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目的分析宜昌市2001-2015年病毒性甲型肝炎发病特征及流行趋势,为本区域甲肝防治提供科学依据。方法收集全市甲肝疫情资料进行三间分布描述,用ELISA法查甲肝抗体阳转率,发病率比较采用卡方检验。结果 2001-2015年宜昌市甲肝发病率总体呈现下降趋势,病例呈现散发,未出现暴发疫情。发病率由2001年9.91/10万降低至2015年2.00/10万,下降了79.82%。累计报告死亡病例5例,年均死亡率为0.01/10万。实施扩大免疫规划前甲肝年均发病率(7.11/10万)高于实施后发病率(2.43/10万)(P<0.01)。发病地区为市郊农村,发病高峰年龄后移、人群以农民为主,无发病季节性特征。开展15岁以下儿童甲肝疫苗接种363628人,累计接种率为80.58%。疫苗接种率与发病率间存在负相关(P<0.05)。结论宜昌市病毒性甲肝发病模式已由高地方流行向中低地方流行转变,青壮年农民是发病重点人群,调整免疫策略增强针对性干预,有效控制本区域甲肝流行。
Objective To analyze the incidence and epidemic trend of viral hepatitis A in Yichang City from 2001 to 2015 and provide a scientific basis for the prevention and control of hepatitis A in this area. Methods A total of three distribution reports of hepatitis A in the city were collected. The positive rate of anti-HBeAg was detected by ELISA. The incidence of hepatitis A was compared by chi-square test. Results The incidence of hepatitis A in Yichang City showed a decreasing trend from 2001 to 2015, and the cases were exuded without any outbreak. The incidence dropped from 9.91 / 100,000 in 2001 to 2.00 / 100,000 in 2015, a decrease of 79.82%. A total of 5 deaths were reported, with an annual average of 0.01 / 100,000 deaths. The annual average incidence of hepatitis A (7.11 / 100,000) before implementation of EPI was higher than that after implementation (2.43 / 100,000) (P <0.01). The incidence of rural areas for the suburbs, the peak incidence of postponed age, mainly farmers to farmers, no seasonal seasonal features. To carry out hepatitis A vaccination of 363628 children under the age of 15, the cumulative vaccination rate was 80.58%. There was a negative correlation between vaccination rate and incidence (P <0.05). Conclusion The pattern of viral hepatitis A in Yichang City has changed from high endemic to low endemic areas. Young and middle-aged peasants are the focus of the epidemic. The immunization strategy was adjusted to enhance targeted interventions to effectively control the prevalence of hepatitis A in this area.