Stępień Małgorzata, Piwowarow Katarzyna, Czarkowski Mirosław P
National Institute of Public Health-National Institute of Hygiene in Warsaw, Department of Epidemiology
Przegl Epidemiol. 2016;70(2):231-241.
The aim of the study was to assess the epidemiological situation of hepatitis B in Poland in 2014 in comparison with the previous years.
The evaluation of the epidemiological situation was carried out on a basis of analysis of data from case-based reports on acute hepatitis B registered by sanitary and epidemiological stations, aggregate data derived from annual bulletins “Infectious diseases and poisonings in Poland”, data from annual bulletin “Vaccinations in Poland” and data on locally registered HBsAg carriers.
In 2014, a total of 2,763 cases of hepatitis B were registered, including 36 cases of HBV and HCV co-infections. Acute cases accounted for 2.5% of all HBV cases, the incidence was 0.18 per 100,000 and was slightly lower than in 2013. In the age group of children up to 14 years which were subject to universal vaccination as neonates, acute infections were not identified, in the age group 15-19 years vaccinated at the age of 14 one acute hepatitis B case was reported . Probably, 75% of acute hepatitis B cases occurred in connection with medical procedures carried out in health care facilities. The incidence of chronic and unknown stage of hepatitis B was 7.0 per 100,000 population and was higher by 85% compared to the previous year. The change in the incidence of chronic and UNK hepatitis B observed is related to the modification of case definition for hep B used in the surveillance in 2014 and changes in the regulations on reporting entities. Chronic and UNK cases were noted 1.4-fold more frequently in men than in women and were 1.5-fold more common among urban than rural dwellers. Great differences in incidence maintain between voivodeships, the highest incidence of chronic hepatitis B was recorded in śląskie voivodeship - 14.5 per 100,000 population. In 2014, 7 people died due to acute hepatitis B, and 44 due to chronic hepatitis B.
Legislation changes in the epidemiological surveillance implemented in 2014 allowed for a more complete assessment of the epidemiological situation of chronic hepatitis B and revealed underestimation of assessments for the previous years. The continuing downward trend in the incidence of acute hepatitis B indicates the effectiveness of universal vaccination of newborns which is effective for 18 years and the sustainability of improvement in sanitary condition and compliance with safety precautions by medical personnel. In a situation when the majority of new infections still occur probably during medical procedures, it is recommended to execute vaccinations in all persons previously unvaccinated, especially those chronically ill and prior to planned surgeries.
本研究旨在评估2014年波兰乙型肝炎的流行病学情况，并与前几年进行比较。
基于对卫生和流行病学站登记的急性乙型肝炎病例报告数据、《波兰传染病和中毒》年度公告中的汇总数据、《波兰疫苗接种》年度公告数据以及当地登记的HBsAg携带者数据进行分析，以评估流行病学情况。
2014年，共登记了2763例乙型肝炎病例，其中包括36例HBV和HCV合并感染病例。急性病例占所有HBV病例的2.5%，发病率为每10万人0.18例，略低于2013年。在新生儿期接受普遍接种疫苗的14岁及以下儿童年龄组中，未发现急性感染病例；在14岁时接种疫苗的15 - 19岁年龄组中，报告了1例急性乙型肝炎病例。可能有75%的急性乙型肝炎病例与医疗机构进行的医疗程序有关。乙型肝炎慢性期和不明阶段的发病率为每10万人口7.0例，比上一年高出85%。观察到的慢性和不明阶段乙型肝炎发病率的变化与2014年监测中使用的乙型肝炎病例定义的修改以及报告实体规定的变化有关。慢性和不明阶段病例在男性中的发现频率比女性高1.4倍，在城市居民中比农村居民高1.5倍。各省份之间的发病率存在很大差异，西里西亚省记录的慢性乙型肝炎发病率最高，为每10万人口14.5例。2014年，7人死于急性乙型肝炎，44人死于慢性乙型肝炎。
2014年实施的流行病学监测立法变化使得能够更全面地评估慢性乙型肝炎的流行病学情况，并揭示了前几年评估的低估情况。急性乙型肝炎发病率持续下降趋势表明新生儿普遍接种疫苗是有效的，这种有效性可持续18年，也表明卫生条件有所改善以及医务人员遵守安全预防措施的可持续性。在大多数新感染可能仍发生在医疗程序期间的情况下，建议对所有以前未接种疫苗的人进行接种，特别是那些慢性病患者和计划手术前的患者。
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