摘要
目的分析2010-2021年承德市乙型病毒性肝炎(乙肝)流行病学特征及监测效果,为提高乙肝监测质量、制定乙肝防控措施提供科学依据。方法通过中国疾病预防控制信息管理系统收集2010-2021年承德市乙肝病例报告数据,采用描述性流行病学方法分析乙肝的流行情况和分布特征。采用SPSS 22.0软件分析未分类乙肝所占比例和附卡信息与报告类型一致性,计算Kappa值。结果2010-2021年承德市共报告乙肝病例25900例,年均报告发病率61.33/10万,乙肝报告发病率从2010年的103.07/10万降至2020年的29.45/10万,整体呈现降低趋势(趋势χ^(2)=3930.88,P<0.01)。全年每月均有乙肝病例报告,没有明显的季节特征;报告发病率最高的是隆化县(105.61/10万),最低的是双桥区(35.27/10万),差异有统计学意义(χ^(2)=3414.06,P<0.01);发病以成年人为主,主要集中在20~69岁组(23610例),占病例总数的91.16%;发病率最高的是60~69岁组(92.56/10万),10岁以下儿童发病率最低(1.84/10万),差异有统计学意义(χ^(2)=7007.61,P<0.01);男性发病率(66.73/10万)高于女性发病率(55.60/10万),差异有统计学意义(χ^(2)=213.35,P<0.01);报告病例的职业分布以农民为主,占78.95%。监测前期(2010-2012年)和监测期(2013-2021年)未分类乙肝占比分别为66.04%和24.36%,相比下降了63.11%,差异有统计学意义(χ^(2)=4493.75,P<0.01)。2013-2021年承德乙肝监测点附卡填写完整率均在90%以上,但附卡填写有效率差别较大,通过附卡信息进行复核诊断的病例948例,Kappa值为0.871,整体一致性检验结果较高。结论2010-2021年承德市乙肝报告发病率呈下降趋势,10岁以下儿童保持较低水平,但成年人乙肝发病水平居高不下;2个乙肝监测试点未分类乙肝占比逐渐下降,分类诊断准确性较高。
Objective To analyze the epidemiological characteristics and surveillance effect of viral hepatitis B(hepatitis B)in Chengde city from 2010to 2021,so as to provide a scientific reference for formulating preventive and control measures of hepatitis B.Methods Data on reported cases of hepatitis B in Chengde city were collected through the China Disease Control and Prevention Information Management System from 2010to 2021,and descriptive epidemiological methods were used to analyze the prevalence of hepatitis B and its distributional characteristics.SPSS 22.0software was used to analyze the proportion of unclassified hepatitis B and the consistency of the attached card information with the type of report,and kappa values were calculated.Results A total of 25900cases of hepatitis B were reported in Chengde city from 2010to 2021,with an average annual incidence of 61.33/105,and the incidence of hepatitis B decreased from 103.07/10^(5) in 2010to 29.45/10^(5) in 2020,with an overall decreasing trend(Trend χ^(2)=3930.88,P<0.01).Cases of hepatitis B were reported every month throughout the year,with no obvious seasonal characteristics.The highest incidence was reported in Longhua county(105.61/105)and the lowest incidence was reported in Shuangqiao district(35.27/105),with a statistically significant difference(χ^(2)=3414.06,P<0.01).The incidence was predominantly in adults,mainly in the 20-69years old group(23610cases),accounting for 91.16%of the total number of cases.The highest incidence was in the 60-69age group(92.56/105),and the lowest incidence was in children under 10years of age(1.84/105),with a statistically significant difference(χ^(2)=7007.61,P<0.01).The incidence was higher in males(66.73/105)than in females(55.60/105),with a statistically significant difference(χ^(2)=213.35,P<0.01).The occupational distribution of the reported cases was dominated by farmers,who accounted for 78.95%.The proportion of unclassified Hepatitis B cases was decreasing 63.11%from 66.04%in early phase to 24.36%in period of supervision,with a statistically significant difference(χ^(2)=4493.75,P<0.01).The complete rate of filling out the attachment card at Chengde hepatitis B surveillance pilot points from 2013-2021was above 90%,but the effective rate of filling out the attachment card varied considerably,and 948 cases were reviewed and diagnosed through the information on the attachment card,with a Kappa value of 0.871,and the overall consistency of the test results was high.Conclusion The reported incidence of hepatitis B in Chengde city shows a decreasing trend from 2010-2021,with children under 10years of age maintaining a low level,but the incidence level of hepatitis B in adults remaining high;the percentage of unclassified hepatitis B in the 2hepatitis B surveillance pilots is gradually decreasing,and the accuracy of classified diagnosis is high.
作者
张扬
黄伟
李琦
魏峰
富志南
陈秋成
ZHANG Yang;HUANG Wei;LI Qi;WEI Feng;FU Zhi-nan;CHEN Qiu-cheng(Department of Infectious Diseases,Chengde City Center for Disease Control and Prevention,Hebei 067000,China;Vice President's Office,Chengde Hospital of Traditional Chinese Medicine)
出处
《预防医学论坛》
2023年第12期898-904,共7页
Preventive Medicine Tribune
基金
中国肝炎防治基金会中国乙肝防控科研基金(YGFK20200096)
河北省承德市基础研究项目(202102A061)
关键词
乙型病毒性肝炎
流行病学
监测
传染病报告
Viral hepatitis B
Epidemiology
Surveillance
Infectious disease reporting
作者简介
张扬(1989-),女,硕士,副主任医师,研究方向:传染病预防与控制;通信作者:陈秋成,E-mail:chenqiucheng007@126.com
