The Effectiveness of National Expanded Program on Immunization With Hepatitis A Vaccines in the Chinese Mainland: Interrupted Time-Series Analysis.
JMIR Public Health Surveill
; 10: e53982, 2024 Feb 28.
Article
em En
| MEDLINE
| ID: mdl-38416563
ABSTRACT
BACKGROUND:
The high prevalence of hepatitis A delivered a blow to public health decades ago. The World Health Organization (WHO) set a goal to eliminate viral hepatitis including hepatitis A by 2030. In 2008, hepatitis A vaccines were integrated into the Expanded Program on Immunization (EPI) in China to alleviate the burden of hepatitis A, although the effectiveness of the EPI has not been well investigated.OBJECTIVE:
We aimed to evaluate the intervention effect at both provincial and national levels on the incidence of hepatitis A in the Chinese mainland from 2005 to 2019.METHODS:
Based on the monthly reported number of hepatitis A cases from 2005 to 2019 in each provincial-level administrative division, we adopted generalized additive models with an interrupted time-series design to estimate province-specific effects of the EPI on the incidence of hepatitis A among the target population (children aged 2-9 years) from 2005 to 2019. We then pooled province-specific effect estimates using random-effects meta-analyses. We also assessed the effect among the nontarget population and the whole population.RESULTS:
A total of 98,275 hepatitis A cases among children aged 2-9 years were reported in the Chinese mainland from 2005 to 2019, with an average annual incidence of 5.33 cases per 100,000 persons. Nationally, the EPI decreased the hepatitis A incidence by 80.77% (excess risk [ER] -80.77%, 95% CI -85.86% to -72.92%) during the study period, guarding an annual average of 28.52 (95% empirical CI [eCI] 27.37-29.00) cases per 100,000 persons among the target children against hepatitis A. Western China saw a more significant effect of the EPI on the decrease in the incidence of hepatitis A among the target children. A greater number of target children were protected from onset in Northwest and Southwest China, with an excess incidence rate of -129.72 (95% eCI -135.67 to -117.86) and -66.61 (95% eCI -67.63 to -64.22) cases per 100,000 persons on average, respectively. Intervention effects among nontarget (ER -32.88%, 95% CI -39.76% to -25.21%) and whole populations (ER -31.97%, 95% CI -39.61% to -23.37%) were relatively small.CONCLUSIONS:
The EPI has presented a lasting positive effect on the containment of hepatitis A in the target population in China. The EPI's effect on the target children also provided a degree of indirect protection for unvaccinated individuals. The continuous surveillance of hepatitis A and the maintenance of mass vaccination should shore up the accomplishment in the decline of hepatitis A incidence to ultimately achieve the goal set by the WHO.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
10_ODS3_salud_sexual_reprodutiva
/
1_ASSA2030
/
2_ODS3
/
4_TD
Problema de saúde:
10_sexually_transmitted_infections
/
1_doencas_transmissiveis
/
2_cobertura_universal
/
2_enfermedades_transmissibles
/
4_hepatitis
Assunto principal:
Vacinas contra Hepatite A
/
Hepatite A
Limite:
Child
/
Humans
País/Região como assunto:
Asia
Idioma:
En
Revista:
JMIR Public Health Surveill
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
China