Background Hepatitis B virus (HBV) infection is a major public health problem in China. Over a decade has passed since the last National Hepatitis Seroepidemiological Survey was conducted in 2006. The lack of updated data on hepatitis B in China makes assessing the current prevalence and burden of the disease inadequate. In response to the above situation, a systematic review and meta-analysis was conducted to provide a better understanding of hepatitis B epidemiology in the general population of China. Methods A systematic search was conducted in international databases (Medline through PubMed, EMBASE, Cochrane, Web of Science) and national databases (CBM, CNKI, WanFang Data) to retrieve primary studies published between January 1, 2013 and December 31, 2017. The pooled prevalence of HBV infection and 95% confidence intervals were calculated. Quality assessment, heterogeneity testing and publication bias assessment were also performed. Results Of the 27 studies included in the meta-analysis, the pooled estimated prevalence of HBV infection in the general population of China from 2013 to 2017 was 6.89% (95% CI:5.84–7.95%), which could be extrapolated to an estimated population of 84 million living with HBsAg in 2018. The prevalence of HBV infection in males was higher than that in females (5.88% vs 5.05%), and rural areas had a higher prevalence than urban areas (5.86% vs 3.29%). The highest prevalence of HBV infection was reported in Western provinces (8.92, 95% CI: 7.19–10.64%). In adults older than 20 years, the prevalence of HBV infection was approximately 7%, which was higher than that in children. Conclusion The prevalence of HBV infection in the general population of China was classified as higher intermediate prevalence (5–7.99%), of which more than 90% of the HBV infection population included adults older than 20 years. The blocking of mother-to-infant hepatitis B transmission and plans involving timely birth dose of hepatitis B vaccine within 24 h should be implemented. Additionally, improving the quality of life and survival rate of the infected population through antiviral therapy and high-risk adult vaccination will be the priority of our future work. Moreover, various control measures should be implemented in different provinces across China.
IntroductionIn past twenty years, incidence of syphilis has been increasing and remained a public issue in China. In order to precisely control syphilis epidemic in the country, it was very important to explore and understand the spatial distribution pattern of syphilis in county level in China.MethodsWe used the software of ArcGIS(version 10) to set up the national geographic information system(GIS) database of syphilis of all counties in China in 2015. The exploratory spatial data analysis(ESDA), including frequency, the global and local spatial autocorrelation methods were used to explore the spatial distribution characteristics of syphilis.ResultsThe median of incidence of syphilis was 26.05/100,000 population (25% percentile and 75% percentile were 15.70 and 44.77/100,000 population, respectively), minimum with 0.84, maximum with 433.28/100,000 population in all 2925 counties of Chinese mainland in 2015, and appeared significant positive skewing (skewness was 3.19). The global trend analysis indicated that the whole distribution of syphilis from northwest to southeast appeared as “U” shape and suggested that the areas of high incidence of syphilis located in northwest and southeast coastal regions in China. The global spatial autocorrelation analysis showed a positive spatial autocorrelation (Global Moran’s I is 0.5962, p<0.001) and a high-high aggregation model (General G is 0.0441, p<0.001) for syphilis epidemics in county-level in China. The local spatial autocorrelation analysis was further used to output the hot-spot mapping of syphilis, including primary and secondary syphilis, latent syphilis in county-level, and 117 hot-spots counties with high incidence of primary and secondary syphilis were recognised and identified, mainly distributed in Yangtze River delta, north-west, north-eastern and south China.ConclusionGIS and exploratory spatial data analysis, with the advantages of visualisation and accurate location, should be as an important tool to apply in syphilis surveillance and control.
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