Liu Z X, Wang Y S, Wang W B
Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Apr 10;42(4):613-619. doi: 10.3760/cma.j.cn112338-20201026-01281.
To analyze the changes in the morbidity and mortality of hepatitis B in China from 1990 to 2017, and provide evidence for prevention and control of hepatitis B. The reported incidence and death data of hepatitis B from the Data-Center of China Public Health Science and demographic data from the National Bureau of Statistics were used, Excel 2016 was used to establish the databases of reported hepatitis B cases and deaths, respectively. The Joinpoint regression model was used through Joinpoint software 4.8.0.1 to estimate the average annual percent change of annual reported incidence and mortality of hepatitis B in different age groups and provinces in China from 1990 to 2017 in order to further explore the trend of hepatitis B incidence. Software R 3.6.2 was used for statistical analysis and data visualization. A total of 20 793 233 hepatitis B cases were reported from January 1990 to December 2017 in China with average annual reported incidence of 58.19/100 000. The average annual reported incidence appeared highest in age group 25-29 years (119.67/100 000) and the annual reported incidence increased in group aged 45 years and above. Besides, the reported case fatality rate reached the highest in group aged 85 years and above (2.26/1 000). The reported incidence showed increasing trends in 23 provinces (<0.05), stable in 7 provinces (>0.05), and decreasing in 2 provinces (<0.05). The report of hepatitis B was mainly from adult population in China, and the reported incidence of hepatitis B in this population was in increase. In some provinces of the eastern China where immunization measures have been in place and the treatment level is relatively high, the incidence of hepatitis B has been leveled off; the incidences in most provinces in western China are still in increase. Therefore, more targeted prevention and control strategies should be taken in different provinces.
分析1990年至2017年中国乙型肝炎发病率和死亡率的变化情况，为乙型肝炎的预防和控制提供依据。利用中国公共卫生科学数据中心报告的乙型肝炎发病和死亡数据以及国家统计局的人口数据，分别使用Excel 2016建立乙型肝炎报告病例和死亡数据库。通过Joinpoint软件4.8.0.1使用Joinpoint回归模型，估计1990年至2017年中国不同年龄组和省份乙型肝炎年度报告发病率和死亡率的年均变化百分比，以进一步探索乙型肝炎发病率趋势。使用软件R 3.6.2进行统计分析和数据可视化。1990年1月至2017年12月中国共报告20793233例乙型肝炎病例，年均报告发病率为58.19/10万。年均报告发病率在25 - 29岁年龄组最高（119.67/10万），45岁及以上年龄组年度报告发病率呈上升趋势。此外，报告病死率在85岁及以上年龄组最高（2.26/1000）。报告发病率在23个省份呈上升趋势（<0.05），7个省份呈稳定趋势（>0.05），2个省份呈下降趋势（<0.05）。中国乙型肝炎报告主要来自成人人群，该人群乙型肝炎报告发病率呈上升趋势。中国东部一些实施了免疫措施且治疗水平相对较高的省份，乙型肝炎发病率已趋于平稳；中国西部大多数省份的发病率仍在上升。因此，不同省份应采取更具针对性的防控策略。
