2005—2023年深圳市&lt;10岁儿童乙型病毒性肝炎发病趋势年龄–时期–队列分析

温莹; 张英娈; 罗日景; 王洪琳; 次仁德吉; 黄芳; 张振; 吕秋莹

doi:10.11847/zgggws1146770

2005—2023年深圳市<10岁儿童乙型病毒性肝炎发病趋势年龄–时期–队列分析

Age-period-cohort analysis of hepatitis B virus incidence trends among children under 10 years of age in Shenzhen city from 2005 to 2023: a longitudinal cohort study

摘要

摘要:
目的了解广东省深圳市<10岁儿童2005—2023年乙型病毒性肝炎（乙肝）的发病趋势以及年龄、时期和出生队列因素对其的影响，为当地制定乙肝防控策略提供参考依据。
方法收集中国疾病预防控制信息系统传染病监测模块中2005—2023年深圳市<10岁儿童乙肝发病率数据，采用Joinpoint回归模型分析深圳市<10岁儿童2005—2023年乙肝发病率的变化趋势并计算年度变化百分比（APC）和平均年度变化百分比（AAPC），并应用年龄–时期–队列（APC）模型拟合并估计深圳市<10岁儿童乙肝发病风险中的年龄效应、时期效应和队列效应。
结果深圳市<10岁儿童乙肝发病率从2005年的10.38/10万下降至2023年的1.26/10万（AAPC= −12.20%，P<0.001），其中2005—2011年（APC= −11.30%，P=0.012）和2018—2023年（APC= −31.47%，P<0.001）乙肝发病率均呈单调递减趋势，2011—2018年乙肝发病率为无规律波动变化（APC=3.77%，P=0.371）。APC模型分析结果显示，年龄效应方面，纵向年龄别乙肝发病率0岁组最高，为27.82/10万（95%CI=20.13/10万～38.46/10万），0～2岁下降明显，2～6岁有小幅波动，6岁后随年龄增加发病率逐渐下降，到9岁～组最低，为3.15/10万（95%CI=2.13/10万～4.65/10万）；时期效应方面，乙肝发病率的时期效应随年份推移呈下降趋势，在2006年最高（RR=3.57，95%CI=2.33～5.47），2023年最低（RR=0.32，95%CI=0.17～0.60）；队列效应方面，出生队列越晚儿童的乙肝发病风险越低，队列效应呈波动下降趋势，1996年出生队列最高（RR=1.39，95%CI=0.61～3.19），2020年出生队列最低（RR=0.08，95%CI=0.03～0.19）；深圳市<10岁儿童各年龄组乙肝发病率的局部偏移值均<0，介于0岁～组的−13.04%（95%CI= −16.42%～−9.53%）至9岁～组的−4.92%（95%CI= −7.32%～−2.47%）之间，各年龄组的乙肝发病率随时间推移均呈下降趋势。
结论深圳市<10岁儿童2005—2023年乙肝发病率总体呈下降趋势，该地区儿童乙肝防控工作成效显著。

Abstract:
Objective To understand the incidence trend of hepatitis B virus (HBV) infection among children under 10 years of age in Shenzhen city, Guangdong province, from 2005 to 2023, and the influence of age, period, and birth cohort effects on this trend, to provide a reference for the development of local HBV prevention and control strategies.
Methods Data on the incidence of HBV in children under 10 years of age in Shenzhen city from 2005 to 2023 were collected from the infectious disease surveillance module of the Chinese Center for Disease Control and Prevention Information System. Joinpoint regression was used to analyze the trends in HBV incidence and calculate the annual percentage change (APC) and average annual percentage change (AAPC). An age-period-cohort (APC) model was applied to estimate and simulate the age, period, and cohort effects on the risk of HBV infection in children under 10 years of age in Shenzhen city.
Results The incidence of HBV in children under 10 years of age in Shenzhen city decreased from 10.38/100 000 in 2005 to 1.26/100 000 in 2023 (AAPC = –12.20%, P < 0.001). The incidence of HBV showed a monotonic decreasing trend from 2005 to 2011 (APC = –11.30%, P = 0.012) and from 2018 to 2023 (APC = –31.47%, P < 0.001), while fluctuating irregularly from 2011 to 2018 (APC = 3.77%, P = 0.371). The APC model analysis showed that, in terms of age effects, the incidence of HBV was highest in the 0-year-old age group at 27.82/100 000 (95%CI: 20.13/100 000–38.46/100 000), decreased significantly from 0 to 2 years of age, fluctuated slightly from 2 to 6 years of age, and then gradually decreased with increasing age after 6 years of age, reaching the lowest level in the 9-year-old age group at 3.15/100 000 (95%CI: 2.13/100 000–4.65/100 000). In terms of period effects, the period effect of HBV incidence showed a downward trend over time, with the highest in 2006 (RR = 3.57, 95%CI: 2.33–5.47) and the lowest in 2023( RR = 0.32, 95%CI: 0.17–0.60). In terms of cohort effects, the later the birth cohort, the lower the risk of HBV infection in children. The cohort effect showed a fluctuating downward trend, with the highest in the 1996 birth cohort (RR = 1.39, 95%CI: 0.61–3.19) and the lowest in the 2020 birth cohort (RR = 0.08, 95%CI: 0.03–0.19). The local drifts of HBV incidence in all age groups of children under 10 years of age in Shenzhen city were less than 0, ranging from –13.04% (95%CI: –16.42% to –9.53%) in the 0-year-old age group to –4.92% (95%CI: –7.32% to –2.47%) in the 9-year-old age group, and the incidence of HBV in all age groups showed a downward trend over time.
Conclusions The incidence of HBV in children under 10 years of age in Shenzhen city showed an overall downward trend from 2005 to 2023, indicating that the HBV prevention and control efforts in this area have been effective.

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