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目的分析湖南省湘西土家族苗族自治州(湘西州)甲型病毒性肝炎(甲肝)流行特征和发病趋势。方法 采用描述流行病学方法 ,对1990-2008年湘西州甲肝疫情资料进行统计分析。结果 1990-2008年湘西州甲肝报告发病率波动在5.76/10万～76.99/10万之间,年均发病率为23.06/10万,流行高峰年是1990、1998、2006年,发病率分别为76.99/10万、25.01/10万、25.66/10万。甲肝在病毒性肝炎中构成比从1991年的55.56%下降到2008年的11.01%。1990-2008年,甲肝先后在吉首、永顺、龙山、凤凰等地局部流行,4县市人口数所占全州总人口数分别为8.93%、18.63%、20.11%、14.01%,甲肝流行年报告病例数分别占同期全州病例总数的33.49%、34.01%、47.90%、46.07%。病例职业以学生为主,占病例总数的31.52%。年龄分布:0～4岁儿童发病率逐年下降,5～14岁儿童和学生是该病高发人群。结论 湘西州甲肝发病呈周期性波动,间隙8年出现一次流行高峰。今后工作重点要把学生作为甲肝疫苗的首选接种对象。发生甲肝流行时,学龄前儿童必须接种甲肝疫苗。落实保护易感人群和切断传播途径等综合防制措施。
Objective To analyze the epidemiological characteristics and pathogenesis of hepatitis A virus in Xiangxi Tujia and Miao Autonomous Prefecture (Xiangxi) in Hunan Province. Methods Descriptive epidemiological methods were used to analyze the data of Hepatitis A in western Hunan during 1990-2008. Results The incidence of Hepatitis A in Xiangxi from 1990 to 2008 fluctuated between 5.76 / 100,000 and 76.99 / 100 000 with an average annual incidence of 23.06 / 100 000. The peak prevalence was 1990, 1998 and 2006, and the incidence rates were 76.99 / 100,000, 25.01 / 100,000, 25.66 / 100,000. The proportion of hepatitis A in viral hepatitis dropped from 55.56% in 1991 to 11.01% in 2008. From 1990 to 2008, hepatitis A was endemic in Jishou, Yongshun, Longshan and Fenghuang respectively. The population of the four counties and cities accounted for 8.93%, 18.63%, 20.11% and 14.01% of the total population, respectively. The prevalence of hepatitis A The number of reported cases accounted for 33.49%, 34.01%, 47.90% and 46.07% respectively of the total number of statewide cases in the same period. Case-based occupations to students, accounting for 31.52% of the total number of cases. Age distribution: The incidence of children aged 0-4 decreases year by year. Children and students aged 5-14 years are the high incidence of the disease. Conclusion The incidence of hepatitis A in western Hunan Province fluctuated cyclically with a peak in 8 years. Future work should focus on students as the preferred target of hepatitis A vaccine. Pre-school children must be vaccinated against hepatitis A when a hepatitis A epidemic occurs. Implement comprehensive prevention and control measures such as protection of susceptible people and interruption of transmission routes.