title: Changing 14-year trends in the epidemiology of hepatitis B virus infection in rural and urban Central-Eastern European areas.
abstract: In Poland, the prevalence of HBV infection constitutes an emerging public health concern. The aim of the study was to analyse changes in hepatitis B incidence rate by age, gender and place of residence in Poland between 1999 and 2012. The data were obtained from Polish state statistics institutions such as the National Institute of Public Health and State Sanitary Inspection. Relationships of hepatitis B incidence with age, gender and rural/urban areas were investigated using χ(2) and tests for two proportions with Bonferroni adjustment. The incidence of hepatitis B in rural and urban populations was compared using Wilcoxon's signed-rank tests. Joinpoint regression was used to analyse trends in hepatitis B incidence rate. In Poland, a total of 26 660 cases of hepatitis B were reported in the studied period and 31.6% of these cases occurred in rural areas. There was significantly declining tendency in the hepatitis B incidence rate in the initial period of the study. However, there were periods of significant increase of HBV incidence rate in women from rural areas aged 15-24 years (9.4%/year) and in women from urban areas aged 15-24 years (10.9%/year) and 25-64 years (3.8%/year) in the final years of the observation. Despite the success in controlling this infection, a significant increase in the incidence of hepatitis B among young women living in rural and urban areas, as well as in adult women in urban areas, has been noted.
authors.affiliation: Faculty of Health Sciences, Medical University of Bialystok, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Genowska
authors.affiliation: Faculty of Health Sciences, Medical University of Bialystok, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Jamiołkowski
authors.affiliation: Faculty of Medicine with Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, Poland.
authors.forename: E
authors.initials: E
authors.lastname: Rodakowska
authors.affiliation: Faculty of Medicine with Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Fryc
authors.affiliation: Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Kozela
authors.affiliation: Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Pająk
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D004196:Disease Outbreaks; D005260:Female; D006515:Hepatitis B virus / Q000254:growth & development; D019694:Hepatitis B, Chronic / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D012424:Rural Population / Q000706:statistics & numerical data*; D017678:Sex Distribution; D016896:Treatment Outcome; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: HBV infection; health inequalities; incidence; rural/urban areas; trends