He Hanqing, Zhou Yang, Xie Shuyun
Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China.
Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China.
Vaccine. 2017 Aug 24;35(36):4702-4706. doi: 10.1016/j.vaccine.2017.07.039. Epub 2017 Jul 24.
Hepatitis B virus (HBV) infection control has seen improvements since the introduction of the HBV vaccination program in China. However, the reported incidence rate of HBV infection remains high owing to the large pool of individuals infected before the start of the HBV immunization program. The duplicated reporting of HBV had a remarkable effect on the overestimation of HBV disease burden, according to the Chinese National Notifiable Diseases Report System (NNDRS).
We analyzed the data of HBV in Zhejiang province, China, collected for the years 2005-2015 from the NNDRS. The duplicate reporting cases of HBV were captured according to the same identification number or the same name, sex and date of birth, or the same name, sex and resident town/street code. We assessed the magnitude of duplicated reporting of HBV and explored the possible factors contributing to duplicated reporting.
There were 20,078 redundant HBV cases reported from the NNDRS during 2005-2015, which accounted for 6.33% (19,272/305,654) of all patients owing to duplicate reporting in Zhejiang province, China. Some risk factors, including male sex, age ≥20years, chronic cases, residence in outside counties, and farming as an occupation (odds ratio [OR]=1.06; 95% confidence interval [CI]: 1.02-1.11) were positively associated with the risks on duplicate reporting.
Our results demonstrated that the duplicated reporting of HBV infection is common in Zhejiang, China, which has contributed to a higher HBV infection prevalence than its real value. Some characteristics might affect the probability of duplicate reporting, including sex, occupation, place of residence, HBV type, and hospital type. These findings indicated the strong need to improve the data collection, deletion of duplications, and HBV classification during HBV surveillance, in order to obtain an accurate estimate of HBV disease burden in China. We also suggest establishing a specialized system to achieve high-quality HBV infection surveillance effectively and practically.
自中国引入乙肝疫苗接种计划以来，乙肝病毒（HBV）感染控制取得了进展。然而，由于在乙肝免疫计划开始之前就存在大量感染者，报告的HBV感染发病率仍然很高。根据中国国家法定传染病报告系统（NNDRS），HBV的重复报告对高估HBV疾病负担有显著影响。
我们分析了中国浙江省2005 - 2015年从NNDRS收集的HBV数据。根据相同的识别号、相同的姓名、性别和出生日期，或相同的姓名、性别和居住城镇/街道代码来捕捉HBV的重复报告病例。我们评估了HBV重复报告的程度，并探讨了导致重复报告的可能因素。
2005 - 2015年期间，NNDRS报告了20,078例冗余HBV病例，在中国浙江省，由于重复报告，这些病例占所有患者的6.33%（19,272/305,654）。一些风险因素，包括男性、年龄≥20岁、慢性病患者、居住在县外以及从事农业职业（优势比[OR]=1.06；95%置信区间[CI]：1.02 - 1.11）与重复报告风险呈正相关。
我们的结果表明，HBV感染的重复报告在中国浙江省很常见，这导致HBV感染患病率高于其实际值。一些特征可能会影响重复报告的概率，包括性别、职业、居住地、HBV类型和医院类型。这些发现表明，在HBV监测期间，迫切需要改进数据收集、删除重复数据以及HBV分类，以便准确估计中国的HBV疾病负担。我们还建议建立一个专门系统，以有效且切实地实现高质量的HBV感染监测。
