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Yin S, Wu S, Huang J, Ren S, Xie W, Peng X. Spatial-temporal analysis of hepatitis B in Fujian Province, China in 2012-2021. INFECTIOUS MEDICINE 2024; 3:100110. [PMID: 38974348 PMCID: PMC11225665 DOI: 10.1016/j.imj.2024.100110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 12/17/2023] [Accepted: 04/02/2024] [Indexed: 07/09/2024]
Abstract
Background Fujian Province has one of the highest reported incidences of hepatitis B virus infection in China. This study aimed to provide a theoretical framework for preventing and controlling hepatitis B in Fujian Province, and to assess the trends and the spatial-temporal distribution patterns of hepatitis B in this region. Methods Data on hepatitis B cases were extracted from the National Notifiable Infectious Disease Surveillance System. Spatial autocorrelation analysis, trend surface analysis, and spatial-temporal scanning statistics were used to identify the spatial and aggregation patterns at the county level. The Joinpoint was used to assess the reported incidence trends. Results The average reported incidence of hepatitis B in Fujian from 2012 to 2021 was 14.46/10,000 population, with 583,262 notified cases. The age-adjusted reported incidence of hepatitis B decreased from 17.44/10,000 population in 2012 to 11.88/10,000 population in 2021, with an average reduction in the annual percentage change of 4.5%. There were obvious spatial-temporal aggregation characteristics in hepatitis B cases, and a high-incidence area was located in eastern Fujian. Spatio-temporal scanning statistics revealed four levels of aggregation of hepatitis B reporting rates. The first level of aggregation area included Minhou, Gulou, Jin'an, Taijiang, and nine other districts and counties. Conclusion The incidence of hepatitis B is declining in Fujian Province. Spatial clusters of hepatitis B cases in Fujian Province were identified, and high-risk areas in eastern Fujian still exist. Closely monitoring the general patterns in the occurrence of hepatitis B and implementing focused control and preventative strategies are important.
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Affiliation(s)
- Shuo Yin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Shenggen Wu
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350122, China
| | - Jingru Huang
- College of Integrated Chinese and Western Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350108, China
| | - Shutong Ren
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Weijiang Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Xian'e Peng
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
- Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, School of Basic Medical Sciences, Fujian Medical University, Fuzhou 350108, China
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Qiu Y, Wu ZK, Wu J, Yao J, Liu Y, Ren W, Sun YJ, Shen LZ, Ren JJ. Modeling long-term persistence after 8 years of hepatitis B booster vaccination in 5- to 15-year-old children. Hum Vaccin Immunother 2022; 18:2061247. [PMID: 35507912 PMCID: PMC9897632 DOI: 10.1080/21645515.2022.2061247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Vaccination remains the most effective and cost-saving measure to protect against hepatitis B, a global health problem. It is crucial to characterize the persistence of the immune response after booster vaccination. This study aimed to quantify the persistence through mathematical modeling. Booster vaccination against hepatitis B was conducted in children 5-15 years in 2009-10 in Zhejiang Province. There were four dosage formulations of hepatitis B vaccines [Shenzhenkangtai Biotechnology Co. Ltd. Dalianhanxin Biotechnology Co. Ltd. NCPC GeneTech Biotechnology Pharmaceutical Co. Ltd. Sinovac Biotech Co. LTD. China]: 5, 10, and 20 μg hepatitis B vaccines or 5 μg hepatitis A and B (HAB) combination vaccine with a 0-1-6-month schedule. These were randomly administered to children negative for all hepatitis B markers, named as the schedule 2 group. Anti-HBs positive subjects were given one dose of booster, named as the schedule 1 group. Anti-HBs antibody was measured 1, 7, 18, 66, and 102 months after the first booster dose. A linear mixed-effects model was proposed to predict long-term persistence. One hundred two months after the booster dose, the mean anti-HBs levels were 33.8 mIU/mL, with 73.7 mIU/mL for the schedule 1 group and 20.2 mIU/mL for the schedule 2 group. The model predicted that 99.5% of subjects would remain seropositive (≥10mIU/mL) at year 20 post booster vaccination, with 100.0% and 98.8% for the schedule 1 group and the schedule 2 group, respectively, whereas at year 30, the seropositivity rates would decrease to 76.8%, with 99.4% for the schedule 1 group and 62.5% for the schedule 2 group. The immunogenicity of the booster vaccination could persist for at least 8 years. Mathematical modeling may predict even longer, up to 30 years of protection.
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Affiliation(s)
- Yan Qiu
- Department of General Practice, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zi-Kang Wu
- Department of Scientific Research, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, China
| | - Jie Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jun Yao
- Department of Immunization Program Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ying Liu
- Department of General Practice, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wen Ren
- Department of General Practice, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yu-Jing Sun
- Department of General Practice, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ling-Zhi Shen
- Department of Immunization Program Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China,CONTACT Jing-Jing Ren Department of General Practice, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou310003, China
| | - Jing-Jing Ren
- Department of General Practice, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,Ling-Zhi Shen Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou310051, China
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Zheng J, Zhang N, Shen G, Liang F, Zhao Y, He X, Wang Y, He R, Chen W, Xue H, Shen Y, Fu Y, Zhang WH, Zhang L, Bhatt S, Mao Y, Zhu B. Spatiotemporal and Seasonal Trends of Class A and B Notifiable Infectious Diseases in China: A Retrospective Analysis (Preprint). JMIR Public Health Surveill 2022; 9:e42820. [PMID: 37103994 PMCID: PMC10176137 DOI: 10.2196/42820] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND China is the most populous country globally and has made significant achievements in the control of infectious diseases over the last decades. The 2003 SARS epidemic triggered the initiation of the China Information System for Disease Control and Prevention (CISDCP). Since then, numerous studies have investigated the epidemiological features and trends of individual infectious diseases in China; however, few considered the changing spatiotemporal trends and seasonality of these infectious diseases over time. OBJECTIVE This study aims to systematically review the spatiotemporal trends and seasonal characteristics of class A and class B notifiable infectious diseases in China during 2005-2020. METHODS We extracted the incidence and mortality data of 8 types (27 diseases) of notifiable infectious diseases from the CISDCP. We used the Mann-Kendall and Sen's methods to investigate the diseases' temporal trends, Moran I statistic for their geographical distribution, and circular distribution analysis for their seasonality. RESULTS Between January 2005 and December 2020, 51,028,733 incident cases and 261,851 attributable deaths were recorded. Pertussis (P=.03), dengue fever (P=.01), brucellosis (P=.001), scarlet fever (P=.02), AIDS (P<.001), syphilis (P<.001), hepatitis C (P<.001) and hepatitis E (P=.04) exhibited significant upward trends. Furthermore, measles (P<.001), bacillary and amebic dysentery (P<.001), malaria (P=.04), dengue fever (P=.006), brucellosis (P=.03), and tuberculosis (P=.003) exhibited significant seasonal patterns. We observed marked disease burden-related geographic disparities and heterogeneities. Notably, high-risk areas for various infectious diseases have remained relatively unchanged since 2005. In particular, hemorrhagic fever and brucellosis were largely concentrated in Northeast China; neonatal tetanus, typhoid and paratyphoid, Japanese encephalitis, leptospirosis, and AIDS in Southwest China; BAD in North China; schistosomiasis in Central China; anthrax, tuberculosis, and hepatitis A in Northwest China; rabies in South China; and gonorrhea in East China. However, the geographical distribution of syphilis, scarlet fever, and hepatitis E drifted from coastal to inland provinces during 2005-2020. CONCLUSIONS The overall infectious disease burden in China is declining; however, hepatitis C and E, bacterial infections, and sexually transmitted infections continue to multiply, many of which have spread from coastal to inland provinces.
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Affiliation(s)
- Junyao Zheng
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Ning Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Guoquan Shen
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Fengchao Liang
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Yang Zhao
- The George Institute for Global Health, Peking University Health Science Center, Beijing, China
- WHO Collaborating Centre on Implementation Research for Prevention and Control of Noncommunicable Diseases, Melbourne, Australia
| | - Xiaochen He
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Ying Wang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Rongxin He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Wenna Chen
- Center for Chinese Public Administration Research and School of Government, Sun Yat-sen University, Guangzhou, China
| | - Hao Xue
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, United States
| | - Yue Shen
- Laboratory for Urban Future, School of Urban Planning and Design, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Yang Fu
- Department of public administration, School of Government, Shenzhen University, Shenzhen, China
| | - Wei-Hong Zhang
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Lei Zhang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
- Artificial Intelligence and Modelling in Epidemiology Program, Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Samir Bhatt
- MRC Centre for Global Infectious Disease Analysis and the Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College, London, United Kingdom
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Bin Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
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Xiang H, Li M, Xiao M, Liu M, Su X, Wang D, Li K, Chen R, Gan L, Chu K, Tian Y, Tang X, Lei X. Factors associated with risk behaviours towards hepatitis B among migrant workers: a cross-sectional study based on theory of planned behaviour. BMJ Open 2022; 12:e056452. [PMID: 36127088 PMCID: PMC9490639 DOI: 10.1136/bmjopen-2021-056452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Rural-to-urban migrant workers are susceptible to hepatitis B because of lack of self-protection awareness and social support. The aim of this study was to explore the factors influencing risk behaviours for hepatitis B among migrant workers based on the theory of planned behaviour (TPB). DESIGN A cross-sectional survey. SETTING Chongqing, China PARTICIPANT: Migrant workers PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcomes were the TPB variables. The secondary outcomes were factors explored by logistic regressions which were associated with hepatitis B related risk behaviours and behavioural intentions (BI). RESULTS Of 1299 recruited migrant workers, 384 (29.56%) participants undertook risk behaviours related to hepatitis B virus infection in the 6 months prior to the survey, and 1111 (85.53%) migrant workers had the BI of doing so. Of 842 migrant workers who undertook sexual activities, 58.19% did not use condoms. Binary logistic regressions showed that migrant workers who were men (p<0.05), less educated (p<0.01), lacked hepatitis B knowledge (p<0.05) and of a young age (p<0.01), were more intent on conducting hepatitis B-related behaviours. Alcohol drinking (p<0.01) was also positively associated with hepatitis B risk. The scores of TPB variables, including attitude towards behaviour and subjective norms, were positively associated with BI when adjusted for sociodemographics (p<0.001). Meanwhile, experience of behaviour and regret feeling were positively associated with BI and actual behaviours (p<0.01 and p<0.05, respectively). CONCLUSIONS A considerable proportion of migrant workers undertake hepatitis B-related risk behaviours, and condoms are seldom used. Health education campaigns targeting the identified TPB variables may play a significant role in improving awareness of hepatitis B prevention among migrant workers, especially for those who are men, younger, alcohol drinkers, less educated and lacking hepatitis B knowledge.
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Affiliation(s)
- Hui Xiang
- Nan'an District Center for Disease Control and Prevention, Chongqing, Yuzhong, China
| | - Mingjing Li
- School of Public Health and Management, Chongqing Medical University, Chongqing, Yuzhong, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, Yuzhong, China
| | - Meng Xiao
- School of Public Health, Peking University, Beijing, Haidian, China
| | - Min Liu
- West-China Guang'an Hospital, Sichuan University, Sichuan, Qingyang, China
| | - Xiaoshan Su
- School of Clinical Medicine, Chongqing Medical University, Chongqing, Yuzhong, China
| | - Dashu Wang
- Army Medical Center of PLA, Army Medical University, Chongqing, Yuzhong, China
| | - Ke Li
- Beijing Institute of Technology, Beijing, Haidian, China
| | - Rui Chen
- Beijing Institute of Technology, Beijing, Haidian, China
| | - Lin Gan
- School of Public Health and Management, Chongqing Medical University, Chongqing, Yuzhong, China
| | - Kun Chu
- School of Public Health and Management, Chongqing Medical University, Chongqing, Yuzhong, China
| | - Yu Tian
- Nan'an District Center for Disease Control and Prevention, Chongqing, Yuzhong, China
| | - Xiaojun Tang
- School of Public Health and Management, Chongqing Medical University, Chongqing, Yuzhong, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, Yuzhong, China
| | - Xun Lei
- School of Public Health and Management, Chongqing Medical University, Chongqing, Yuzhong, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, Yuzhong, China
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Incidence trend and disease burden of seven vaccine-preventable diseases in Shandong province, China, 2013-2017: Findings from a population-based observational study. Vaccine X 2022; 10:100145. [PMID: 35243321 PMCID: PMC8867126 DOI: 10.1016/j.jvacx.2022.100145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/19/2021] [Accepted: 01/25/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Although vaccines provide a cost-effective solution to vaccine-preventable diseases (VPDs), the disease burden of VPDs is still very high in most parts of the world. Methods A population-based observational study was conducted in Shandong province, China, from 2013 to 2017, giving an insight into the epidemiological characteristics and disease burden of seven VPDs. The incidence trend was estimated using the Poisson regression model. The disease burden was calculated using the disability-adjusted life years (DALYs). Results Most VPDs included in the China’s National Immunization Program had higher incidence density (ID) in inland cities. The ID of mumps decreased significantly, while herpes zoster increased (both P < 0.05). The top three causes of the disease burden as assessed with DALYs included tuberculosis, herpes zoster, and hepatitis B, with the rates of 72.21, 59.99, and 52.10 DALYs/100 000, respectively. The disease burden of influenza and herpes zoster were relatively high in people aged > 50 years, while highest DALYs of hepatitis B were found in young adults. Conclusion Inequalities in the vaccine coverage by geography, socio-economic status, and targeted population contribute to the increasing incidence and high burden of VPDs and call for renewed and sustained immunization strategies in China.
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Han B, Liu W, Du J, Liu H, Zhao T, Yang S, Wang S, Zhang S, Liu B, Liu Y, Cui F. 12 Months Persistent Immunogenicity after Hepatitis B Vaccination in Patients with Type 2 Diabetes and Immunogenicity of Revaccination in Non-Responders: An Open-Label Randomized Controlled Trial. Vaccines (Basel) 2021; 9:1407. [PMID: 34960153 PMCID: PMC8705985 DOI: 10.3390/vaccines9121407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/22/2021] [Accepted: 11/26/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND In initial studies, the immunogenicity and safety of hepatitis B vaccines in patients with diabetes has been assessed in China. METHODS In six township health centers in Gansu Province, 232 diabetic patients and 77 healthy people were allocated to receive two 3-dose hepatitis B vaccines (Group D20SC 0-1-6; Group D20CHO 0-1-6; Group ND20SC 0-1-6). Participants were followed up at 12 months after being fully vaccinated. One dose of the vaccine was randomly administered to non-responders. Chi-square test was used to compare the differences in response rate between two groups. RESULTS The anti-HBs response rates of three groups decreased from 84.1%, 89.1% and 88.3% at one month to 64.6%, 79.8% and 71.4% at twelve months. There was no statistical difference in the immune response rates between Group D20SC 0-1-6 and Group ND20SC 0-1-6; however, that of Group D20CHO 0-1-6 was higher than that of Group D20SC 0-1-6. After revaccination, the geometric mean concentrations were 491.7 mIU/mL and 29.7 mIU/mL after using vaccines containing 60 μg and 20 μg HBsAg. CONCLUSIONS At 12 months, immune response in diabetic patients were not significantly different from that in healthy people. Revaccination with one dose of hepatitis B vaccine containing 60 μg HBsAg for non-responders was more satisfactory.
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Affiliation(s)
- Bingfeng Han
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (B.H.); (H.L.); (T.Z.); (S.Z.)
| | - Wu Liu
- Jingyuan County Center for Disease Control and Prevention, Baiyin 730600, China; (W.L.); (S.Y.)
| | - Juan Du
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (J.D.); (B.L.); (Y.L.)
| | - Hanyu Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (B.H.); (H.L.); (T.Z.); (S.Z.)
| | - Tianshuo Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (B.H.); (H.L.); (T.Z.); (S.Z.)
| | - Shubo Yang
- Jingyuan County Center for Disease Control and Prevention, Baiyin 730600, China; (W.L.); (S.Y.)
| | - Shuai Wang
- Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China;
| | - Sihui Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (B.H.); (H.L.); (T.Z.); (S.Z.)
| | - Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (J.D.); (B.L.); (Y.L.)
| | - Yaqiong Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (J.D.); (B.L.); (Y.L.)
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (J.D.); (B.L.); (Y.L.)
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Jiang Y, Dou X, Yan C, Wan L, Liu H, Li M, Wang R, Li G, Zhao L, Liu Z, Zhao X, Wan K. Epidemiological characteristics and trends of notifiable infectious diseases in China from 1986 to 2016. J Glob Health 2021; 10:020803. [PMID: 33214900 PMCID: PMC7649044 DOI: 10.7189/jogh.10.020803] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Since the 1980s, China has undergone significant social change and the incidence of infectious diseases has also changed considerably. Here, we report the epidemiological features and changes in notifiable infectious diseases in China from 1986 to 2016 to explore the factors contributing to the successful control of infectious diseases and the challenges faced in the prevention and control of infectious diseases. Methods The data of notifiable infectious diseases in China from 1986 to 2016 were collected from the monthly analysis report of the National Infectious Disease Surveillance System. Joinpoint regression models were used to examine incidence and mortality trends from 1986 to 2016. IBM SPSS Statistics version 22.0, Excel 2010 and R x64 3.5.2 were used for data analysis. Results A total of 132 858 005 cases of notifiable infectious diseases were reported over these 31 years, with an average yearly incidence of 342.14/100 000. There were 284 694 deaths with an average yearly mortality rate of 0.73/100 000. The overall incidence and overall mortality of notifiable infectious diseases both showed a "U" distribution (ie, a decrease, stable, an increase, stable again). The top five diseases in terms of incidence were hand, foot and mouth disease, viral hepatitis, tuberculosis, other infectious causes of diarrhea and dysentery, accounting for 78.0% of all reported cases. The top five causes of death were HIV/AIDS, rabies, tuberculosis, viral hepatitis and epidemic encephalitis B, which accounted for 76.07% of all mortalities. The diseases with the top five fatality rates were rabies, H5N1, H7N9, HIV/AIDS and plague, with rates of 91.06%, 66.07%, 38.51%, 25.19% and 10.31%, respectively. Conclusions This analysis will benefit the future monitoring of infectious diseases and public health measures in China.
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Affiliation(s)
- Yi Jiang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiangfeng Dou
- Beijing Center for Diseases Prevention and Control, Beijing, China
| | - Chenqi Yan
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.,Foshan Women and Children Hospital, Guangdong Province, China
| | - Li Wan
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.,Department of Physiology, Xiangya School of Medicine, Central South University, Changsha, China
| | - Haican Liu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Machao Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ruibai Wang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guilian Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lili Zhao
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhiguang Liu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiuqin Zhao
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Kanglin Wan
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
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Du Y, Du B, Fang X, Shu M, Zhang Y, Chung H, Sun Y, Teng J, Visalath P, Qiu H, Cai W. ALT Flare Predicts Hepatocellular Carcinoma Among Antiviral Treated Patients With Chronic Hepatitis B: A Cross-Country Cohort Study. Front Oncol 2021; 10:615203. [PMID: 33552989 PMCID: PMC7859526 DOI: 10.3389/fonc.2020.615203] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/04/2020] [Indexed: 12/21/2022] Open
Abstract
Objectives Alanine aminotransferase (ALT) level is one of the crucial indexes to evaluate disease status for chronic hepatitis B (CHB) patients. However, whether the ALT level after nucleos(t)ide analog (NA) treatment is associated with hepatocellular carcinoma (HCC) development remains unclear. Materials and Methods We evaluated the association between ALT level and HCC occurrence in NA-treated patients and investigated the predictive value of ALT flare for HCC. The associations between ALT level and HCC were analyzed by logistic regression and Cox proportional hazards models. Results There were 21,223 CHB patients at Ruijin Hospital of China and 16,737 CHB patients in the Optum electronic health records (EHR) in the United States (US) treated with NAs between 2010 and 2018. Among them, 8,152 and 4,893 patients who achieved a normal ALT value were included in the study cohorts, respectively. A significant positive dose-dependent correlation between the peak ALT level and HCC was identified in both cohorts. Within the China cohort, ALT flare was significantly associated with increased risks of HCC compared to normal ALT (HR 2.55, 95%CI 1.45-4.50). Stronger increased risks associated with ALT flare were observed in the US cohort (HR 7.62, 95%CI 4.85-11.98). Conclusions ALT flare is a strong predictor for HCC occurrence in the CHB patients treated with NAs. Elevation of ALT, especially ALT flare warrants close monitoring for early HCC detection.
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Affiliation(s)
- Yanan Du
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bingying Du
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyan Fang
- Department of Epidemiology, Janssen Research and Development, Shanghai, China
| | - Meng Shu
- Department of Epidemiology, Janssen Research and Development, Shanghai, China
| | - Yongjing Zhang
- Department of Epidemiology, Janssen Research and Development, Shanghai, China
| | - Hsingwen Chung
- Global Epidemiology, Janssen Research and Development, Titusville, NJ, United States
| | - Ye Sun
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaming Teng
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Phimphone Visalath
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Qiu
- Global Epidemiology, Janssen Research and Development, Titusville, NJ, United States
| | - Wei Cai
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Liu Y, Ren J, Wu Z, Shen L, Shan H, Dai X, Li J, Qiu Y, Ren W, Yao J, Li L. The effect of hepatitis B vaccination after five years on an entire population in an insular region of Southeast China. Hum Vaccin Immunother 2020; 17:1530-1535. [PMID: 33315518 DOI: 10.1080/21645515.2020.1814096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Prevalence of hepatitis B (HB) remains high among adults in insular regions of southeast China. To address this issue, large-scale HB vaccination was implemented in Putuo County of Zhoushan City in 2013. To examine the effects of this large-scale HB vaccination, a cross-sectional serological survey was conducted on two isolated islands, Putuo (intervention group) and Dinghai (control group) Counties of Zhoushan City in southeastern China five years later. The data showed lower prevalence of HBsAg and negative results for all HBV markers in the intervention group compared to the control group (4.2% and 6.0%, 20.8% and 33.0%), while the positive rate for anti-HBs and only anti-HBs were higher (68.4% and 53.4%, 47.9% and 34.3%). Therefore, large-scale adult HB vaccination could lower the HB epidemic level. However, the proportion of susceptible people who were negative for all HBV markers remained high. Hence, several additional measures to limit the spread of HBV should be taken by the government.
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Affiliation(s)
- Ying Liu
- The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jingjing Ren
- The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Zikang Wu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lingzhi Shen
- Department of Immunology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Huan Shan
- Department of Quality Management, Zhejiang Hospital, Hangzhou, China
| | - Xuewei Dai
- Jingdezhen Center for Disease Control and Prevention, Jingdezhen, Jiangxi, China
| | - Jing Li
- Department of Information, Zhejiang Hospital, Hangzhou, China
| | - Yan Qiu
- The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Wen Ren
- The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jun Yao
- Department of Immunology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Qiu Y, Ren JJ, Wu ZK, Shen LZ, Shan H, Dai XW, Li J, Liu Y, Ren W, Yao J, Li LJ. Strategies for hepatitis B booster vaccination among children: an 8-year prospective cohort study. Hum Vaccin Immunother 2020; 16:2822-2830. [PMID: 32429793 DOI: 10.1080/21645515.2020.1738169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Debate continues regarding the need for a booster vaccination in children who received a universal infant hepatitis B virus (HBV) vaccination. The aim was to explore the need and the strategies for the booster HBV vaccination. 8-year prospective cohort study was conducted among children aged 5-15 years in 2009-2010 in Zhejiang Province. The participants were divided into groups A (<0.1 mIU/mL), B (0.1 to < 1 mIU/mL) and C (1 to <10 mIU/mL) according to the pre-booster anti-HBs antibody levels. 5 μg (group I), 10 μg (group II), 20 μg hepatitis B vaccines (group III) or 5 μg hepatitis A and B (HAB) vaccines (group IV) with 0-1-6-month schedule were randomly administered to children negative for all markers. Blood samples were collected at baseline HBV marker testing, 1 month after the first dose, 1 month, 1 year, 5 years and 8 years after the third dose. Among 4170 children, 2326 (55.8%) were negative for all HBV markers. Group II showed the highest seropositive rates of 92.8%, 99.7%, 97.6%, 90.3% and 83.4% with GMTs of 4194.5 mIU/ml, 4163.9 mIU/ml, 466.9 mIU/ml, 190.6 mIU/ml, 122.6 mIU/ml from 1 month after dose 1 to 8 years after dose 3, respectively (P < .01). Participants in group C showed seropositive rates of 98.9%, 99.9%, 99.5%, 95.5%, 92.8% after the revaccination with GMTs of 6519.6 mIU/ml, 5267.4 mIU/ml, 547.1 mIU/ml, 249.5 mIU/ml, 155.3 mIU/ml, respectively, higher than group A and B (P < .001), except 1 month after the third dose. The 10 μg of HBV vaccine with a 0-1-6-month booster regimen may elicit robust responses and persist for 8 years or longer. Additionally, 1-dose revaccination maybe suitable for children with 1 to < 10 mIU/ml anti-HBs titers.
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Affiliation(s)
- Yan Qiu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University , Hangzhou, China
| | - Jing-Jing Ren
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University , Hangzhou, China
| | - Zi-Kang Wu
- Women's Hospital, School of Medicine, Zhejiang University , Hangzhou, China
| | - Ling-Zhi Shen
- Department of Immunololgy, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China
| | - Huan Shan
- Department of Quality Management, Zhejiang Hospital , Hangzhou, China
| | - Xue-Wei Dai
- JingDezhen Center for Disease Control and Prevention, JingDezhen , Jiangxi, China
| | - Jing Li
- Department of Information, Zhejiang Hospital , Hangzhou, China
| | - Ying Liu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University , Hangzhou, China
| | - Wen Ren
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University , Hangzhou, China
| | - Jun Yao
- Department of Immunololgy, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China
| | - Lan-Juan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University , Hangzhou, China
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Immune response to different types of hepatitis B vaccine booster doses 2–32 years after the primary immunization schedule and its influencing factors. Int J Infect Dis 2020; 93:62-67. [DOI: 10.1016/j.ijid.2020.01.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 12/15/2022] Open
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Xu S, Zhang W, Wang Q, Cui J, Yan W, Xie H, Ni A. Hepatitis B virus serological screen in a general hospital in Beijing from 2008 to 2018, and challenges to our vaccination policy. Vaccine X 2020; 4:100057. [PMID: 32123866 PMCID: PMC7038442 DOI: 10.1016/j.jvacx.2020.100057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/30/2020] [Accepted: 02/12/2020] [Indexed: 12/12/2022] Open
Abstract
Objective Hepatitis B virus (HBV) has a worldwide distribution and remains a leading public health problem in China. Method Automated chemiluminescence microparticle immunoassay was used to test all five markers of HBV serology in serum samples among 696,048 patients, pregnant women, and normal subjects in Beijing from 2008 to 2018. Results The overall prevalence of subjects categorized as previous/ occult HBV infection, inactive HBsAg carrier, active HBV infection, HBsAg, HBV susceptible, and immune via vaccination was 29.4%, 4.8%, 1.4%, 6.4%, 33.9% and 30.3%, respectively; men had a significantly higher prevalence of HBV infection than women. The prevalence of HBsAg was around 0.5% in subjects ≤ 10 years of age, increased dramatically to 3.7% in subjects between 11 and 20 years of age, reached the highest level of 7.9% in subjects between 41 and 50 years of age, and finally decreased to 2.8% in subjects ≥ 81 years of age. During the 10 years from 2008 to 2018, the prevalence of HBsAg was stabilized at about 6.0%, and indicators of HBV susceptibility, previous/ occult HBV infection, and immunity via vaccination were not further improved, despite the constant implementation of HBV vaccination since 1992. All four age groups (21 − 30y, 31 − 40y, 41 − 50y and 51 − 60y) of the normal adult population were found to have a significantly lower prevalence of HBsAg and HBV susceptibility but significantly higher prevalence of immunity via vaccination compared with corresponding age groups of the sub-total population. Conclusions Although high coverage has been established among infants and young children, their vaccination alone could not reduce HBV infection in the adult Chinese population quickly. Adult populations with more vaccinated individuals are found to have fewer individuals with HBsAg. Vaccination in adults or at least in high-risk adults is an urgent need to decrease horizontal HBV transmission in China.
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Study on Status and Willingness towards Hepatitis B Vaccination among Migrant Workers in Chongqing, China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16204046. [PMID: 31652590 PMCID: PMC6843977 DOI: 10.3390/ijerph16204046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/16/2019] [Accepted: 10/21/2019] [Indexed: 01/08/2023]
Abstract
Background: Rural-to-urban migrant workers may serve as a bridge population for the cross-regional spread of hepatitis B vaccination (HBV) due to frequent shifts between their work areas and homelands, and they are less likely to be covered by the national hepatitis B (HB) immunization program. This study aimed to investigate the current inoculation status of HB vaccine among migrant workers and the willingness to be vaccinated among non-vaccinated ones. Methods: We conducted a cross-sectional survey using anonymous interviews with migrant workers selected by two-stage cluster sampling from July to December 2018. Binary logistic regression models were adopted to detect influencing factors associated with HB inoculation status and vaccination willingness. Results: 1574 respondents were recruited in the surveys, and 773 (49.11%) respondents reported that they had been inoculated with HB vaccine. Only 285 (35.58%) non-vaccinated respondents were willing to be inoculated. Logistic regression indicated that younger age, higher education level, less wearing of condoms, higher knowledge scores of HB, and higher risk perception of HBV infection were positively associated with inoculation of HB vaccine. Respondents who were more highly educated, and drinkers, with higher knowledge scores of HB and with higher risk perception of HBV infection were more willing to be vaccinated. Conclusions: the HB vaccination rate of migrant workers in Chongqing was relatively low and only a small section of non-vaccinated migrant workers had vaccination willingness. Health interventions and policies are needed to improve knowledge and cognition of HB among migrant workers, particularly for those who are older, less educated, poor in HB knowledge, less likely to wear condoms, and non-drinkers. Peer education, as well as the combination of traditional and new media, would be accessible and effective ways to disseminate HB related knowledge for migrant workers.
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Zhu B, Liu J, Fu Y, Zhang B, Mao Y. Spatio-Temporal Epidemiology of Viral Hepatitis in China (2003-2015): Implications for Prevention and Control Policies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E661. [PMID: 29614809 PMCID: PMC5923703 DOI: 10.3390/ijerph15040661] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/19/2018] [Accepted: 03/30/2018] [Indexed: 12/18/2022]
Abstract
Viral hepatitis, as one of the most serious notifiable infectious diseases in China, takes heavy tolls from the infected and causes a severe economic burden to society, yet few studies have systematically explored the spatio-temporal epidemiology of viral hepatitis in China. This study aims to explore, visualize and compare the epidemiologic trends and spatial changing patterns of different types of viral hepatitis (A, B, C, E and unspecified, based on the classification of CDC) at the provincial level in China. The growth rates of incidence are used and converted to box plots to visualize the epidemiologic trends, with the linear trend being tested by chi-square linear by linear association test. Two complementary spatial cluster methods are used to explore the overall agglomeration level and identify spatial clusters: spatial autocorrelation analysis (measured by global and local Moran's I) and space-time scan analysis. Based on the spatial autocorrelation analysis, the hotspots of hepatitis A remain relatively stable and gradually shrunk, with Yunnan and Sichuan successively moving out the high-high (HH) cluster area. The HH clustering feature of hepatitis B in China gradually disappeared with time. However, the HH cluster area of hepatitis C has gradually moved towards the west, while for hepatitis E, the provincial units around the Yangtze River Delta region have been revealing HH cluster features since 2005. The space-time scan analysis also indicates the distinct spatial changing patterns of different types of viral hepatitis in China. It is easy to conclude that there is no one-size-fits-all plan for the prevention and control of viral hepatitis in all the provincial units. An effective response requires a package of coordinated actions, which should vary across localities regarding the spatial-temporal epidemic dynamics of each type of virus and the specific conditions of each provincial unit.
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Affiliation(s)
- Bin Zhu
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, China.
- Department of Public Policy, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, China.
| | - Jinlin Liu
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, China.
| | - Yang Fu
- College of Management, Shenzhen University, Nanhai Ave 3688, Shenzhen 518060, China.
| | - Bo Zhang
- School of Human Settlements and Civil Engineering, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, China.
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, China.
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He H, Zhou Y, Xie S. Assessment of the duplicate notifiable reporting of hepatitis B infection in Zhejiang province, China, 2005-2015. Vaccine 2017; 35:4702-4706. [PMID: 28750855 DOI: 10.1016/j.vaccine.2017.07.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 06/29/2017] [Accepted: 07/13/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hepatitis B virus (HBV) infection control has seen improvements since the introduction of the HBV vaccination program in China. However, the reported incidence rate of HBV infection remains high owing to the large pool of individuals infected before the start of the HBV immunization program. The duplicated reporting of HBV had a remarkable effect on the overestimation of HBV disease burden, according to the Chinese National Notifiable Diseases Report System (NNDRS). METHODS We analyzed the data of HBV in Zhejiang province, China, collected for the years 2005-2015 from the NNDRS. The duplicate reporting cases of HBV were captured according to the same identification number or the same name, sex and date of birth, or the same name, sex and resident town/street code. We assessed the magnitude of duplicated reporting of HBV and explored the possible factors contributing to duplicated reporting. RESULTS There were 20,078 redundant HBV cases reported from the NNDRS during 2005-2015, which accounted for 6.33% (19,272/305,654) of all patients owing to duplicate reporting in Zhejiang province, China. Some risk factors, including male sex, age ≥20years, chronic cases, residence in outside counties, and farming as an occupation (odds ratio [OR]=1.06; 95% confidence interval [CI]: 1.02-1.11) were positively associated with the risks on duplicate reporting. CONCLUSIONS Our results demonstrated that the duplicated reporting of HBV infection is common in Zhejiang, China, which has contributed to a higher HBV infection prevalence than its real value. Some characteristics might affect the probability of duplicate reporting, including sex, occupation, place of residence, HBV type, and hospital type. These findings indicated the strong need to improve the data collection, deletion of duplications, and HBV classification during HBV surveillance, in order to obtain an accurate estimate of HBV disease burden in China. We also suggest establishing a specialized system to achieve high-quality HBV infection surveillance effectively and practically.
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Affiliation(s)
- Hanqing He
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China.
| | - Yang Zhou
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Shuyun Xie
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
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Liu F, Guo Z, Dong C. Influences of obesity on the immunogenicity of Hepatitis B vaccine. Hum Vaccin Immunother 2017; 13:1014-1017. [PMID: 28059607 DOI: 10.1080/21645515.2016.1274475] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Hepatitis B vaccine is regarded as the most effective method for the prevention of hepatitis B virus (HBV) infection. However, several factors such as age, body mass index and immunocompetent state have been reported to be associated with reduced immunization responses. The present commentary was aimed to discuss the influences of obesity on the immunogenicity of hepatitis B vaccines. DATA SOURCES Available peer-reviewed literatures, practice guidelines, and statistics published on hepatitis B vaccine in obesity between 1973 and 2015. CONCLUSIONS Obesity was significantly associated with non-response to hepatitis B vaccine immunization. The risk of nonresponsiveness of hepatitis B vaccine among obese people increased with BMI. Moreover, the obesity might lead to an increased risk of HBV vaccine-escape mutations. The mechanism responsible for decreased immunization responses in obesity included leptin-induced systemic and B cell intrinsic inflammation, impaired T cell responses and lymphocyte division and proliferation. Therefore, more studies should be performed to analyze the influences of obesity on the immunogenicity of hepatitis B vaccines to improve the immunoprotecive effect of hepatitis B vaccines in future.
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Affiliation(s)
- Fang Liu
- a Suzhou Center for Disease Control and Prevention , Suzhou , China
| | - Zhirong Guo
- b Department of Epidemiology and Statistics , School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University , Suzhou , Jiangsu , China
| | - Chen Dong
- b Department of Epidemiology and Statistics , School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University , Suzhou , Jiangsu , China
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