Objective: To analyze epidemiological characteristics and spatiotemporal clustering of hepatitis A in China from 2005 to 2023. Methods: The incidence data of hepatitis A in China during 2005-2023 were collected from the China Disease Control and Prevention Information System . Results: From 2005 to 2023, a total of 605 509 cases of hepatitis A were reported in China. The average annual reported incidence rate was 2.32/100 000, the incidence was 2.85/100 000 in men and 1.81/100 000 in women, and the incidence was 3.25/100 000 in age group 0-14 years, 2.10/100 000 in age group 15-64 years and 2.49/100 000 in age group ≥65 years , respectively. The case count in farmers was highest (40.57%, 245 639/605 509). The proportion of the cases in jobless or the unemployed increased most obviously (347.32%), and the proportion of the cases in students decreased most significantly (90.27%). The average annual reported incidence rate in the western China was highest (4.45/100 000), followed by that in northeastern China (2.02/100 000), central China (1.89/100 000) and eastern China (1.16/100 000). From 2020 to 2023, the incidence of hepatitis A showed no spatial clustering. From 2005 to 2019, the obvious hot spots and high-high clustering areas mainly distributed in provinces, such as, Sichuan, Qinghai, Xinjiang, Xizang and Gansu. The low-low clustering areas were mainly distributed in Beijing, Tianjin, Hebei, Shandong, Jiangsu, Shanghai, Zhejiang, Fujian, Henan, Anhui, Jiangxi, Jilin and Liaoning. An independent high-low clustering was found in Shanxi during 2014-2019. A total of 5 high incidence clustering areas were detected through spatiotemporal scanning analysis. Conclusions: The incidence rate of hepatitis A in China declined significantly from 2005 to 2023. The reported incidence rate in the elderly showed no obvious decrease, and the reported cases accounted for the highest proportion in the whole population. Before 2020, the reported incidence rate of hepatitis A showed high-high clustering in western China, the spatiotemporal clustering disappeared from 2020 to 2023, but the reported incidence rate of hepatitis A in western China was still high. It is suggested to pay attention to the prevention and control of hepatitis A in populations at high risk and areas with high incidence of hepatitis A.
目的： 分析2005-2023年中国甲型肝炎（甲肝）流行病学特征和时空聚集性。 方法： 资料来源于中国疾病预防控制信息系统传染病报告信息管理系统2005-2023年甲肝发病数据，对甲肝报告发病率进行描述性流行病学和时空聚集性分析。 结果： 2005-2023年共报告甲肝病例605 509例，年均报告发病率为2.32/10万，男、女性分别为2.85/10万、1.81/10万，0~、15~和≥65岁年龄组人群分别为3.25/10万、2.10/10万和2.49/10万。在报告病例的职业分布中，以农民占比最高（40.57%，245 639/605 509），占比增加较明显的是离/退休人员和家务及待业（347.32%），占比减少较明显是学生（90.27%）。在年均报告发病率的地区分布中，西部地区最高（4.45/10万），其次分别为东北部（2.02/10万）、中部（1.89/10万）和东部地区（1.16/10万）。2020-2023年无空间聚集性，2005-2019年明显的热点地区和高-高聚集区主要为四川省、西藏自治区、甘肃省、青海省和新疆维吾尔自治区，低-低聚集区主要为北京市、天津市、河北省、山东省、江苏省、上海市、浙江省、福建省、河南省、安徽省、江西省、辽宁省和吉林省，2014-2019年山西省呈高-低聚集性。时空扫描分析发现，共探测出5个甲肝高发聚集区。 结论： 2005-2023年中国甲肝报告发病率显著下降，≥65岁老年人下降速度较慢，报告病例数在全人群中占比增加；2020年以前，甲肝报告发病率在西部地区呈高-高聚集，2020-2023年无空间聚集性，但西部地区的甲肝报告发病率仍较高。建议对甲肝发病的高风险人群和高发病聚集地区的疫情防控予以重点关注。.