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2018年波兰的乙型肝炎情况

Hepatitis B in Poland in 2018.

作者信息

Wiktor Aleksandra, Stępień Małgorzata

机构信息

National Institute of Public Health - National Institute of Hygiene in Warsaw, Department of Epidemiology of Infectious Diseases and Surveillance.

出版信息

Przegl Epidemiol. 2020;74(2):196-208. doi: 10.32394/pe.74.16.

Abstract

OBJECTIVE

Evaluation of the epidemiological situation of hepatitis B in Poland in 2018 compared to the situation in previous years.

MATERIAL AND METHODS

The epidemiological situation was assessed based on the results of the analysis of individual data on hepatitis B cases and HBV infections registered by Local Sanitary- Epidemiological Stations in the central database using Epidemiological Interview Registration System (SRWE). Aggregate data published in the annual bulletins "Infectious Diseases and Poisonings in Poland" and "Vaccinations in Poland" were also used.

RESULTS

In 2018, a total of 3 196 hepatitis B cases were registered, which corresponds to an incidence of 8.3 cases per 100,000 population. Acute hepatitis B cases accounted for about 1.3 % of total. The incidence of acute hepatitis B was lower by 33% than in 2017 and lower by 44% than median of the years 2012-2016. No acute cases were reported among children and adolescents aged 0-19 years and in the age group 20-24. The incidence of chronic and unknown (in terms of the stage) was lower by 4.5% than in the previous year however, in comparison to median incidence of chronic hepatitis B in 2012-2016 an increase of 17% was noted. As in the previous years, acute, chronic and unknown stage (UNK) hepatitis B were more often detected in men and in urban residents. The dominant route of transmission of HBV infections still remains procedures performed in medical settings - 86% of cases with a known transmission route. The coverage with the third HBV vaccine dose in children aged two years was 91 % and remains ( since 2017) below the 95% required in the elimination strategy. In 2018 three people died due to acute hepatitis B and 35 people due to chronic hepatitis B.

CONCLUSIONS

In 2018 decrease in the incidence of acute and chronic hepatitis B was observed. In group of persons born after 1994 covered by obligatory hepatitis B vaccinations as newborns no acute cases have been reported, however, a progressive decline in children's vaccination coverage poses a risk for new HBV infection also among people subjected to mandatory vaccinations. Maintenance of a low incidence of acute hepatitis B requires improvement in carrying out of mandatory vaccination among newborns and further recommendation of vaccination for all persons previously unvaccinated. A slight decline in the detection of chronic and UNK cases may be related to the number of tests performed in a given year.

摘要

目的

评估2018年波兰乙型肝炎的流行病学状况,并与前几年的情况进行比较。

材料与方法

基于使用流行病学访谈登记系统(SRWE)对地方卫生防疫站在中央数据库中登记的乙型肝炎病例和HBV感染的个体数据进行分析的结果,评估流行病学状况。还使用了发表在年度公报《波兰的传染病和中毒》及《波兰的疫苗接种》中的汇总数据。

结果

2018年共登记了3196例乙型肝炎病例,发病率为每10万人8.3例。急性乙型肝炎病例约占总数的1.3%。急性乙型肝炎的发病率比2017年低33%,比2012 - 2016年的中位数低44%。在0 - 19岁儿童和青少年以及20 - 24岁年龄组中未报告急性病例。慢性和不明(阶段方面)病例的发病率比上一年低4.5%,然而,与2012 - 2016年慢性乙型肝炎的中位数发病率相比,增加了17%。与前几年一样,急性、慢性和不明阶段(UNK)的乙型肝炎在男性和城市居民中更常被检测到。HBV感染的主要传播途径仍然是医疗环境中进行的操作——86%的病例有已知传播途径。两岁儿童的第三剂乙肝疫苗接种覆盖率为91%,并且(自2017年以来)仍低于消除战略要求的95%。2018年有3人死于急性乙型肝炎,35人死于慢性乙型肝炎。

结论

2018年观察到急性和慢性乙型肝炎发病率下降。在1994年以后出生的新生儿中接受强制性乙肝疫苗接种的人群中未报告急性病例,然而,儿童疫苗接种覆盖率的逐渐下降也给接受强制性疫苗接种的人群带来了新的HBV感染风险。维持急性乙型肝炎的低发病率需要改善新生儿强制性疫苗接种的实施情况,并进一步建议所有以前未接种疫苗的人接种疫苗。慢性和UNK病例检测的轻微下降可能与特定年份进行的检测数量有关。

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