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目的为了解湖南省1~59岁人群乙型肝炎(乙肝)病毒表面抗原(Hepatitis B Virus Surface Antigen,HBs Ag)和抗乙肝病毒表面抗原抗体(Antibody to HBs Ag,Anti-HBs)流行率,掌握乙肝流行现况,评价乙肝疫苗(Hepatitis B Vaccine,Hep B)纳入儿童免疫规划后的效果,制定今后乙肝预防控制(防控)计划提供参考。方法采用分层三阶段整群随机抽样方法,第一阶段抽取县(市、区),第二阶段抽取村(居委会),第三阶段抽取调查对象个体。根据公式n=400×Q/P进行样本量估算,P(1~59岁人群HBs Ag流行率)按4%计算,本次调查需总样本量为9600。使用统计分析系统(Statistical Analysis System,SAS)9.4编程软件对本次的HBs Ag、Anti-HBs流行率调查资料进行统计分析。统计分析方法采用复杂调查设计为基础的估计方法进行参数估计,用调查设计权重进行总体率的加权估计,采用泰勒级数线性法估计率的方差。结果湖南省1~59岁人群HBs Ag、Anti-HBs流行率分别为7.23%、52.02%。城市人群HBs Ag、Anti-HBs流行率分别为6.09%、50.98%;农村人群HBs Ag、Anti-HBs流行率分别为8.33%、53.04%。男性HBs Ag、Anti-HBs流行率分别为8.18%、51.37%;女性HBs Ag、Anti-HBs流行率分别为6.27%、52.68%。1~4岁、5~14岁、15~59岁HBs Ag流行率分别为0.82%、1.71%、8.68%,Anti-HBs流行率分别为54.77%、55.25%、51.25%。结论湖南省Hep B纳入儿童免疫规划效果显著,1~4岁儿童HBs Ag流行率已降至<1%。但乙肝防控形势仍然严峻,1~59岁人群HBs Ag流行率>7%,仍属乙肝中度流行地区。
Objective To understand the prevalence of Hepatitis B Virus Surface Antigen (HBsAg) and anti-HBsAg (Anti-HBs) in people aged 1- 59 in Hunan province. Hepatitis B Vaccine (Hep B) to assess the effect of Hepatitis B Vaccine (Hep B) on children’s immunization program, and to provide a reference for future plans of Hepatitis B prevention and control (Hepatitis B Prevention and Control). Methods The stratified three-stage cluster random sampling method was adopted. In the first stage, counties (cities and districts) were drawn, and villages (neighborhood committees) were taken in the second stage. Individuals were selected in the third stage. The sample size was estimated according to the formula n = 400 × Q / P. P (prevalence of HBsAg in people aged 1-59 years) was calculated at 4%. The total sample size required for this survey was 9,600. The statistical analysis system (Statistical Analysis System, SAS) 9.4 programming software was used for statistical analysis of the prevalence survey data of HBs Ag and Anti-HBs. The statistical analysis method uses the complex survey design-based estimation method to estimate the parameters, uses the survey design weight to carry on the weighted estimation of the overall rate, and adopts the Taylor series linear method to estimate the variance of the rate. Results The prevalence rates of HBs Ag and Anti-HBs in Hunan Province from 1 to 59 years old were 7.23% and 52.02% respectively. The prevalence rates of HBsAg and Anti-HBs in urban population were 6.09% and 50.98% respectively. The prevalence rates of HBsAg and Anti-HBs in rural population were 8.33% and 53.04% respectively. The prevalence rates of HBsAg and Anti-HBs in males were 8.18% and 51.37% respectively. The prevalence rates of HBsAg and Anti-HBs in males were 6.27% and 52.68% respectively. The prevalence rates of HBsAg between 1 to 4 years old, 5 to 14 years old and 15 to 59 years old were 0.82%, 1.71% and 8.68%, respectively. The prevalences of Anti-HBs were 54.77%, 55.25% and 51.25% respectively. Conclusion The inclusion of Hep B in children’s immunization program in Hunan Province is remarkable. The prevalence of HBsAg in children aged 1 to 4 has dropped to <1%. However, the status of prevention and control of hepatitis B is still grim. The prevalence of HBsAg in people aged 1-59 is> 7%, which is still moderately epidemic in hepatitis B patients.