2002-2021 年中国病毒性肝炎流行状况及国家层面影响因素分析：基于模型研究

Viral hepatitis in China during 2002-2021: epidemiology and influence factors through a country-level modeling study.

机构信息

School of Mathematics and Computing Science, Guangxi Colleges and Universities Key Laboratory of Data Analysis and Computation, Guilin University of Electronic Technology, Guilin, 541004, China.

Center for Applied Mathematics of Guangxi (GUET), Guilin, 541004, China.

出版信息

BMC Public Health. 2024 Jul 8;24(1):1820. doi: 10.1186/s12889-024-19318-8.

DOI:10.1186/s12889-024-19318-8

PMID:38978017

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11232300/

Abstract

BACKGROUND

Viral hepatitis imposes a heavy disease burden worldwide and is also one of the most serious public health problems in China. We aimed to describe the epidemiological characteristics of hepatitis in China and to investigate the influencing factors.

METHODS

We first used the JoinPoint model to analyze the percentage change (APC) and average annual percentage change (AAPC) of hepatitis in Chinese provinces from 2002 to 2021. We then explored the influencing factors by using the time-series global principal component analysis (GPCA) and the panel fixed-effects model.

RESULTS

The disease burden varied across different provinces from 2002 to 2021. The AAPC of the total HAV incidence decreased by 10.39% (95% CI: [-12.70%, -8.02%]) from 2002 to 2021. Yet the AAPC of HBV, HCV, and HEV increased by 1.50% (95% CI: [0.23%, 2.79%]), 13.99% (95% CI: [11.28%, 16.77%]), and 7.10% (95% CI: [0.90%, 13.69%]), respectively. The hotspots of HAV, HBV, HCV, and HEV moved from the west to the center, from the northwest to the southeast, from the northeast to the whole country, and from the northeast to the southeast, respectively. Different types of viral hepatitis infections were associated with hygiene, pollutant, and meteorological factors. Their roles in spatial-temporal incidence were expressed by panel regression functions.

CONCLUSIONS

Viral hepatitis infection in China showed spatiotemporal heterogeneity. Interventions should be tailored to its epidemiological characteristics and determinants of viral hepatitis.

摘要

背景

病毒性肝炎在全球造成了沉重的疾病负担，也是中国最严重的公共卫生问题之一。本研究旨在描述中国肝炎的流行病学特征，并探讨其影响因素。

方法

首先，我们使用 JoinPoint 模型分析了 2002 年至 2021 年中国各省份肝炎的百分比变化（APC）和平均年百分比变化（AAPC）。然后，我们使用时间序列全局主成分分析（GPCA）和面板固定效应模型探讨了影响因素。

结果

2002 年至 2021 年，不同省份的疾病负担存在差异。2002 年至 2021 年，总甲型肝炎发病率的 AAPC 下降了 10.39%（95%CI：[-12.70%，-8.02%]）。然而，乙型肝炎、丙型肝炎和戊型肝炎的 AAPC 分别增加了 1.50%（95%CI：[0.23%，2.79%]）、13.99%（95%CI：[11.28%，16.77%]）和 7.10%（95%CI：[0.90%，13.69%]）。甲型肝炎、乙型肝炎、丙型肝炎和戊型肝炎的热点地区分别从西部转移到中部，从西北转移到东南，从东北转移到全国，从东北转移到东南。不同类型的病毒性肝炎感染与卫生、污染物和气象因素有关。它们在时空发病率中的作用由面板回归函数表示。