贵州省少数民族地区外出务工者乙型肝炎流行模式

宋文君; 黄文湧; 杨敬源; 蒋芝月; 汪俊华; 官志忠

doi:10.16462/j.cnki.zhjbkz.2019.10.019

贵州省少数民族地区外出务工者乙型肝炎流行模式

doi: 10.16462/j.cnki.zhjbkz.2019.10.019

550025 贵安, 贵州医科大学公共卫生学院流行病与卫生统计学系、环境污染与疾病监控教育部重点实验室、贵州省卫生发展研究院、贵州省医学分子生物学重点实验室

基金项目:

科技部“十二五”国家科技支撑计划 2013BAI05B03

详细信息

通讯作者:
杨敬源, E-mail: yang8880@sina.com

中图分类号: R183
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- 被引次数: 0
出版历程
- 收稿日期: 2019-05-28
- 修回日期: 2019-08-05
- 刊出日期: 2019-10-10

A study on epidemic model of hepatitis B virus in migrant workes in Guizhou minority areas

Department of Epidemiology and Health Statistics, School of Public Health, Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Health Development Research Institute, Key Laboratory of Medical Molecular, Guizhou Medical University

Funds:

Ministry of Science and Technology "Twelfth Five-Year Plan" National Science and Technology Support Programme 2013BAI05B03

More Information

Corresponding author: YANG Jing-yuan, E-mail: yang8880@sina.com

摘要

摘要: 目的调查贵州少数民族地区外出务工人员乙肝流行模式特点，为乙肝的防控措施提供参考。方法采用多阶段分层整群抽样方法，对贵州少数民族地区雷山和荔波县分别抽取4个村为调查地点，对当地居民进行问卷调查和血清乙肝五项检测。结果本次调查贵州少数民族总人群1 629人，外出务工464人中乙肝感染率为44.8%、HBsAg携带率为8.4%、抗-HBs阳性率为28.0%、抗-HBc阳性率为25.6%。外出务工感染模式检出率（19.8%）低于非外出务工者（23.2%），但差异无统计学意义（P>0.05）；外出务工者易感模式检出率为（52.2%）高于非外出务工者（43.4%），免疫模式检出率（28.0%）低于非外出务工者（33.4%），差异均具有统计学意义（均有P < 0.05）。经多分类Logistic回归分析模型调整相关因素后，相对于非外出务工居民，外出务工仍为易感模式的影响因素（OR=1.568，95% CI：1.206~2.039）。结论贵州少数民族地区外出务工人员乙肝易感性相对较高，应大力加强对外出务工者乙肝疫苗免疫接种，提高其特异性免疫，以减少乙肝的感染与流行。
- 乙型肝炎病毒 /
- 外出务工人口 /
- 贵州少数民族 /
- 易感模式
Abstract: Objective To research the prevalence model of hepatitis B virus in the minority areas of Guizhou and to provide reference for the prevention and control virus of hepatitis B virus. Methods Using multi-stage cluster simple random sampling, four villages were selected from Leishan and Libo counties in minority areas of Guizhou. Questionnaires were investigated by trained investigators and serum hepatitis B virus five-item test results were collected from the subjects. Results A total of 1 629 participants were surveyed, the outcome showed that migrant workers' infection rate of hepatitis B was 44.8%, and the carrying rate of HBsAg was 8.4%. The positive rates of anti-HBs and anti-HBc were 28.0% and 25.6% respectively. The infection model rate of migrant workers was 19.8%, which was lower than that of non-migrant workers (23.2%) (P>0.05).The detection rate of susceptible model in migrant workers (52.2%) was higher than that in non-migrant workers (43.4%), while the detection rate of immune mode migrant workers (28.0%) was lower than that in non-migrant workers (33.4%), which the difference was statistically significant (all P < 0.05). After adjusted related factors by multivariate Logistic regression analysis model, migrant workers were still the influencing factors of vulnerability model (OR=1.568, 95% CI: 1.206-2.039) compared with non-migrant workers. Conclusion There was a high susceptibility to hepatitis B virus among migrant workers in minority areas of Guizhou, In order to reduce the infection and prevalence of hepatitis B virus, we should strengthen the immunization of hepatitis B vaccine to migrant workers and to improve their specific immunity.
- Hepatitis B virus /
- Rural migrant worker /
- Minorities area /
- Susceptibility model

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图 1 外出务工与非务工乙肝模式检出率情况比较

Figure 1. Comparison of the detection rate of hepatitis B pattern between migrant workers and non-migrant workers

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表 1 外出务工与非外出务工的人口学特征[n(%)]

Table 1. The demographic characteristics of migrant workers and non-migrant workers [n(%)]

人口学特征	总人数 (人)	外出务工	非外出务工	χ²值	P值
人口学特征	总人数 (人)	n(%)	n(%)	χ²值	P值
性别				5.06	0.025
男	722	226(48.7)	496(42.6)
女	907	238(51.3)	669(57.4)
年龄组(岁)				327.27	< 0.001
≤20	226	17(3.7)	209(17.9)
21~	343	208(44.8)	135(11.6)
41~	554	193(41.8)	361(31.0)
≥61	506	46(9.9)	460(39.5)
民族				15.61	0.001
苗族	673	205(44.2)	468(40.2)
侗族	68	27(5.8)	41(3.5)
布依族	757	211(45.5)	546(46.9)
其他	131	21(4.5)	110(9.4)
职业				25.63	< 0.001
务农	1 278	339(87.5)	879(76.2)
非务农	332	57(12.5)	275(23.8)
婚姻状况				57.52	< 0.001
未婚	259	40(8.6)	219(18.8)
已婚	1 220	407(87.7)	813(69.8)
离异/丧偶	150	17(3.7)	133(11.4)
文化程度				48.09	< 0.001
文盲半文盲	492	84(18.2)	408(35.6)
小学/初中	1 024	342(74.0)	682(59.5)
高中及以上	93	36(7.8)	57(5.0)
家庭年收入(元)				25.58	< 0.001
< 5 000	566	146(34.4)	420(46.1)
5 000	357	111(26.2)	246(27.0)
10 000	308	130(30.7)	178(19.5)
≥30 000	104	37(8.7)	67(7.4)

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表 2 贵州少数民族地区外出务工人员的乙肝模式分布[n(%)]

Table 2. Distribution of hepatitis B model among migrant workers in Guizhou minority areas[n(%)]

变量	易感模式	免疫模式	感染模式	χ²值	P值
性别				4.88	0.087
男	312(43.2)	249(34.5)	161(22.3)
女	436(48.1)	270(29.8)	201(22.2)
年龄组(岁)				62.25	< 0.001
≤20	81(35.8)	119(52.7)	26(11.5)
21~	175(51.0)	102(29.7)	66(19.2)
41~	259(46.8)	148(26.7)	147(26.5)
≥61	233(46.0)	150(29.6)	123(24.3)
民族				70.55	< 0.001
苗族	322(47.8)	261(38.8)	90(13.4)
侗族	35(51.5)	24(35.3)	9(13.2)
布依族	337(44.5)	202(26.7)	218(28.8)
其他	54(41.2)	32(24.4)	45(34.4)
文化程度				10.65	0.031
文盲半文盲	245(49.8)	133(27.0)	114(23.2)
小学/初中	451(44.0)	341(33.3)	232(22.7)
高中及以上	46(49.5)	34(36.6)	13(14.0)
婚姻状况				39.76	< 0.001
未婚	99(38.2)	124(47.9)	36(13.9)
已婚	579(47.5)	356(29.2)	285(23.4)
离异/丧偶	70(46.7)	39(26.0)	41(27.3)
家庭年收入(元)				9.372	0.154
< 5 000	250(44.2)	172(30.4)	144(25.4)
5 000~	162(45.4)	114(31.9)	81(22.7)
10 000~	165(53.6)	77(25.0)	66(21.4)
≥30 000	53(51.0)	30(28.8)	21(20.2)
乙肝疫苗接种史				9.29	0.010
有	62(46.6)	54(40.6)	17(12.8)
无	686(45.9)	465(31.1)	345(23.1)
与HBV感染的家人在一起生活				125.83	< 0.001
有	30(19.4)	36(23.2)	89(57.4)
无	718(48.7)	483(32.8)	273(18.5)

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表 3 外出务工影响乙肝流行模式的Logistic回归分析(外出vs非外出)

Table 3. Logistic regression analysis of the influence of migrant workers on hepatitis B epidemic model (migrant workers vs non-migrant workers)

流行模式	模型1		模型2
流行模式	OR值(95%CI)	P值	OR值(95%CI)	P值
二分类Logistic回归
易感模式	1.420(1.144~1.762)	0.001^a	1.471(1.171~1.846)	0.001^a
免疫模式	0.776(0.613~0.983)	0.036^a	0.680(0.531~0.870)	0.002^a
感染模式	0.820(0.629~1.069)	0.143	0.984(0.734~1.319)	0.914
多分类Logistic回归(参比免疫模式)
易感模式	1.431(1.114~1.839)	0.005^a	1.568(1.206~2.039)	0.001^a
感染模式	1.020(0.749~1.389)	0.902	1.295(0.923~1.815)	0.134
注：1、模型中，以是否外出为自变量，非外出务工为参比。2、模型1:没有调整。模型2:调整了性别、年龄、民族、文化程度、疫苗史等。3、^a表示差异具有统计学意义P < 0.05。

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