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目的了解甲型肝炎疫苗(甲肝疫苗)纳入免疫规划对甲型肝炎发病率的影响,为制定甲型肝炎防控策略提供依据。方法利用细菌性痢疾平衡疫情漏报率和卫生习惯对甲型肝炎发病率的影响,分析接种率和甲型肝炎调整发病率间的关系。结果全人群甲型肝炎的发病率由2005年的1.43/10万下降到了2014年的0.42/10万,下降幅度70.63%;调整后的全人群甲型肝炎发病率由2005年的0.98/10万下降到了2014年的0.76/10万,下降幅度22.45%。评价单纯甲肝疫苗接种对甲型肝炎发病的影响,0~4岁组儿童甲型肝炎发病率下降68.85%,其中疫苗贡献44.44%;5~9岁组下降95.52%,其中疫苗贡献77.14%;10~14岁组下降94.97%,其中疫苗贡献79.73%;15~20岁组下降78.84%,其中疫苗贡献3.19%。结论从全人群角度来看,生活习惯的改变对甲型肝炎发病率下降的贡献要高,但从疫苗覆盖年龄组来看,14岁以下儿童甲肝疫苗接种对甲型肝炎发病率下降的贡献要高于生活习惯的改变,并且随着时间的延长,疫苗接种受益人群的扩大,甲肝疫苗接种对降低甲型肝炎发病率的贡献将更加明显。
Objective To understand the influence of hepatitis A vaccine (Hepatitis A vaccine) on the incidence of hepatitis A in immunization programs and provide evidence for the development of Hepatitis A prevention and control strategies. Methods The use of bacillary dysentery to balance the incidence of false negatives and health habits on the incidence of hepatitis A, analysis of vaccination rates and the incidence of hepatitis A relationship between the adjustment. Results The incidence of hepatitis A in the entire population dropped from 1.43 / 100 000 in 2005 to 0.42 / 100 000 in 2014, a decrease of 70.63%. The adjusted incidence of hepatitis A in the entire population increased from 0.98 / 100 000 in 2005 Dropped to 0.76 / 100,000 in 2014, a decrease of 22.45%. The incidence of hepatitis A in children aged 0-4 years decreased by 68.85%, of which the vaccine contribution was 44.44%. The incidence of hepatitis A decreased 95.52% in 5 to 9 years old groups, of which the vaccine contributed 77.14%. 10 ~ 14 years old group decreased 94.97%, of which 79.73% vaccine contribution; 15 to 20 years old group decreased 78.84%, of which 3.19% vaccine contribution. CONCLUSIONS From a population perspective, lifestyle changes have a higher contribution to the decline in the incidence of hepatitis A, but from the vaccine-covered age group, the contribution of hepatitis A vaccination among children under 14 years to the decline in the incidence of hepatitis A Higher than lifestyle changes, and with the extension of time, the beneficiary population of vaccination to expand, hepatitis A vaccination to reduce the incidence of hepatitis A contribution will be more apparent.