showed a downward trend from2004 to 2012,and the incidence rate increased slowly from 2013 to 2016;The incidence was highest from March to May.2.In Jilin Province from 2004 to 2016,local cities reported cases of hepatitis A.The highest reported incidence rate was in Jilin City,followed by Liaoyuan City,and the lowest incidence rate was in Yanbian Prefecture;4.The incidence of hepatitis A in Jilin Province is higher than that in females.Incidence of all ages.The incidence was highest in the 30⁵5 age group.The incidence of hepatitis A in Jilin Province is mainly concentrated in farmers,households,households and unemployed people.5.Since the expansion of the immunization program in 2009,the prevention and treatment of hepatitis A has achieved good results,and the incidence rate from 2009 to2016 has been significantly lower than that from 2004 to 2008.6.The ARIMA?0,1,1??1,0,1?₁₂ model is the optimal model for this study,and the model predicts a slightly declining trend in 2017 incidence.