| Objectives1. To analysis the epidemic situation from the National Notifiable Disease Reporting System (NNDRS) of HBV in Hubei province,2004-2012.2. To find out the HBV prevalence rate and seromarkers epidemiological distribution characteristics in different ages, gender, regional population in Hubei province,2011.3. To clarify the type of HBV serum markers combined mode and the HBV infection related factors among youngsters and adults, from9to59years old.4.Through the crowd of HepB coverage rate, complete HepB coverage rate and first dose of HepB rate, evaluate the effects of hepatitis B vaccine immunization,and analysis the variation tendency of HBV infection, provide the theoretical basis for future HBV control strategies in Hubei province.Methods1. Using descriptive epidemiological methods to analysis the surveillance data of Hubei province, from2004to2012.2. We performed a provincial serosurvey of HBV by multiple-stage systematic sampling in2011, and9955participants for this study were selected from13counties of Hubei province.which one or three towns/streets was taken, then two or four resident committees or villages committee were selected at the investigation county.1-8,9-19and20-59age groups was set by the starting year of Expanded Programme on Immunization (1992and2002).3.A house-to-house investigation was carried out by trained staff. All participants were informed of the study purpose and of their right to keep information confidential.The basic information and immunization history of participants were collected by a standard questionnaire. The serum specimens were collected and tested for HBsAg,HBsAb,HBcAb HBeAg,and HBeAb by enzyme-linked immunosorbent assay.4.All data were double-inputted into the Epidata3.1database, and were analyzed by SAS9.0, SPSS18.0.The weighted prevalence rates of HBV seromarkers include the point estimates and their estimated95%confidence intervals. The proportion ratios for different composite models of HBV seromarkers were also analyzed. A case-control study was performed to dentify potential HBV risk factors between the participants who were aged9to59years and positive for HBV infection and the participants who were negative for HBV infection in the same age. Multivariable logistic regression was used to secreening for the risk factors and OR was also calculated.Results1. HBV report incidence trends:There was a total of591076cases of hepatitis B infection reported, including386245male patients (65.35%),204831cases of women (34.65%), total average annual incidence of114.29/lakh, incidence of men (144.54/lakh) and women (81.96/lakh) in Hubei province from2004to2012, respectively. The average age of female patients than male, and the incidence was among smooth graphics "M" shape. There are difference incidences between regions in Hubei.2. The HBV prevalence rate and distribution characteristics of HBV seromarkers:The weighted HBsAg prevalence rate was6.79%(95%CI=4.32%-9.26%) among the population aged1to59years and was0.34%,3.41%and8.29%among the population aged1to8,9to19and20to59respectively.The HBsAg prevalence rate of the population aged20to59years was higher than those aged1to8years and9to19years. The differences of the HBsAg prevalence rate between any two age groups were statistically significant(P<0.001). In addition, the diffrences of the HBsAg prevalence rate between men and women was statistically significant(x2=5.79, P=0.0161)The wighted HBsAb prevalence rate was61.24%(95%CI=53.25%～69.23%) among the population aged1to59years and was58.90%,67.87%and60.09%among the population aged1to8,9to19and20to59respectively. The HBsAb prevalence rate of the population aged9to19years was higher than those aged1to8years and20to59years.The differences of the HBsAb prevalence rate between any two age groups were statistically significant,(P<0.001). The diffrences of the HBsAb prevalence rate between men and women was significantly (x2=34.14, P＜0.001), and differences were statistically significant in the eastern, central and western districts of Hubei Province (P＜0.001).The weighted HBV prevalence rate was22.56%(95%CI=15.94%-29.19%) among the population aged1to59years and was2.34%,16.05%and26.37%among the population aged1to8,9to19and20to59respectively. The HBV prevalence rate of the population aged1to8years was lower than those aged9to19years and20to59years, the differences of the HBV prevalence rate between any two age groups were statistically significant(P<0.001).The weighted prevalence rate of HBV susceptibility was28.64%(95%CI=21.03%～36.26%) among the population aged1to59years and was39.38%,27.73%and27.56%among the population aged1to8,9to19and20to59respectively.The HBV susceptibility in the rural areas than in urban and significantly between the two areas(P<0.001).3. The proportion ratios for different composite models of HBV seromarkers.16kinds of composite models of HBV seromarkers were detected in this study. The model solely positive for HBsAb accounted for49.69%of the subjects and the model negative for all of the five HBV seromarkers accounted for32.20%. The third higher composite models of HBV seromakers were positive both for HBsAb and HBcAb and account for9.02%. The three modles account for90.91%. In the subjects of child-bearing age (20～49),38.91%,32.05%and15.68%were account for the three models, respectively.4. Risk factors for HBV infection in target population.The main risk factors in population aged9to59years old were the marrytime>10years, living with HBsAg positive person, history of blood transfusion, accupation is presents, age of>30years, acupuncture and moxibustion treatment, the OR value of these factors were2.31,1.80,1.71,1.25and1.21respectively. The hepatitis B vaccination was the protective factor (OR=0.46).5. Hepatitis B coverages.The complete HepB coverage was88.88%(95%CI=88.01%～89.75%) among the population aged1to19years. The complete HepB coverage of the children aged1to8years old was much lower than that of the children aged9to19years old and the difference between the two age groups were significantly (x2==254.92, P＜0.001). The whole course of HepB vaccination (3doses) rate and the rate of the first dose of HepB (HepB1) were the older the lower. The HepBl timely coverage was73.47%(95%CI=72.25%-74.69%) among children aged1to19years. It was higher among children aged1to8years(85.84%) than that among the children aged9to19years(61.81%)(x2=365.99, P＜0.001). The lower HepB1timely coverage was found in children residing in rural areas and being born at home when compared with those residing in urban areas,being born in hospitals respectively (P＜0.001).ConclusionsIn comparison with the1996and2006survey, the HBV infection was significantly dropped and the immunity against HBV infection was improved in Hubei province. Hubei province was a intermediate endemic area for HBV. Although, in Hubei province, there has been a great improvement in infant hepatitis B vaccination coverage and a reduced prevalence rate of HBsAg among young children, this study shows that many populations remain at high risk of HBV infection. To further reduce the prevalence of HBsAg,strongest efforts should be made to strengthen the implementation in the people of immunization program.InnovationsIt was the first large-scale seroepidemiological study on the hepatitis B in Hubei province since1992.It was a comprehensive research with high-quality design, scientific analysis method and detailded finding,which were useful for providing the theoretical basis for future HBV control strategies in Hubei province. |
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