| Objectives The study aims to investigate and explore the epidemiologic characteristics and variational trend after hepatitis B vaccine inoculation program among children carried out during last 14 years, to evaluate the effect of hepatitis B vaccine immunization, to analyze the influencial factors of HBsAg positive carriers.The studuy is also to provid reliable data and base for adjusting prevention and intervention strategy in the high epidemic areas of hepatitis B virus.Methods 36 villages were selected from six districts of Xiamen city by multistage stratified sampling technique. 4423 persons aged between 1 and 59 were selected by stratified sampling with different age-groups. Each subjects received a questionnaire interview and detection for serological markers of hepatitis B virus. A case-control analysis was conducted among children aged 1-14 who had been inoculated three times, that 40 HBsAg-positive children are cases and 1690 HBsAg-negative are controls. Another case-control analysis was conducted among subjects between 1 and 59, 399 HBsAg positive persons are cases and 2148 HBsAg-negative persons are controls. A database was constructed with Epidata 3.1 and analyzed with SPSS 11.5. Factors in case-control studies were analyzed by unconditional Logistic regression analysis. Rates were adjusted by sample weight according to sample design. Results Among subjects between 1 and 59,the adjusted HBsAg positive rate was 13.79%, the adjusted anti-HBs positive rate was 53.63%, and the adjusted HBV positive rate was 65.87%. The adjusted HBsAg positive rate was 1.04% among children between 1 and 4 years old and 3.07% among subjects between 1 and 14. Among subjects between 1 and 14, the rate of hepatitis B vaccine inoculation was 96.22% and the protection rate of vaccine was 78.88%. The index such as the rate of hepatitis B vaccine inoculation inversely linear correlated with the HBsAg positive rate and HBV positive rate. It was estimated that hepatitis B vaccine inoculation program among children had reduced 26097 HBsAg carriers, 6524 chronic HBV cases and 783 hepatitis cirrhosis cases during last 14 years in Xiamen city. Single factor analysis among HBsAg carriers between 1 to 14 who were vaccinated showed that age, mother that carried HBsAg, father that carried HBsAg, other kinfolks that carried HBsAg, unsafe injection history were risk factors and vaccination with qualification and whole range was protection factor. Mu1ti-factor analysis showed age and mother that carried HBsAg were two main risk factors. Single factor analysis among HBsAg carriers between 15 and 59 showed birth native, sex, mother that carried HBsAg, other kinfolks that carried HBsAg were risk factors and vaccine inoculation, inoculation with whole range were protection factors. Multi-factor analysis showed male and living-folks that carried HBsAg were the main risk factors. The study predicted that the HBsAg positive rate would be 6.58% by the year 2020 in Xiamen city.Conclusions Xiamen still belonged to high HBV epidemic region and the whole epidemic situation was urgent.Hepatitis B vaccine vaccination program carried out among newborns during last 14 years harvested notable effect, which had leveled the peak of the children epidemic curve. Some effective measures should be done to to control HBV epidemic, such as strengthening vaccine inoculation, perfecting the surveillance system, preventing level transmission and following-up carriers scientifically.
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