Objective: To analyze the epidemiological characteristics of hepatitis A cases in China from 2004 to 2015. Methods: Data of hepatitis A were reported through national notifiable disease information reporting system, which covered the 31 provinces (Hong Kong, Macau and Taiwan excluded). The inclusion criteria was: date of illness onset was between January 1(st) 2004 and December 31(st) 2015, the status of reported card was confirmed, the case was classified as laboratory confirmed or clinical diagnosed, the disease was Hepatitis A. The information such as sex, date of birth, date of illness onset, place of residence was collected. The data was divided into three phases, 2004-2007, 2008-2011, 2012-2015, which represented the phase before expanded program on immunization (EPI), first 4 years after EPI, second 4 years after EPI. Results: From 2004 to 2015, there were totally 574 697 hepatitis A cases in China, the mean annual incidence was 3.62/100 000. The risk ratio of hepatitis A in 2015 was 0.23 when compared with 2004. Sichuan, Xinjiang and Yunnan contributed to 27.27% of the total cases in China. In 2012-2015, the incidence of western (3.46/100 000) region was significantly higher than that in central (1.21/100 000) and eastern (1.08/100 000) regions. From 2004-2015, number of cases in each age group declined greatly, with number of cases declining from 43 711 to 5 938 in the age group of 5-9 years, from 29 722 to 3 438 in 10-14, from 23 212 to 3 646 in 15-19. The number of cases declined from 24 079 to 10 304 in the age group of 0-4 (declined by 57.21%), but in 2012-2015, the incidence of 0-4 age group was still the highest, with 77.72% cases in Xinjiang and Sichuan. Famers, students and scattered children accounted for 69.95% of total cases, with student cases declined from 24.08% (2004-2007) to 8.67% (2012-2015). Conclusion: The incidence of hepatitis A in China is decreasing year by year, the risk has been decreasing to a relatively low level. However, in western regions and children under age five, the risk is still high. Precision intervention is needed for further prevention and control of hepatitis A.
目的： 分析中国2004—2015年甲型肝炎流行病学特征。 方法： 资料来源于2004—2015年"中国疾病预防控制信息系统"的监测数据库，该系统覆盖中国31省份（不包括中国香港、澳门和台湾数据），病例纳入标准为：发病日期为2004年1月1日至2015年12月31日，传染病报告卡审核状态为"已终审卡"，病例分类为"实验室诊断病例"和"临床诊断病例"，疾病名称为"甲型肝炎"，病例信息包括患者性别、出生日期、发病日期、现住地址编码等。将发病数据分为2004—2007、2008—2011和2012—2015年3个时段，分别代表甲型肝炎疫苗纳入扩大国家免疫规划前4年、纳入扩大国家免疫规划后第1个4年和第2个4年。 结果： 2004—2015年，中国累计报告574 697例甲型肝炎病例，平均发病率为3.62/10万，2015年甲型肝炎发病风险为2004年的0.23倍。四川、新疆、云南的发病例数占全国病例数的27.27%，2012—2015年中部、东部省份发病率均降至2/10万以下，分别为1.21/10万和1.08/10万，西部省份仍较高，为3.46/10万。2004—2015年，甲型肝炎报告病例数在各年龄组均大幅下降，5~9岁报告病例数从43 711例下降至5 938例，10~14岁从29 722例下降至3 438例，15~19岁从23 212例下降至3 646例，降幅分别为86.42%、88.43%和84.29%；0~4岁儿童甲型肝炎发病数从24 079例下降为10 304例（下降57.21%）；但2012—2015年0~4岁儿童发病数却居各年龄组之首，病例主要集中在新疆和四川，共报告甲型肝炎病例8 008例，占同期全国0~4岁病例数的77.72%。农民、学生、散居儿童占总病例数的69.95%（402 023例），学生病例构成比从24.08%（2004—2007年）下降至8.67%（2012—2015年）。 结论： 中国甲型肝炎发病呈逐年下降趋势，发病风险降至较低水平。但西部省份、5岁以下儿童甲型肝炎发病风险仍较高，应采取精准干预措施进行预防控制。.
Keywords: Epidemiological characteristics; Hepatitis A vaccine; Viral hepatitis A.