评估接种疫苗对白俄罗斯共和国乙型肝炎流行病学的影响

V. Vysotskaya, N. Kolomiets, I. Glinskaya, O. Romanova, E. Gasich, E. Samoilovich
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引用次数: 0

摘要

将乙型肝炎(HBV)疫苗接种纳入国家免疫规划已导致乙型肝炎病毒(HBV)在世界范围内传播的显著减少,特别是在以前高度流行的国家。消除乙型肝炎病毒战略的一个关键方面是在新生儿进一步接种乙型肝炎疫苗后给予出生剂量。其他预防措施包括怀孕期间的筛查、抗病毒药物的使用以及HB免疫球蛋白的使用。尽管HB病例数量显著减少,但成人,特别是高危人群的疫苗接种仍然是一项重要挑战。目标。评估白俄罗斯共和国疫苗接种策略对乙肝流行病学的影响。材料和方法。白俄罗斯共和国乙型肝炎病毒发病率是根据国家统计报告表格的数据估计的。使用Statistica V.10.0程序(Statsoft, USA)对结果进行统计处理。结果。在此期间,急性和无症状乙型肝炎的发病率显著下降(发病率(ТсН.)分别为- 13.25%和- 11.99%),而慢性乙型肝炎(CHB)的发病率呈上升趋势(发病率(Тpr.)为+ 1.09%)。在2002-2022年期间,CHB在病因结构中占主导地位,占2018年以来HB总结构观察值的70%以上。HBV的发病模式因地区而异。目前,总发病率的主要人群是30-49岁的人群。该年龄组的乙肝发病率(每10万人320.57人)比0-29岁年龄组(每10万人136.50人)高2.35倍,这是由于预防接种覆盖率低(根据医疗记录),30-49岁年龄组的乙肝发病率为39.3%。2000年开始实行的定期疫苗预防已成为白俄罗斯共和国有效监测乙型肝炎流行病学的基础。结论。这一时期的特点是病源性乙型肝炎发病率显著下降(发病率为7.5%),慢性乙型肝炎发病率中度上升(发病率(Тpr.)为1.09%。尽管乙肝疫苗接种取得了不可否认的进展和成功,但应该提到的是,估计超过65%的未接种疫苗的成年人口可能形成病毒潜在传播的聚集性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
ASSESSMENT OF VACCINATION IMPACT ON HEPATITIS B EPIDEMIOLOGY IN THE REPUBLIC OF BELARUS
Integration of hepatitis B (HBV) vaccination into national immunization programs has resulted in a significant reduction in hepatitis B virus (HBV) transmission worldwide, and specifically in previously highly endemic countries. A key aspect of HBV elimination strategy is the administration of a birth dose followed by a further hepatitis B vaccination of newborns. Additional preventive measures include screening during pregnancy, administration of antivirals as well as the use of HB immunoglobulin. Despite a significant decrease in the number of HB cases, vaccination of adults, in particular those of high-risk groups, remains an important challenge. Objective. To evaluate the impact of vaccination strategies on HB epidemiology in the Republic of Belarus. Material and methods. HBV incidence in the Republic of Belarus has been estimated according to the data from state statistical reporting forms. The results were statistically processed using Statistica V.10.0 program (Statsoft, USA). Results. Over the period in question there has been noted a marked decrease in the incidence of acute and asymptomatic HBV forms (the rate (ТсН.) equals to -13,25% and -11,99% respectively), while the incidence of chronic hepatitis B (CHB) tends to increase (the rate (Тpr.) equals to +1,09%). Over the period of 2002-2022, CHB prevails in the etiological structure, constituting more than 70% of observations in the total structure of HB since 2018. HBV incidence pattern varies according to the regions. Currently, the leading cohort in the overall incidence is the population aged 30-49. The incidence rate of hepatitis B among individuals of this age cohort (320.57 per 100 thousand people) is 2.35 times higher than that of a 0-29-yearage cohort (136.50 per 100 thousand people) that is accounted for by a low level of preventive vaccination coverage (according to medical records), equal to 39.3% for the cohort aged 30-49. Scheduled vaccine prophylaxis introduced in 2000 has become the basis for the effective HB epidemiology surveillance in the Republic of Belarus. Conclusions. The period in question is characterized by both a marked decrease in the incidence of nosological HBV forms (the rate is 7.5%) and a moderate increase in the incidence of chronic hepatitis B (the rate (Тpr.) equals to +1,09%. Despite the undeniable progress and success of HB vaccination, it should be mentioned that an estimated over 65% of unvaccinated adult population may form a cluster for the potential spread of the virus.
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