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目的了解海南省现阶段人群乙型病毒(HBV)性肝炎(以下简称乙肝)感染状况,评价1992年我国乙肝疫苗推广接种和2002年纳入儿童计划免疫实施效果。方法采用多阶段随机抽样方法,随机抽取1～59岁人群进行问卷调查,同时采集静脉血标本,标本由中国疾病预防控制中心统一检测乙肝感染标识物。结果海南省1～59岁人群HBV感染率为40.8%,HBsAg携带率为8.4%,分别较1992年前自然感染期下降了43.6个和9.4百分点。人群中有乙肝疫苗免疫史者占45.4%。1～4岁和5～14岁儿童乙肝疫苗全程接种率分别为97.3%和65.4%,及时接种率分别为84.0%和41.1%,HBV感染率为3.7%和20.6%,HBsAg携带率分别为1.1%和4.04%。15～59岁人群HBV感染率和HBsAg携带率分别为65.9%和13.5%,HBV感染率随年龄增长而升高。除1～4岁组外,城市人群乙肝疫苗接种率、首针及时接种率高于农村,人群HBV感染率、HBsAg携带率远低于农村。农民、工人HBV感染率、HB-sAg携带率高于其它职业人群,人群感染率和HBsAg携带率有随文化程度提高而下降趋势。人群乙肝感染存在家庭聚集性,聚集率为44.1%。结论海南省自1992年推广应用乙肝疫苗后,特别纳入儿童计划免疫实行免费接种后,有效控制了乙肝的传播,15岁以下儿童乙肝接种率和首针及时接种率大幅提高,HBV感染率、HBsAg携带率大幅下降,母婴垂直传播导致的家庭聚集感染是海南省人群乙肝感染率高的主要因素。
Objective To understand the current status of hepatitis B virus (HBV) infection in Hainan Province at this stage and to evaluate the implementation effect of vaccination and hepatitis B vaccination in China in 1992 and planned immunization in 2002. Methods A multi-stage random sampling method was used to randomly select the population from 1 to 59 years old to conduct questionnaire survey. Venous blood samples were collected at the same time. The specimens were tested for HBV infection by the Chinese Center for Disease Control and Prevention. Results In Hainan Province, the HBV infection rate was 40.8% and the HBsAg carrier rate was 8.4% in the population aged 1- 59 years, down 43.6 and 9.4 percentage points from the natural infection period before 1992 respectively. The population has a history of hepatitis B vaccine immunization accounted for 45.4%. The overall vaccination rates of hepatitis B vaccine in children aged 1 to 4 years and children aged 5 to 14 were 97.3% and 65.4% respectively, the timely vaccination rates were 84.0% and 41.1%, the HBV infection rates were 3.7% and 20.6%, and the HBsAg carrier rates were 1.1 % And 4.04%. The HBV infection rate and HBsAg carrier rate in 15- 59-year-old population were 65.9% and 13.5%, respectively. The HBV infection rate increased with age. In addition to 1 to 4-year-old group, the city population hepatitis B vaccination rate, the first needle timely vaccination rate higher than the rural population HBV infection rate, HBsAg carrier rate far lower than in rural areas. HBV infection rate of farmers and workers, HB-sAg carrier rate higher than other occupational groups, population infection rates and HBsAg carrier rate with the education level increased and declining. There is family aggregation of hepatitis B infection in the population, with an aggregation rate of 44.1%. CONCLUSIONS: After hepatitis B vaccine was introduced and used in Hainan Province in 1992, immunization of children with special vaccination was included to effectively control the spread of hepatitis B. The hepatitis B vaccination rate and timely first-dose vaccination rate of children under 15 years old were significantly increased. HBV infection rate, HBsAg The incidence of hepatitis B infection in Hainan Province is the main factor in the family aggregation infection caused by the vertical transmission of mother and baby.