Changing trend in reported hepatitis B incidence among residents of mainland China, 2004 – 2017
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摘要:
目的 分析中国大陆居民2004 — 2017年乙型肝炎(乙肝)的发病趋势,为制定乙肝防控策略提供科学依据。 方法 收集公共卫生科学数据中心2004年3月 — 2017年3月中国大陆31个省/市/自治区(不包括台湾省、香港特别行政区和澳门特别行政区)居民的乙肝报告发病率数据,以年平均变化百分比(AAPC)作为量化指标分析中国2004 — 2017年不同地区、性别和年龄居民乙肝发病的趋势变化。 结果 中国大陆居民2004 — 2017年乙肝报告发病率依次为70.50/10万、75.57/10万、84.82/10万、89.00/10万、88.52/10万、88.82/10万、79.46/10万、81.54/10万、80.68/10万、71.12/10万、69.05/10万、68.57/10万、68.74/10万、72.61/10万,2004 — 2017年乙肝报告发病率总体无显著变化(AAPC = 0.2 %,P > 0.05)。全国31个省/市/自治区中,山西省、安徽省、江西省、湖北省、湖南省、广东省、广西壮族自治区、海南省、西藏自治区和新疆维吾尔自治区2004 — 2017年乙肝报告发病率均呈上升趋势(均P < 0.05),AAPC分别为5.80 %、4.20 %、1.50 %、1.70 %、11.30 %、6.70 %、3.50 %、3.10 %、14.50 % 和4.40 %。男性和女性居民的年均乙肝报告发病率分别为97.03/10万和57.38/10万,2004 — 2017年男性和女性居民的乙肝报告发病率总体均无显著变化(AAPC = – 0.1 %和0.5 %,均P > 0.05)。0~4岁、5~9岁、10~19岁、20~39岁、40~59岁和 ≥ 60岁居民的年均乙肝报告发病率分别为12.78/10万、17.64/10万、80.21/10万、211.00/10万、181.62/10万和163.11/10万,2004 — 2017年0~4岁、5~9岁和10~19岁居民的乙肝报告发病率总体均呈下降趋势(AAPC = – 7.7 %、 – 13.6 %和 – 11.6 %,均P < 0.001),≥ 60岁居民的乙肝报告发病率总体呈上升趋势(AAPC = 5.0 %,P < 0.001)。 结论 中国大陆居民2004 — 2017年乙肝报告发病率总体无显著变化,但全国仍有部分地区居民乙肝报告发病率呈上升趋势,其中 ≥ 60岁居民是乙肝防控的重点人群。 Abstract:Objective To analyze the trend of reported incidence of hepatitis B (HB) in mainland China from 2004 to 2017 to provide evidences for developing strategies on HB prevention and control. Methods From National Public Health Science Data Center, we extracted the data on HB incidence in 31 provincial-level administrative divisions (not including Chinese Taiwan, Hong Kong Special Administrative Region and Macao Special Administrative Region) reported from March 2004 through March 2017. The average annual percentage change (AAPC) in region-, gender- and age group-specific HB incidence were calculated to assess variation trend of HB incidence during the period. Results From 2004 to 2017, the average reported incidence (per 100 000 population) of HB for the 31 divisions were 70.50, 75.57, 84.82, 89.00, 88.52, 88.82, 79.46, 81.54, 80.68, 71.12, 69.05, 68.57, 68.74 and 72.61, with no significant variation in the reported incidence as a whole (AAPC = 0.2%, P > 0.05); while, the increased HB incidences were reported in 9 of the divisions, with the APPCs of 5.80% for Shanxi, 4.20% for Anhui, 1.50% for Jiangxi, 1.70% for Hubei, 11.30% for Hunan, 6.70% for Guangdong, 3.50% for Guangxi Zhuang Autonomous Region, 3.10% for Hainan, 14.50% for Tibet Autonomous Region, and 4.40% for Xinjiang Production and Construction Corps, respectively (all P < 0.05). The mean reported annual HB incidence (per 100 000 population) during the period was 97.03 for males and 57.38 for females and there was no significant variation in the incidence for both the males (AAPC = – 0.1%) and the females (AAPC = 0.5%) (both P > 0.05). The age group-specific HB incidences (per 100 000 population) were 12.78, 17.64, 80.21, 211.00, 181.62 and 163.11 for the population aged 0 – 4, 5 – 9, 10 – 19, 20 – 39, 40 – 59, and 60 years and above, respectively; the age group-specific HB incidence decreased for the groups less than 20 years (AAPC = – 7.7%, – 13.6%, and – 11.6% for groups of 0 – 4, 5 – 9, 10 – 19 years, all P < 0.001) but increased for the age groups 60 years old and above (AAPC = 5.0%, P < 0.001). Conclusion During 2004 – 2017 in mainland China, the reported incidence of hepatitis B was not significantly changed generally but the incidence showed an increasing trend in some regions and the residents aged 60 years and above is the key population for hepatitis B prevention. -
Key words:
- hepatitis B /
- incidence /
- trend analysis /
- residents of mainland China
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表 1 中国不同地区居民2004 — 2017年乙肝报告发病情况
地区 2004 — 2005年 2006 — 2007年 2008 — 2009年 2010 — 2011年 2012 — 2013年 2014 — 2015年 2016 — 2017年 发病数 发病率
(1/10万)发病数 发病率
(1/10万)发病数 发病率
(1/10万)发病数 发病率
(1/10万)发病数 发病率
(1/10万)发病数 发病率
(1/10万)发病数 发病率
(1/10万)北京市 12578 41.68 16264 52.14 8385 25.20 6288 16.92 4556 11.15 3331 7.81 3596 8.28 天津市 8294 42.08 12066 56.97 5250 22.92 4239 16.81 3752 13.56 3600 12.04 4002 12.87 河北省 90389 66.42 114267 83.11 112794 80.96 102612 72.16 113033 77.80 107770 73.23 116042 77.90 山西省 52301 78.66 75998 112.92 84879 124.76 84715 121.05 102725 142.59 93951 129.09 82364 112.12 内蒙古自治区 51268 107.72 63944 133.69 64621 134.10 53366 109.07 52831 106.27 44594 89.14 42023 83.53 辽宁省 42378 50.57 56323 66.32 57742 67.04 53075 61.05 47022 53.60 40359 45.96 39362 44.93 吉林省 28425 52.89 29708 54.62 34581 63.29 36204 66.00 30111 54.75 23955 43.53 15889 28.96 黑龙江省 62842 83.11 46949 61.43 40912 53.49 32939 43.02 29126 37.98 21669 28.26 20155 26.48 上海市 9933 31.89 12065 33.58 11968 31.94 9316 22.06 22399 47.38 16977 35.07 20765 42.95 江苏省 40742 27.11 35593 23.69 30206 19.74 25209 16.17 22967 14.52 25713 16.17 26417 16.54 浙江省 83804 87.54 78426 79.39 67494 66.30 64292 60.52 32091 29.33 26714 24.27 29298 26.33 安徽省 60952 48.66 63209 51.68 65480 53.44 64927 53.74 71411 59.73 71205 58.79 94161 76.31 福建省 68598 96.49 82504 116.32 101744 141.05 95697 130.80 97305 130.30 95831 126.43 85304 110.60 江西省 66649 77.85 64167 74.18 70033 79.87 65645 73.85 70480 78.38 73882 81.51 83216 90.87 山东省 79296 43.18 81634 43.99 68596 36.52 59300 31.13 81538 42.20 95161 48.74 117990 59.61 河南省 215226 113.14 319189 170.03 323136 171.98 287297 152.09 206824 110.05 124461 66.03 127879 67.26 湖北省 108737 92.93 129182 113.29 153440 134.48 136457 119.24 123180 106.77 120080 103.38 129699 110.51 湖南省 34355 26.48 59954 47.33 78782 61.84 81510 62.82 103594 78.28 110684 82.43 116184 85.45 广东省 122780 71.87 211095 114.12 251531 132.43 263783 131.44 282008 133.66 287027 134.33 315863 144.57 广西壮族自治区 62369 65.80 68824 73.38 78372 81.77 85517 90.41 87014 93.29 82543 87.14 92897 96.43 海南省 16203 99.11 12910 77.58 12210 71.87 14034 81.06 19104 108.30 23125 128.56 25360 138.74 重庆市 63692 107.59 60331 107.62 49131 86.88 35040 61.01 37802 64.46 38229 64.13 41639 68.65 四川省 170203 100.70 169686 103.59 126436 77.52 111641 68.80 94218 58.43 77259 47.55 78176 47.48 贵州省 37295 49.56 55428 74.03 68878 91.22 50594 69.57 40741 58.59 40542 57.83 38091 53.77 云南省 31716 36.17 44542 49.86 40433 44.64 43573 47.53 49541 53.33 46931 49.92 28271 29.72 西藏自治区 600 11.21 760 13.62 915 16.02 1362 23.09 2220 36.32 4233 67.23 4114 62.81 陕西省 98533 133.82 63507 85.19 62363 83.04 53963 71.91 53276 71.08 49056 65.07 38640 50.80 甘肃省 98913 190.50 124229 238.90 127996 244.03 106509 205.10 42584 82.82 20558 39.74 20939 40.19 青海省 20938 194.33 26614 243.94 40895 369.66 28027 250.25 26705 233.98 17045 146.79 20189 170.89 宁夏回族自治区 18231 155.36 17897 149.14 15316 126.00 11360 90.49 11631 90.40 7940 60.35 5404 40.24 新疆维吾尔自治区 40483 105.21 81811 201.50 94657 224.00 85426 196.82 88271 198.74 75492 165.45 80291 168.75 表 2 中国不同性别居民2004 — 2017年乙肝报告发病情况
年份 男性 女性 发病数 发病率(1/10万) 发病数 发病率(1/10万) 2004 611222 91.22 304733 48.39 2005 651435 97.25 330720 52.49 2006 723372 109.46 385756 59.65 2007 757906 111.90 412038 64.66 2008 753805 110.78 415764 64.88 2009 756396 111.04 423209 65.43 2010 675780 98.76 384800 59.16 2011 685543 99.72 407788 62.41 2012 679323 98.36 407761 62.10 2013 602913 86.88 360059 54.55 2014 587058 84.40 348637 52.86 2015 592927 84.95 341282 51.36 2016 597432 85.08 344836 51.58 2017 636961 90.31 364991 54.11 表 3 中国不同年龄居民2004 — 2017年乙肝报告发病情况
年份 0~4岁 5~9岁 10~19岁 20~39岁 40~59岁 ≥ 60岁 发病数 发病率
(1/10万)发病数 发病率
(1/10万)发病数 发病率
(1/10万)发病数 发病率
(1/10万)发病数 发病率
(1/10万)发病数 发病率
(1/10万)2004 7647 20.82 17543 36.45 150015 123.99 445322 188.42 229732 156.68 65696 98.17 2005 6546 16.30 15020 39.27 148696 123.69 473342 219.66 260563 153.69 77988 108.74 2006 6869 16.77 14139 38.83 153067 129.75 535549 252.61 304890 173.97 94614 130.38 2007 6932 16.89 11867 32.00 137837 120.31 558954 263.44 342655 187.62 111699 149.37 2008 6339 15.35 9119 24.19 115361 106.32 550284 256.51 365289 195.66 123177 160.49 2009 5884 14.05 7682 20.02 95891 93.27 546270 256.25 385113 199.53 138765 176.28 2010 5337 12.45 4594 11.35 62007 64.82 482241 226.30 367319 185.99 139082 170.91 2011 5143 13.08 3418 9.28 49891 54.81 494349 228.51 388083 191.14 152447 174.57 2012 4716 11.99 2979 7.72 41335 49.40 474045 214.82 396751 194.19 167258 183.33 2013 3904 9.92 2444 6.33 31809 37.87 404406 182.35 363822 177.23 156587 170.64 2014 3602 9.00 2299 5.57 26374 35.16 379475 174.48 361194 171.21 162751 169.01 2015 3318 8.27 2353 5.69 23253 30.78 361913 165.43 369439 174.44 173933 179.67 2016 2909 7.23 2151 5.22 20323 27.08 357337 164.53 376519 179.34 183029 174.45 2017 2902 7.14 2414 5.82 19380 25.65 366263 167.79 405641 192.47 205352 194.05 -
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