海南省人群乙型肝炎血清流行病学调查研究

目的了解海南省人群乙型肝炎病毒（HBV）感染现状，评价乙肝疫苗纳入儿童免疫策略后的效果。方法采取整群抽样方法，按照经济水平、民族、地理位置，选择被调查市县。在被选市县中随机抽取2个乡镇，每个乡镇随机抽取1个村．以家庭为单位对全部人群采集静脉血用ELISA检测HBsAg、抗-HBs和抗-HBc，并完成个案调查。结果共采集3945人血清进行检测，人群中HBsAg阳性率为13.18％、抗-HBs阳性率为52.72％、HBV流行率为56．96％。HBsAg阳性率最高年龄组为20—29岁组（21．52％）。最低为0-4岁组（4，02％），10岁以下儿童为6．21％；HBV流行率最高为50～59岁组（83．43％），最低是0—4岁（29．99％），10岁以下组为30．69％。HBsAg阳性率和HBV流行率：城市低于农村。差异有非常显著性（x^2=13．66，P〈0．01；x^2=12．56，P〈0．01）。富裕地区、经济欠发达地区、贫困地区三者间比较。差异也存在显著性（x^2=50．13，P〈0．01；x^2=13．17，P〈0．01）。HBsAg阳性率，男性高于女性（x^2=11．97，P〈0．01）；HBV流行率男性低于女性（x^2=7．74．P〈0．01），差异均存在显著性。结论海南省人群HBV流行率是高的，人群HBsAg携带率仍远高于全国平均水平，但人群中乙肝流行病学特征已发生了改变，乙肝疫苗纳入儿童免疫规划后效果显著，降低了人群HBsAg携带率和HBV流行率，特别是10岁以下儿童下降幅度更为明显。

Sero-epidemiological survey of hepatitis B in different populations in Hainan Province

Objective To understand the current infectious status of hepatitis B virus in Hainan Province and evaluate the effect of immunization with hepatitis B vaccine after implementation of the Expanded Programme on Immunization （ EPI）. Methods Cluster random sampling method was used to select surveyed counties or cities according to economic level, nationality and geographical position. 2 townships were selected in random in every county or city and 1 village was selected in random in every township. Vein blood samples were colleeted from everyone in surveyed families and the Case Survey Form was completed. HBsAg, anti- HBs and anti - HBe antibodies were tested with ELISA reagents. Results The total 3 945 serum samples were tested, the positive rates of HBsAg and anti - HBs were 13.18 %, 52.72 %, respectively. The prevalence rate was 56.96 %. The highest positive rate of H BsAg was 21.52% in 20 - 29 years old group, the lowest rate was 4.02% in 0 - 4 years old group. The positive rate of HBsAg was 6.21 % for less than 10 years old group. The highest prevalence rate of HBV was 83.43% in 50 - 59 years old group and the lowest was 29.99% in 0 - 4 years old group and 30.69% in less than 10 years old group. The HBsAg positive rate and HBV prevalence rate of urban populations were significantly lower than that of rural populations （x^2 = 13.66, P 〈 0.01 ;x^2 = 12.56, P 〈 0.01）, and the above rates were significantly different in areas with diverse economical levels （ P 〈 0.01）. There were significant difference within prosperous area, undeveloped area and poor area （x^2 = 50.13, P 〈 0.01;x^2 = 13.17, P 〈 0.01 ）. The H BsAg positive rate of the males was significant higher than that of the females （x^2 = 11.97, P 〈 0.01）, but the HBV prevalence rate of the male was lower than that of the female and the differences were significant （x^2 = 7.74, P 〈 0.01 ）. Conclusion The prevalence rate of HBV is high in Hainan province. The current HBsAg carrying rate in Hainan Province is still higher th