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美国越南裔人群乙型肝炎患病率及危险因素分析:基于社区筛查项目的横断面研究。

Insight into hepatitis B prevalence and risk factors among Vietnamese Americans: a cross-sectional analysis of data from a community-based screening program.

机构信息

Department of Public Health, California State University, Fullerton, California, USA

Department of Kinesiology, California State University, Stanislaus, Turlock, California, USA.

出版信息

BMJ Open. 2019 Aug 26;9(8):e029616. doi: 10.1136/bmjopen-2019-029616.

Abstract

OBJECTIVES

The aims of our study were to describe current hepatitis B prevalence among Vietnamese Americans and to examine predictors of hepatitis B risk in this specific ethnic community.

DESIGN

Cross-sectional analysis of data from a community-based screening program.

SETTING

This analysis was based on hepatitis screening community events in Southern California.

PARTICIPANTS

2508 Vietnamese Americans in Southern California.

OUTCOME MEASURES

Serological tests for hepatitis B surface antigen, hepatitis B surface antibody, and total hepatitis B core antibody were used to classify participants as one of four hepatitis B infection statuses: currently infected, previously infected, susceptible, or immune due to a previous hepatitis B vaccination.

RESULTS

Across 2508 participants, 9.0% were currently infected with hepatitis B and 17.7% were at risk for hepatitis B. Females and those reporting a previous hepatitis B vaccination were at significant decreased risk of hepatitis B (OR=0.48, 95% CI 0.33 to 0.69 and OR=0.53, 95% CI 0.31 to 0.93, respectively) whereas those born outside of the USA and with a family history of the disease showed substantial increased risk (OR=13.36, 95% CI 1.62 to 110.05 and OR=4.68, 95% CI 2.66 to 8.22, respectively). Among those who reported a previous hepatitis B vaccination, less than half (42.9%) possessed the protective antibodies that result from a hepatitis B vaccination.

CONCLUSIONS

Vietnamese Americans remain disproportionately burdened by hepatitis B. Public health efforts that focus on improving hepatitis B awareness and vaccination knowledge and that are tailored to specific high-risk subgroups, such as immigrants and those with infected family members, could help in addressing the disease's burden in this high-prevalence population.

摘要

目的

本研究旨在描述越南裔美国人中乙型肝炎的流行情况,并探讨该特定族裔社区中乙型肝炎风险的预测因素。

设计

基于社区为基础的筛查计划的数据的横断面分析。

地点

本分析基于南加州的肝炎筛查社区活动。

参与者

南加州的 2508 名越南裔美国人。

结局指标

使用乙型肝炎表面抗原、乙型肝炎表面抗体和总乙型肝炎核心抗体的血清学检测将参与者分为以下四种乙型肝炎感染状态之一:目前感染、既往感染、易感染或因既往乙型肝炎疫苗接种而具有免疫力。

结果

在 2508 名参与者中,9.0%目前感染乙型肝炎,17.7%有乙型肝炎感染风险。女性和报告既往乙型肝炎疫苗接种者乙型肝炎风险显著降低(OR=0.48,95%CI 0.33 至 0.69 和 OR=0.53,95%CI 0.31 至 0.93),而出生于美国以外和有家族史的人乙型肝炎风险显著增加(OR=13.36,95%CI 1.62 至 110.05 和 OR=4.68,95%CI 2.66 至 8.22)。在报告既往乙型肝炎疫苗接种的人群中,不到一半(42.9%)具有乙型肝炎疫苗接种产生的保护性抗体。

结论

越南裔美国人仍然不成比例地受到乙型肝炎的影响。针对特定高危亚组(如移民和感染家庭成员)的公共卫生努力,重点是提高乙型肝炎的认识和疫苗接种知识,可能有助于解决该高流行人群的疾病负担问题。

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