Meng T T, Miao N, Wang F Z, Zheng H, Yin Z D, Liang X F, Zhang G M
Department of National Immunization Program，Chinese Center for Disease Control and Prevention，Beijing 100050，China.
School of Medicine，Jinan University，Guangzhou 510632，China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Sep 10;42(9):1532-1536. doi: 10.3760/cma.j.cn112338-20210319-00233.
To understand the characteristics of hepatitis B cases reported through the National Notifiable Disease Reported System (NNDRS) of China in 2019, analyze the quality of hepatitis B reporting. The survey forms and reporting cards of hepatitis B cases in 200 surveillance points in China in 2019 were collected from NNDRS, the completeness rate of the reporting card was calculated, and the reported hepatitis B cases were verified based on the diagnostic criteria (WS 299-2008). The clinical types of the cases after verification were compared with the reported ones, the consistency was evaluated with Kappa test. The reasons for the inconsistent clinical types of the cases were analyzed. In 2019, a total of 64 686 hepatitis B cases were reported through NNDRS. Acute, chronic and unclassified hepatitis B cases accounted for 5.8%, 92.4% and 1.8%, respectively. The average age of reported cases was 47 (47±15) years, and males accounted for 64.4%. The average level of alanine aminotransferase was 214.2 (214.2±1 253.4) U/L. The reported cases mainly worked in agriculture, forestry, animal husbandry, fishery, and water conservancy (50.6%, 32 722). The proportions of cases reported from the eastern, western and central regions were 42.5% (27 501),22.1% (14 315) and 35.4% (22 870), respectively. The consistent rate of the clinical types between the reported cases and the verified cases was 58.8%, with a Kappa value of 0.15. For the 39 271 cases confirmed as acute and chronic hepatitis B cases in the reporting cards, the consistent rate of the clinical types between the reported cases and the verified cases was 96.9%, with a Kappa value of 0.73. In 94.5% (24 267/25 681) of the cases with inconsistent clinical types, the reporting card information were incomplete. The diagnosis of hepatitis B has been improved in the hepatitis B surveillance in China, but it is necessary to improve the completeness of the reporting cards of hepatitis B cases to NNDRS.
为了解2019年通过中国国家法定传染病报告系统（NNDRS）报告的乙型肝炎病例特征，分析乙型肝炎报告质量。从NNDRS收集2019年中国200个监测点乙型肝炎病例的调查表和报告卡，计算报告卡完整率，并依据诊断标准（WS 299-2008）对报告的乙型肝炎病例进行核实。将核实后病例的临床类型与报告的临床类型进行比较，采用Kappa检验评估一致性。分析病例临床类型不一致的原因。2019年通过NNDRS共报告乙型肝炎病例64686例。急性、慢性和未分类乙型肝炎病例分别占5.8%、92.4%和1.8%。报告病例的平均年龄为47（47±15）岁，男性占64.4%。丙氨酸氨基转移酶平均水平为214.2（214.2±1253.4）U/L。报告病例主要从事农、林、牧、渔业和水利业（50.6%，32722例）。东部、西部和中部地区报告病例的比例分别为42.5%（27501例）、22.1%（14315例）和35.4%（22870例）。报告病例与核实病例临床类型的一致率为58.8%，Kappa值为0.15。对于报告卡中确诊为急性和慢性乙型肝炎病例的39271例，报告病例与核实病例临床类型的一致率为96.9%，Kappa值为0.73。在临床类型不一致病例的94.5%（24267/25681）中，报告卡信息不完整。中国乙型肝炎监测中乙型肝炎诊断已有改善，但仍需提高向NNDRS报告的乙型肝炎病例报告卡的完整性。
