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目的了解怀远县甲型病毒性肝炎(以下简称“甲肝”)流行特征,制定有效控制措施,最终消除甲肝。方法采用描述流行病学方法对怀远县1990～2011年甲肝流行特征进行分析。结果怀远县甲肝疫情呈总体下降趋势,基本经历3个阶段:病例高发阶段、疫情快速下降阶段和疫情有效控制阶段。具有明显的周期性流行,基本为每3～4年呈现一次流行高峰,2000年以后流行周期性则不明显,但仍有周期性趋势。季节性分布特征较为明显,1992年前以春季高峰为主,1992年以后呈现较为明显的冬季发病高峰,2000年以后季节性发病高峰消失,呈现高度散发状态。性别分布中男性多于女性,男∶女为1.69∶1。1999年前城区发病高于农村,2000年以后基本一致。甲肝疫苗使用前后流行特征有所改变:流行周期性消失,甲肝的低年龄发病年龄高峰和青壮年发病高峰消失,出现明显的发病年龄后移,60岁以上人群发病构成比明显增加。结论接种甲肝疫苗是有效控制甲肝疫情的关键,经过采取以接种甲肝疫苗为主的综合性措施,怀远县甲肝疫情已得到有效控制,目前已属甲肝低流行区,仍需提高甲肝疫苗有效接种率和加强疫情监测。
Objective To understand the epidemiological characteristics of type A viral hepatitis in Huaiyuan County (hereinafter referred to as “Hepatitis A”) and establish effective control measures to eventually eliminate hepatitis A. Methods Descriptive epidemiological methods were used to analyze the prevalence of hepatitis A in Huaiyuan County from 1990 to 2011. Results The overall incidence of hepatitis A in Huaiyuan County showed an overall downward trend. It basically experienced three stages: the high incidence of the disease, the rapid decline of the outbreak and the effective control of the epidemic. There is a clear cyclical epidemic, with a peak every 3 to 4 years. After 2000, epidemic cyclicality is not obvious, but there is still a cyclical trend. Seasonal distribution is more obvious. Before 1992, the spring peak was the main peak. After 1992, the peak appeared in winter. After 2000, the peak of seasonal peak disappeared and showed a highly distributed state. Male distribution is more than female, male: female 1. 69: 1. The incidence of urban areas before 1999 was higher than that in rural areas, basically the same after 2000. Prevalence of hepatitis A vaccine before and after the change has been the epidemic: the cyclical disappearance of the epidemic, the age of onset of low age of hepatitis A peak peak age and young adults disappeared, the apparent age of onset of the shift, the incidence of disease over the age of 60 significantly increased. Conclusion Hepatitis A vaccine is the key to effective control of hepatitis A infection. After the comprehensive measures of hepatitis A vaccine are taken, the epidemic situation of hepatitis A in Huaiyuan County has been effectively controlled. Currently it is a low-prevalence area of hepatitis A, and the effective vaccination rate of hepatitis A vaccine still needs to be improved And strengthen epidemic monitoring.