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1992—2020年宁波市奉化区新生儿乙肝疫苗接种效果评价——一项回顾性随访研究

Evaluation of the effectiveness of hepatitis B vaccination among newborns in Fenghua district, Ningbo city from 1992 to 2020: a follow-up study

    摘要
  • 摘要:
    目的 评价1992—2020年浙江省宁波市奉化区乙肝疫苗接种效果。
    方法  收集1992年和2020年奉化区乙肝血清流行病学调查资料，比较乙肝表面抗原（HBsAg）及乙肝表面抗体（抗–HBs）阳性率。收集 1992—2020年乙肝发病资料，比较计划免疫管理阶段（1992—2001年）、免疫规划管理阶段（2002—2011年）及乙肝母婴阻断策略实施阶段（2012—2020年）的年均乙肝发病率。使用决策树马尔科夫模型评估1992—2020年新生儿乙肝疫苗接种效果。
    结果 全人群HBsAg阳性率由1992年13.79%下降至2020年5.42%（χ2=31.73，P<0.01），其中0～24岁人群中所有年龄组HBsAg阳性率均降为0%。0～4岁组抗–HBs阳性率由1992年34.48%上升至2020年90.16%（χ2=30.38，P<0.01）。乙肝发病率在0～29岁人群显著下降，尤其是0～4、5～9、10～14岁组，2012—2020年较1992—2001年分别下降86.08%、94.63%和94.55%。决策树马尔科夫模型结果显示，与未接种乙肝疫苗相比，1992—2020年奉化区乙肝疫苗接种114 670人可预防6 894例急性乙肝、30 832例乙肝携带者、4 705例慢性乙肝、4 043例肝硬化、3 265例肝癌和4 411例乙肝相关死亡。
    结论 奉化区乙肝疫苗接种效果显著，低年龄段HBsAg阳性率和乙肝发病率均大幅下降，应继续做好新生儿乙肝疫苗接种工作。

     

    Abstract:
    Objective To evaluate the effectiveness of hepatitis B vaccination in Fenghua district, Ningbo city from 1992 to 2020.
    Methods  The epidemiological survey data on hepatitis B serology in Fenghua district in 1992 and 2020 were collected for comparison of the positive rates of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs). Furthermore, data on the incidence of hepatitis B from 1992 to 2020 were collected for comparison of the average annual incidence of hepatitis B during the planned immunization management stage (1992–2001), the immunization planning management stage (2002–2011), and the implementation stage of the hepatitis B mother-to-child transmission prevention strategy (2012–2020). The decision tree-Markov model was adopted to evaluate the effectiveness of hepatitis B vaccination in newborns from 1992 to 2020.
    Results The positive rate of HBsAg across the entire population declined from 13.79% in 1992 to 5.42% in 2020 (χ2 = 31.73, P < 0.01), with all age groups within the cohort of 0–24 years old experiencing a reduction to 0%. The positive rate of anti-HBs in the age group of 0–4 years old increased from 34.48% in 1992 to 90.16% in 2020 (χ2 = 30.38, P < 0.01). The incidence of hepatitis B significantly decreased among individuals aged 0–29 years old. Particularly, the age groups of 0–4, 5–9, and 10–14 years old during 2012–2020 showed declines of 86.08%, 94.63%, and 94.55% respectively, compared with those in 1992–2001. According to the decision tree-Markov model, compared with those who did not receive hepatitis B vaccination, the vaccination among 114 670 individuals in Fenghua district from 1992 to 2020 prevented 6 894 cases of acute hepatitis B, 30 832 cases of hepatitis B carriers, 4 705 cases of chronic hepatitis B, 4 043 cases of liver cirrhosis, 3 265 cases of liver cancer, and 4 411 hepatitis B-related deaths.
    Conclusions The hepatitis B vaccination program in Fenghua district has yielded remarkable results, significantly decreasing both the positive rate of HBsAg and the incidence of hepatitis B among young age groups. It is imperative to continue enhancing the hepatitis B vaccination efforts for newborns.

     

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