Marschall Tanja, Kretzschmar Mirjam, Mangen Marie-Josee J, Schalm Solko
Department of Public Health Medicine, School of Public Health, University of Bielefeld, Bielefeld, Germany.
Eur J Gastroenterol Hepatol. 2008 Dec;20(12):1214-25. doi: 10.1097/MEG.0b013e32830e289e.
A representative serosurveillance study (1995) resulted in an estimate of 0.2% for the HBsAg prevalence in the Netherlands. Some risk groups, especially migrants, were not well represented in the study, which probably led to an underestimation of the true HBsAg prevalence. The aim of this study was to calculate an adjusted HBsAg prevalence estimate for the total Dutch population including these risk groups.
According to their country of origin first-generation migrants (FGM) were classified into groups with low, intermediate and high prevalence using data from the WHO and Statistics Netherlands. The number of chronic HBsAg carriers in different age and population groups was estimated based on studies about age-specific prevalence in different countries. The number of carriers in the indigenous population was estimated using the serosurveillance study. A combination of these estimates led to an estimate of the total prevalence rate in the Netherlands.
Nearly 10% of the Dutch population are FGM. Of these, about 18% were born in low-endemic, 71% in middle-endemic and 11% in high-endemic countries. The overall prevalence of HBsAg in FGM is estimated to be at 3.77%. Combining these results with the results of the serosurveillance study the HBsAg prevalence in the Dutch population is estimated to be between 0.32 and 0.51%, and when including injecting drug users and mentally handicapped persons the prevalence rates are 0.36 and 0.55%, respectively.
Our results show the high importance of targeting migrants and their close contacts adequately in screening programmes, vaccination and treatment for chronic hepatitis B.
一项具有代表性的血清学监测研究（1995年）得出荷兰乙肝表面抗原（HBsAg）流行率估计值为0.2%。一些风险群体，尤其是移民，在该研究中代表性不足，这可能导致对真实HBsAg流行率的低估。本研究的目的是计算包括这些风险群体在内的荷兰总人口经调整后的HBsAg流行率估计值。
根据其原籍国，利用世界卫生组织和荷兰统计局的数据，将第一代移民（FGM）分为低、中、高流行率组。根据不同国家特定年龄流行率的研究，估计不同年龄和人群组中慢性HBsAg携带者的数量。利用血清学监测研究估计本土人群中的携带者数量。将这些估计值相结合，得出荷兰总流行率的估计值。
近10%的荷兰人口是第一代移民。其中，约18%出生在低流行区国家，71%出生在中流行区国家，11%出生在高流行区国家。第一代移民中HBsAg的总体流行率估计为3.77%。将这些结果与血清学监测研究结果相结合，荷兰人口中HBsAg流行率估计在0.32%至0.51%之间，若将注射吸毒者和智障人士包括在内，流行率分别为0.36%和0.55%。
我们的结果表明，在慢性乙型肝炎的筛查计划、疫苗接种和治疗中，充分针对移民及其密切接触者具有高度重要性。
