2004 - 2021年中国不明病因肝炎的时空模式变化：一项基于人群的监测研究

Changing spatiotemporal patterns for hepatitis of unspecified aetiology in China, 2004-2021: a population-based surveillance study.

作者信息

Zhao Na, Guo Xiangyu, Wang Lan, Zhou Hongming, Gong Lei, Miao Ziping, Chen Yijuan, Qin Shuwen, Yu Zhao, Liu Shelan, Wang Supen

机构信息

School of Ecology and Environment, Anhui Normal University, Wuhu, Anhui Province, China.

Institute of Zoology, Chinese Academy of Sciences, Beijing, China.

出版信息

Front Public Health. 2023 May 5;11:1177965. doi: 10.3389/fpubh.2023.1177965. eCollection 2023.

DOI:10.3389/fpubh.2023.1177965

PMID:37213628

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10196104/

Abstract

OBJECTIVES

As global efforts continue toward the target of eliminating viral hepatitis by 2030, the emergence of acute hepatitis of unspecified aetiology (HUA) remains a concern. This study assesses the overall trends and changes in spatiotemporal patterns in HUA in China from 2004 to 2021.

METHODS

We extracted the incidence and mortality rates of HUA from the Public Health Data Center, the official website of the National Health Commission of the People's Republic of China, and the National Notifiable Infectious Disease Surveillance System from 2004 to 2021. We used R software, ArcGIS, Moran's statistical analysis, and joinpoint regression to examine the spatiotemporal patterns and annual percentage change in incidence and mortality of the HUA across China.

RESULTS

From 2004 to 2021, a total of 707,559 cases of HUA have been diagnosed, including 636 deaths. The proportion of HUA in viral hepatitis gradually decreased from 7.55% in 2004 to 0.72% in 2021. The annual incidence of HUA decreased sharply from 6.6957 per 100,000 population in 2004 to 0.6302 per 100,000 population in 2021, with an average annual percentage change (APC) reduction of -13.1% ( < 0.001). The same result was seen in the mortality (APC, -22.14%, from 0.0089/100,000 in 2004 to 0.0002/100,000 in 2021, < 0.001). All Chinese provinces saw a decline in incidence and mortality. Longitudinal analysis identified the age distribution in the incidence and mortality of HUA did not change and was highest in persons aged 15-59 years, accounting for 70% of all reported cases. During the COVID-19 pandemic, no significant increase was seen in pediatric HUA cases in China.

CONCLUSION

China is experiencing an unprecedented decline in HUA, with the lowest incidence and mortality for 18 years. However, it is still important to sensitively monitor the overall trends of HUA and further improve HUA public health policy and practice in China.

摘要

目标

随着全球继续努力实现到2030年消除病毒性肝炎的目标，病因不明的急性肝炎（HUA）的出现仍然令人担忧。本研究评估了2004年至2021年中国HUA的总体趋势以及时空模式的变化。

方法

我们从中华人民共和国国家卫生健康委员会官方网站公共卫生数据中心以及国家法定传染病监测系统中提取了2004年至2021年HUA的发病率和死亡率。我们使用R软件、ArcGIS、莫兰统计分析和连接点回归来研究中国HUA发病率和死亡率的时空模式以及年度百分比变化。

结果

2004年至2021年，共诊断出707559例HUA病例，其中636例死亡。HUA在病毒性肝炎中的比例从2004年的7.55%逐渐降至2021年的0.72%。HUA的年发病率从2004年的每10万人6.6957例急剧下降至2021年的每10万人0.6302例，年度百分比变化（APC）平均下降-13.1%（P<0.001）。死亡率也有同样的结果（APC，-22.14%，从2004年的每10万人0.0089例降至2021年的每10万人0.0002例，P<0.001）。中国所有省份的发病率和死亡率均呈下降趋势。纵向分析发现，HUA发病率和死亡率的年龄分布没有变化，15至59岁人群中发病率和死亡率最高，占所有报告病例的70%。在新冠疫情期间，中国儿童HUA病例没有显著增加。