Background. Endemic hepatitis B virus (HBV) infection is a serious health problem in China. Hepatitis B vaccination of infants was introduced in 1992 and was progressively expanded during the subsequent 15 years.Methods. We conducted a national serosurvey, with participants selected by multiple-stage random sampling. Demographic characteristics and hepatitis B vaccination history were collected by a questionnaire and a review of vaccination records, and serum specimens were tested for hepatitis B surface antigen, antibody to hepatitis B core antigen, and hepatitis B surface antibody by enzyme-linked immunosorbent assay.Results. Hepatitis B vaccine coverage (3 doses) increased from 30.0% for children born in 1992 to 93.4% for children born in 2005. Receipt of a timely birth dose increased from 22.2% to 82.6% for children born during this interval. Multivariate analysis showed that older age, western and rural residence, birth at home, and certain ethnicities were risk factors for undervaccination with both full vaccine series and timely birth dose. The prevalence of hepatitis B surface antigen was reduced to 2.1% among all children and 1.0% among children born after 1999. The efficacy of hepatitis B vaccination with a timely birth dose was 88.3%.Conclusions. Hepatitis B vaccine has been successfully integrated into routine infant immunization in China, now reaching most infants within 24 h after birth, and the prevalence of hepatitis B surface antigen has been greatly reduced among children born after 1992.

Objective: To determine the prevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core anti-body(anti-HBc) in a representative population in China 14 years after introduction of hepatitis B vaccination of infants.Methods: National serosurvey, with participants selected by multi-stage random sampling. Demographics and hepatitis B vaccination history collected by questionnaire and review of vaccination records, and serum tested for HBsAg, antibody to anti-HBc and anti-HBs by ELISA.Findings: The weighted prevalences of HBsAg, anti-HBs and anti-HBc for Chinese population aged 1-59 years were 7.2%, 50.1%, 34.1%, respectively. HBsAg prevalence was greatly diminished among those age <15 years compared to that found in the 1992 national serosurvey, and among children age <5 years was only 1.0% (90% reduction). Reduced HBsAg prevalence was strongly associated with vaccination among all age groups. HBsAg risk in adults was associated with male sex, Western region, and certain ethnic groups and occupations while risk in children included birth at home or smaller hospitals, older age, and certain ethnic groups (Zhuang and other).Conclusions: China has already reached the national goal of reducing HBsAg prevalence to less than 1% among children under 5 years and has prevented an estimated 16-20 million HBV carriers through hepatitis B vaccination of infants. Immunization program should be further strengthened to reach those remaining at highest risk. (C) 2009 Elsevier Ltd. All rights reserved.

Objective To better understand and measure the effect from 10-year immunization activities,we conducted seroepidemiological study using the remaining blood samples of the nationwide survey of Nutrition and Health in Chinese residents in 2002.Methods HBsAg,anti-HBs and anti-HBc in blood samples were tested using ELISA reagents and revised by SPRIA and Abbott ELISA reagents.Results Among the children aged(3-12) yearold,the prevalence rate of HBsAg is 5.03%,the rate of HBV infection is 29.10%. For the vaccinated children,the rates are 3.63% and 26.88% respectively.For the unvaccinated children,the rates are 11.19% and 47.03% respectively.Among the children,the rate of HBsAg is 2.07% in urban areas and 8.17% in rural areas.For the vaccinated children,the rate of HBsAg is 1.96% in urban areas and 6.65% in rural areas. For the unvaccinated children,the rate of HBsAg is 2.39% in urban areas and 10.84% in rural areas.Conclusion The prevalence rates of HBsAg and HBV infection have obviously declined in the children aged 3-12 year-old.And the effect from 10-years immunization activities has achieved great success.

Objective To know the status of Hepatitis B of the Eastern,Middle,and Western areas in China.Methods We analyzed the data of the seroepidemiological study using the remaining blood samples of the nationwide survey of Nutrition and Health in Chinese residents,which was done in 2002.Results (1)Among population in the Eastern areas,the adjusted prevalence rate of HBsAg is 9.20%,the rate of HBsAg is 4.29% in the urban areas and 11.79% in the rural areas.For15-years-old children,the rate is 6.46% in the whole children,2.29% in the urban areas and 12.39% in the rural areas respectively.(2)Among population in the Middle areas,the adjusted prevalence rate of HBsAg is 7.24%,the rate of HBsAg is 4.41% in the urban areas and 7.84% in the rural areas.For15-years-old children,the rate is 4.47% in the whole children,1.61% in the urban areas and 6.82% in the rural areas respectively.(3)Among the whole population in the Western areas,the adjusted prevalence rate of HBsAg is 8.24%,the rate of HBsAg is 4.53% in the urban areas and 9.05% in the rural areas.For15-years-old children,the rate is 5.48% in the whole children,2.57% in the urban areas and 7.35% in the rural areas respectively.Conclusions The results show that the prevalence rate of the HBsAg of the Eastern,Middle,and Western areas in China has obviously been descending in different levels,especially to the children less than 15 years old,and suggest that the impacts of(Hepatitis B) are prominent in these areas since the Hepatitis B vaccine has been introduced into expanded program on immunization(EPI) since 1992.

Objective To discuss the reasonable cost of EPI at all levels in different regions and provide economic basis for the governments' financial support to EPI.Methods Based on the actual cost of EPI,the reasonable costs were estimated by expert evaluation method.Results The EPI reasonable costs per child in Shandong,Hunan,and Gansu are 291.63 Yuan,260.85 Yuan and 274.39 Yuan respectively.The average reasonable cost in the three Provinces is 275.62 Yuan per child.The annual reasonable cost should be 4.42 billion Yuan in China.The proportions of township and village costs 46.41%,23.47%,respectively.The cost in county,township and village is 233.27 Yuan per child,which takes up 84.63% of total cost.The costs in staff,vaccine,EPI operation,logistic and cold chain equipment occupy 54.97%,8.22%,23.01%,8.60% and 5.20%,respectively.Actual and reasonable subsidies for village doctors' immunization are 2.74 yuan/dose and 3.84 Yuan/dose.Conclusions The government should ensure the finance for EPI according to the reasonable costs.County,township,and village have born the majority of EPI cost.The government at all levels should increase input for EPI and ensure the operational machanism on cost.The central and provincial governments need provide financial support for EPI in poor areas.The central,provincial,and county governments need provide salaries and reasonable subsidy for village doctors.

OBJECTIVETo better understand and measure the impact from immunization activities over the last 10-years, we conducted a sero-epidemiological study using the remaining blood samples of a nationwide survey on Nutrition and Health in Chinese residents, in 2002.METHODSHBsAg, anti-HBs and anti-HBc in blood samples were tested using enzyme-linked immunosorbent assay(ELISA) reagents and revised by solid phase radioimmunoassay and Abbott ELISA reagents.RESULTSAmong population older than 3 years, the prevalence rates of HBsAg, anti-HBs and hepatitis B virus(HBV) infection were 9.09%, 37.48% and 50.04% but for children between 3 and 12 year olds, they were 5.03%, 45.33% and 29.10% respectively. Among population older than 3 years, the rates of HBsAg and HBV infection in urban area were 4.61% and 43.51%, but the rates in rural area were 9.41% and 56.77% respectively while for children from 3-years to 12-years old, they rates were 2.10%, 20.45% in urban area and 8.25%, 39.22% in rural areas, respectively.CONCLUSIONResults revealed that since the hepatitis B vaccine was introduced into the expanded program on immunization(EPI) from 1992, the prevalence rates of HBsAg and HBV infection, especially in the children from 3 to 12 years of age, had obviously declined, suggesting that some changes had happened in the epidemic characters of hepatitis B in China.

Objective To understand and measure the effect of 10-years immunization activities,we decided to conduct seroepidemiological study using the remaining blood sampling of Nationwide Survey of Nutrition and Health in Chinese residents,which was conducted in 2002.Methods HBsAg,anti-HBs,and anti-HBc in blood samples were detected using ELISA reagents and revised by SPRIA and Abbott ELISA reagents.Results(1)Among the vaccinated population,the adjusted prevalence rate of HBsAg is 5.28%,and the rate of HBV infection is 54.44%.For the vaccinated children from 3-12 years old,the rate is 3.63% and 26.88%,respectively.(2)Among the unvaccinatted population,the rate of HBsAg is 9.51% and the rate of HBV infection is 64.63%.For the children of 3-12 years old,the rate is 11.19% and 47.03% respectively.(3)Among the vaccinatted population,the rate of HBsAg is 2.55% in urban area and 7.10% in rural area.For the unvaccinatted population,the rate is 7.24% and 10.12%,respectively.Among the vaccinatted children from 3-12 years old,the rate of HBsAg is 1.96% in urban area and 6.65% in rural area.For the unvaccinated children,the rate is 2.39% and 10.84%,respectively.Conclusion The results showed that the effect of 10years immunization activities is prominent and suggested that it was the most important to improve the coverage of hepatitis B vaccine in the rural children for prevention and control campaign of hepatitis B.

This paper presents the results of a study on simplified surveillance methods conducted in 23 pilot counties in 11 provinces and municipalities in China where reside 15 million people and malaria control has been in the late consolidation phase. Two simplified surveillance Schemes (A and B) taking treatment of clinical cases as the main measure were implemented in 1992-1994. The rate of annual blood examination for case detection was 1.0% in pilot Scheme A, while in areas of scheme B it was 0.3%. The implementation of both Scheme A and Scheme B, simplified or without treatment of infection foci and management of mobile populations, acquired satisfactory effects against malaria. Consequently, malaria incidence was declining steadily, only a few indigenous and introduced cases were detected. The parasite rate in residents and the IFA positive rate in children were very low. The results of pilot studies and cost-effectiveness analysis indicated that Scheme B is effective, rational and economic, and can be implemented to replace the routine surveillance measures in areas where malaria has been at the late consolidation phase in China.