The Epidemiological Features And Risk Factors Of Hepatitis B Among People Under 15 Years Old In Xi'an City

BackgroundHepatitis B virus?HBV?infection is a global public health problem that brings great harm to the physical and mental health of patients.At present,the most effective prevention method for controlling the hepatitis B epidemic is the large-scale hepatitis B vaccine immunization in population.Xi'an city has implemented the newborn hepatitis B vaccine free of charge since 2004.In recent years,hepatitis B vaccine coverage rate has remained above 95%.However,from the China Disease Surveillance Information Report Management System,it has been found that the reported incidence of hepatitis B below the age of 15 still fluctuates in the city.Therefore,it is imperative to analysis the prevalence of hepatitis B in people under 15 years old in Xi'an,and to discuss the risk factors of hepatitis B infection under the current immunization planning policy.ObjectiveTo analyze the distribution characteristics of hepatitis B epidemic in people under 15years in Xi'an city in the past decades,to explore the risk factors for hepatitis B infection by using epidemiological surveys under the current immunization planning policy,to provide targeted and scientifically effective prevention and treatment of hepatitis B.Methods1.Descriptive epidemiological analysis of all hepatitis B cases below 15 years in Xi'an city based on the data of hepatitis B surveillance from 2004 to 2015 in China's Disease Surveillance Information Report Management System.We divide Xi'an into central urban areas,combined urban-rural areas,and rural areas.We use Excel 2010 to establish and organize the database,and use ArcGIS10.2software to map the incidence of regional distribution.SPSS19.0 statistical software was used to analyze the data.The qualitative data sets were compared using the?²test.The test level was?=0.05.2.A case-control study was conducted to analyze the risk factors for hepatitis B patients aged below 15 years from 2013 to 2017.Cases selection criteria:?1?Newly diagnosed hepatitis B from 2013 to 2017;?2?Age<15 years;?3?The resident population of Xi'an.The number of control group was in a ratio of 1:2 with case group.The controls must meet the following conditions:?1?HBsAg was negative by serological survey from2013 to 2017;?2?Who had the same sex and had an age of±2 years with same case pair;?3?Who is also the resident people of Xi'an and the same place of residence with the cases.After investigators have been trained,they conduct surveys according to a uniform survey questionnaire designed by researchers.The main contents of the questionnaire include the general demographic characteristics of the study subjects,history of hepatitis B vaccination,and possible risk factors for HBV infection.Using Epidata 3.1 to establish a database and enter data,using SPSS19.0 statistical software for data analysis.First,each variable was analyzed by univariate analysis.Then the multivariate conditional logistic regression analysis was performed on the selected variables.Results1.From 2004 to 2015,a total of 2310 cases of hepatitis B was reported.The annual average incidence was 15.47/100 000.The incidence of hepatitis B from 2005 to 2015showed a decreasing trend(?² _trend=2783.784,P<0.001).The annual average incidences of the central urban area?15.33/100 000?and the fringe areas?19.38/100 000?were higher than those of rural area?12.31/100 000?.The highest incidence rate was in the 13-14 age group?28.47/100 000?,followed by<1 year group?26.84/100 000?.Among the HBV vaccine immunization history of 293 cases from 2010 to 2015,the full immunization ratewas 54.95%,and the first dose rate of HBV vaccination in time was 72.35%.2.We collected 193 pairs,a total of 579 subjects according to 1:2 matched case-control study.Univariate analysis showed that the mother's education level,dental treatment,hepatitis B virus infection in the family,a dose of hepatitis B within 24 hours of birth,and the full course vaccination had statistical differences between the two groups.Further multivariate analysis found that the risk factors for the onset of hepatitis B in children were lower maternal education?OR=4.152,95%CI:1.892⁹.108?,dental treatment?OR=5.637,95%CI:1.049¹0.281?,and family which have hepatitis B patients or carriers?OR=10.062,95%CI:5.328¹9.004?.The timely birth dose of hepatitis B vaccination within 24 hours of birth?OR=0.080,95%CI:0.031⁰.209?,and the whole course dose of hepatitis B vaccination?OR=0.018,95%CI:0.005⁰.064?were protective factors.ConclusionIn the past ten years,the incidence of hepatitis B in the population below the age of15 in Xi'an has shown a declining trend.The main risk factors for the onset of hepatitis B in children are the low level of maternal education,the history of dental treatment,hepatitis B virus infection in the family,the inability of the first dose of hepatitis B vaccination and incomplete vaccination.Therefore,in the future,the mother's knowledge about hepatitis B prevention and control should be further strengthened,and increase the percentage of newborn infants who received a dose of HepB within 24 hours of birth and rate of full vaccination.HBsAg positive mothers should actively carry out antiviral drug treatment during pregnancy.The disinfection and hygiene supervision should to be strengthened in the local hospital dentistry and dental clinics.HepB vaccination operations,vaccination procedures and implement safe injections should be standardized.At the same time,in order to provide the basis for timely adjustment of prevention and control strategies in Xi'an city and evaluation of the effectiveness of immunization programs,hepatitis B infection surveillance and a sound hepatitis B surveillance system should to be strengthened.