Abstract
Zhejiang Province was a high endemicity for hepatitis B disease in the 1990's. A number of measures implemented since then have begun to control and prevent hepatitis B. In 1992, hepatitis B vaccine came on the market. In 2002, hepatitis B vaccine was included in the national Expanded Programme on Immunization (EPI). Between 2007 and 2010, catch-up vaccination was implemented for children under 15. Since 2010, vaccination guidelines for high-risk groups have also been adopted. This study evaluated the impact of these control and prevention strategies on acute hepatitis B notification rates from 2005 through 2013. Data from the National Notifiable Disease Reporting System (NNDRS) revealed a steady downward trend in notification rates of acute hepatitis B. The most dramatic decline occurred among pre-adults, highlighting the benefits of EPI's policy of universal vaccination for children. However, the highest notification rates occurred among young adults of lower socio-economic status. These findings indicate the strong need to vaccinate young adults at risk for HBV infection as well as to collect risk-factor information in the NNDRS for monitoring and following up persons with acute hepatitis B.
Highlights
An estimated 120 million Chinese are hepatitis B surface antigen (HBsAg)positive carriers, which means approximately one-third of the world’s hepatitis B carriers live in China [1,2]
Since 2005, mandatory reporting of acute hepatitis B cases in China has been accomplished via the National Notifiable Disease Reporting System (NNDRS) under the Infectious Diseases Notification
The trend of the acute hepatitis B notification rate was followed over a period of nine years, from 2005 to 2013
Summary
An estimated 120 million Chinese are hepatitis B surface antigen (HBsAg)positive carriers, which means approximately one-third of the world’s hepatitis B carriers live in China [1,2]. An estimated 4 million of these live in Zhejiang Province [3]. In 1992, the Chinese national hepatitis B epidemiological survey determined that, in the general population in Zhejiang Province, the rate of HBsAg positivity was 11.7% [4,5]. This rate was significantly greater than the national average rate of 9.8% [6,7]. PLOS ONE | DOI:10.1371/journal.pone.0114645 December 12, 2014
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