Postgraduate Training for Applied Epidemiology, Robert Koch Institute, Berlin, Germany.
Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
Epidemiol Infect. 2020 Feb 24;148:e36. doi: 10.1017/S0950268820000242.
Since 2015, the number of hepatitis B virus (HBV) cases increased substantially in Germany. In 2015, a more sensitive HBV case definition was introduced. This coincided with an asylum seeker influx with differing screening strategies. Information on the asylum seeker status has been collected since 09/2015. We investigated this increase to interpret HBV notification data in Germany. We compared HBV surveillance data from 2010-2013 (baseline) with 2015-2016, excluding 2014 due to beginning of asylum seeker influx. We estimated the excess above the mean case number (baseline) using Poisson regression and compared asylum seeker cases and the excess of cases with the unknown asylum seeker status. HBV cases increased from 1855 (mean baseline) to 3873 (2015) and 3466 (2016) with 1903 asylum seeker cases and 1099 excess-cases with the unknown asylum seeker status in 2015-2016. Cases only fulfilling the changed case definition increased from 60% (1119) in baseline to 81% (P < 0.01) in 2015-2016; 69% of asylum seeker cases and 61% of excess-cases were males <40 years compared to 27% (baseline) (P < 0.01). Changed case definition increased the number of cases in official statistics substantially. Demographic and geographical distributions suggest that screening of asylum seekers increased the case numbers even to a higher extent than surveillance data indicates.
自 2015 年以来，德国乙型肝炎病毒（HBV）病例数量大幅增加。2015 年，采用了更敏感的 HBV 病例定义。这与寻求庇护者的涌入以及不同的筛查策略同时发生。自 2015 年 9 月以来，一直收集有关寻求庇护者身份的信息。我们调查了这种增长，以解释德国的 HBV 通报数据。我们将 2010-2013 年（基线）的 HBV 监测数据与 2015-2016 年进行了比较，由于寻求庇护者涌入的开始，2014 年除外。我们使用泊松回归估计了平均值以上的病例数（基线），并比较了寻求庇护者病例和未知寻求庇护者身份的病例数。HBV 病例从 1855 例（基线平均值）增加到 3873 例（2015 年）和 3466 例（2016 年），2015-2016 年有 1903 例寻求庇护者病例和 1099 例未知寻求庇护者身份的病例。仅满足变更后病例定义的病例从基线的 60%（1119 例）增加到 2015-2016 年的 81%（P<0.01）；69%的寻求庇护者病例和 61%的超额病例是年龄<40 岁的男性，而基线为 27%（P<0.01）。变更后的病例定义使官方统计数据中的病例数量大大增加。人口统计学和地理分布表明，对寻求庇护者的筛查使病例数量增加的程度甚至超过了监测数据所表明的程度。
