2007年至2021年中国东部甲型肝炎发病率的趋势与预测：年龄-时期-队列分析

Trends and projections of Hepatitis A incidence in eastern China from 2007 to 2021: an age-period-cohort analysis.

作者信息

Peng Hui, Wang Yin, Wei Songting, Kang Weili, Zhang Xuefeng, Cheng Xiaoqing, Bao Changjun

机构信息

GuSu Center for Disease Prevention and Control, Suzhou, China.

Jiangsu Field Epidemiology Training Program, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China.

出版信息

Front Public Health. 2024 Dec 4;12:1476748. doi: 10.3389/fpubh.2024.1476748. eCollection 2024.

DOI:10.3389/fpubh.2024.1476748

PMID:39697280

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11652658/

Abstract

OBJECTIVE

This study aimed to analyze the trends in Hepatitis A incidence associated with age, period, and birth cohorts from 2007 to 2021 in Jiangsu Province, China, and projects the future burden through 2031.

METHODS

Data on Hepatitis A cases in Jiangsu Province from 2007 to 2021 were obtained from the National Notifiable Disease Reporting System. Joinpoint regression analysis identified significant changes in incidence trends. The age-period-cohort model assessed the effects of age, period, and cohort on Hepatitis A incidence rates. Projections for 2022-2031 were generated using the Bayesian age-period-cohort model.

RESULTS

From 2007 to 2021, Hepatitis A incidence in Jiangsu Province significantly declined, with an average annual percent change (AAPC) of -10.77%. The decline was more pronounced in males (AAPC = -12.87%) compared to females (AAPC = -7.46%). The overall net drift was -10.61% (95% CI: -11.14% to -10.07%), the net drift for males was -12.77% (95% CI: -13.40% to -12.13%), which was higher than that for females at -7.27% (95% CI: -7.93% to -6.60%). The local drift indicates the incidence of hepatitis A decreased gradually, with the rate of decline slowing in the later period. Descriptive analysis revealed the highest incidence of Hepatitis A cases in the 40-59 age group, while age-period-cohort analysis indicated higher incidence rates in younger individuals. The cohort effect showed a continuous decline from the earliest cohort in 1923-1927 (Overall RR = 64.93, 95% CI: 42.55 to 99.07) to the most recent cohort in 1993-1997 (Overall RR = 0.008, 95% CI: 0.004 to 0.01). But Bayesian age-period-cohort model projections for 2022-2031 suggest that incidence rates will remain low, though they may slightly increase by 2031, with peak incidence shifting to the 60-64 age group.

CONCLUSION

The incidence of Hepatitis A in Jiangsu Province has significantly decreased from 2007 to 2021, primarily due to public health measures and vaccination programs. Future efforts should focus on maintaining vaccination coverage and improving sanitation and hygiene practices to sustain these achievements.

摘要

目的

本研究旨在分析2007年至2021年中国江苏省甲型肝炎发病率随年龄、时期和出生队列的变化趋势，并预测到2031年的未来负担。

方法

从国家法定传染病报告系统获取江苏省2007年至2021年甲型肝炎病例数据。Joinpoint回归分析确定发病率趋势的显著变化。年龄-时期-队列模型评估年龄、时期和队列对甲型肝炎发病率的影响。使用贝叶斯年龄-时期-队列模型生成2022年至2031年的预测。

结果

2007年至2021年，江苏省甲型肝炎发病率显著下降，年均变化百分比（AAPC）为-10.77%。男性下降更为明显（AAPC = -12.87%），高于女性（AAPC = -7.46%）。总体净漂移为-10.61%（95%CI：-11.14%至-10.07%），男性净漂移为-12.77%（95%CI：-13.40%至-12.13%），高于女性的-7.27%（95%CI：-7.93%至-6.60%）。局部漂移表明甲型肝炎发病率逐渐下降，后期下降速度放缓。描述性分析显示40-59岁年龄组甲型肝炎病例发病率最高，而年龄-时期-队列分析表明年轻人发病率较高。队列效应显示从1923-1927年最早的队列（总体RR = 64.93，95%CI：42.55至99.07）到1993-1997年最近的队列（总体RR = 0.008，95%CI：0.004至0.01）持续下降。但2022年至2031年的贝叶斯年龄-时期-队列模型预测表明，发病率将保持在较低水平，尽管到2031年可能略有上升，发病高峰将转移到60-64岁年龄组。