| Objective:We studied the epidemiological characteristics and prevention and control strategies of hepatitis B in Honghe Prefecture from 2005 to 2020 to understand the epidemiological characteristics of hepatitis B in Honghe Prefecture,the serological epidemiological characteristics of hepatitis B,the quality of hepatitis B surveillance reports,preventing mother-to-child transmission and hepatitis B health education,and to grasp the epidemiological characteristics of hepatitis B in Honghe Prefecture.To identify problems in the management of surveillance reports and prevention and control strategies,and to provide reference data for the prevention and control of the hepatitis B epidemic in Honghe Prefecture in the next step.Methods:1.We collected case information of hepatitis B report cards in Honghe Prefecture from2005 to 2020 through the National notifiable disease reporting system.Statistics were categorized according to time of onset,reporting region,age of onset,and gender of reported cases to describe the epidemiological characteristics of hepatitis B cases in Honghe Prefecture at different times,regions,genders,and ages from 2005 to 2020.To develop a serological surveillance program for hepatitis B in Honghe Prefecture,collect serological surveillance data on HBs Ag,Anti-HBs and Anti-HBc and timely vaccination of the entire hepatitis B vaccine and the first dose of hepatitis B vaccine in the surveyed population in Honghe Prefecture from 2016 to 2020,and conduct descriptive analysis of the surveillance data.2.We collected hepatitis B vaccination data for school-age children from 2010 to 2020,data for preventing mother-to-child transmission from 2017 to 2020,case data of hepatitis B cases from 2005 to 2020,and hepatitis B health education data through the Yunnan Provincial Immunization Planning Information System,the Honghe Prefecture Maternal and Child Health Care Management System,the National notifiable disease reporting system,and the Honghe Prefecture Hepatitis B Publicity Statistical Report,respectively.Descriptive analysis of surveillance data was conducted.3.Data entry and statistical methods:Serological surveillance data for HBs Ag,Anti-HBs and Anti-HBc were doube-inputted into Epi Data 3.1.We collated and analysed the data using WPS and SPSS 17.0.Rates were analysed using the chi-square test,where theoretical frequencies<1 were tested using Fisher’s test.A regional distribution map was drawn using a landmap.Results:1 Epidemiological characteristics of viral hepatitis B in Honghe Prefecture from2005 to 20201.1General overviewFrom 2005 to 2020,a total of 30,396 cases of hepatitis B were reported in Honghe Prefecture,with an average annual incidence rate of 41.78/100,000,with a peak incidence of 56.45/100,000 in 2006 and a low of 34.10/100,000 in 2008.The incidence of hepatitis B in Honghe Prefecture has shown random fluctuations over the past 16 years,with no downward trend.The second most prevalent infectious disease in category B,followed by the third most prevalent.1.2Three-dimension distributionCases were reported every month from 2005 to 2020 in Honghe Prefecture,with no obvious seasonal peaks in incidence.There are differences in incidence rates among the13 counties and cities under the jurisdiction of Honghe Prefecture.The counties and cities with a higher incidence of hepatitis B are located in the northern part of Honghe Prefecture.The incidence of hepatitis B in Mile,Kaiyuan,Mengzi and Pingbian counties is higher than the average incidence of 41.78 per 100,000 in Honghe Prefecture.The incidence rates in the 0-4,5-9,10-14,15-19 and 20-24 age groups in Honghe Prefecture showed a decreasing trend,while those aged 25 years and above did not show a decreasing trend.The incidence of hepatitis B is lowest among people under 15 years of age in Honghe Prefecture,and the incidence of hepatitis B increases gradually with age.The average annual incidence rate for males is higher than the average annual incidence rate for females.The incidence in Honghe Prefecture was predominantly among farmers,accounting for 67.67%of the total number of reported cases.Students,children living in the diaspora and children in early childhood care accounted for a lower proportion of cases,at 3.97%,0.89%and 0.19%respectively.1.3 Serological epidemiological characteristics of hepatitis B in Honghe Prefecture from 2016 to 2020A total of 20,415 people above the age of 8 months were surveyed in the state from2016-2020.According to this survey,the HBs Ag positivity rate in the population of Honghe Prefecture gradually became higher with increasing age,with 0.68%,1.4%,2.25%and 4.07%for people aged 8 months-6 years,7-14 years,15-24 years and 25 years and above,respectively.The difference in HBs Ag positivity rates between age groups was statistically significant(X~2=215.15,P<0.001).The Anti-HBs positivity rates were70.26%,36.10%,37.55%and 42.99%for those aged 8 months-6 years,7-14 years,15-24years and 25 years and above respectively,with statistically significant differences in Anti-HBs positivity rates between the age groups(X~2=1783.43,p<0.001).The Anti-HBs positivity rate decreased with increasing age.The highest rate of Anti-HBs positivity is found in people under 7 years of age.HBs Ag positivity rates were lower in the northern counties than in the southern counties for ages 8 months-6 years and 7-14years.Anti-HBs positivity rates were higher in the northern counties than in the southern counties between the ages of 8 months-6 years and 7-14 years.The Hani and Yi ethnic groups had lower rates of HBs Ag positivity rates than other ethnic groups.2 Implementation of Hepatitis B prevention and control measures2.1 Hepatitis B vaccinationThe full vaccination rates of Hep B in Honghe Prefecture were 96.15%,90.29%,20.08%,and 0.77%for people aged 8 months-6 years,7-14 years,15-24 years,and 25 years and above respectively,with statistically significant differences(X~2=14191.34,P<0.001).Timely Hep B1 vaccination rates for people aged 8 months-6 years,7-14 years,15-24years,and 25 years and above were 98.97%,92.24%,20.97%,and 0.8%respectively,with statistically significant differences(X~2=15158.03,P<0.001).The vaccination rates were 98.97%,92.24%,20.97%and 0.8%respectively,with statistically significant differences(X~2=15158.03,P<0.001).The rates of full Hep B vaccination and timely Hep B1 vaccination in the population gradually decreased with age.The rates of full Hep B vaccination and timely Hep B1 vaccination in the population aged 15 years and above were lower than 90%.The differences in the rates of full Hep B vaccination and timely Hep B1 vaccination between the northern and southern counties and cities aged 8months-6 years were not statistically significant.The rates of full Hep B vaccination and timely Hep B1 vaccination in the northern counties and cities aged 7-14 years were higher than those in the southern counties.Hep B1 timely vaccination rates were higher in the northern counties than in the southern counties.The Hani and Yi ethnic groups had higher rates of full vaccination than other ethnic groups,and the hospital-born population had higher rates of full vaccination than the home-born population.2.2 Preventing mother-to-child transmissionA total of 6682 people were monitored in the preventing mother-to-child transmission study.The success rate of preventing mother-to-child transmission was higher for those who were up to date with Hep B and HBIG compared to those who were not up to date,with a success rate of 84.74%and 84.77%respectively.The success rate of preventing mother-to-child transmission was higher in areas with state hospitals than in counties without state hospitals.The success rate of preventing mother-to-child transmission was higher in northern counties than in southern counties.2.3Hepatitis B case surveillance reportIn Honghe Prefecture,hepatitis B timely reporting rate and timely audit rate are 100%from 2005 to 2020,the annual heavy card rate of 0%.The cases were mainly diagnosed and reported by county-level medical institutions.There was a high number of empty and missing information on the hepatitis B attachment card filled in by medical staff from2005 to 2007.The information on the Hepatitis B Supplementary Card was completed well from 2013 to 2020.A consistency test was conducted between the classification of diagnosed cases on the Hepatitis B Supplementary Card and the classification of reported cases on the National notifiable disease reporting system,and the overall consistency was good.2.4Health Education on prevention and control of Hepatitis BFrom 2014 to 2020,the promotional methods in Honghe Prefecture were relatively diverse,with relatively few TV broadcasts of public service advertising films.Publicity aimed at key groups mainly includes schools,construction sites,and stations.Conclusion:Hepatitis B is one of the major infectious diseases in Honghe Prefecture.The average annual incidence rate is 41.78/100,000,higher than the provincial average rate of33.19/100,000 and lower than the national average rate of 97.33/100,000.The incidence of hepatitis B tends to fluctuate randomly and is in a state of epidemic,with the incidence of hepatitis B declining year by year among people under 15 years of age,while the incidence is higher among people over 25 years of age and is mainly among farmers.The incidence of hepatitis B accounts for 67.67%of the total number of reported cases in the state,while the incidence is lower in the younger age groups such as children living in the diaspora,children in early childhood care and students.The results of this sero-epidemiological survey showed that the HBs Ag positivity rate in the population of Honghe Prefecture was 2.17%.The rate of HBs Ag positivity in the population increased with age,and decreased by 17.80%compared to 2.64%in 2014.The rate of hepatitis B vaccination in the population under 15 years old was high,reaching over 90%,and the rate of Anti-HBs positivity decreased with age.The success rate of mother-to-child interruption was higher among those who received Hep B and HBIG in a timely manner and those who completed the full course of hepatitis B vaccination,but there were still people who failed to receive hepatitis B vaccine.The strategy of protecting the population with hepatitis B vaccination of newborns has worked well for many years in Honghe Prefecture.However,there are still a large number of immunisation gaps in the population over 25 years of age,for which hepatitis B vaccination needs to be further strengthened. |
PDF Full Text Request