摘要
目的分析2017—2022年四川省甲乙类肠道传染病流行特征和时空聚集性,为防控工作提供参考和依据。方法采用描述性流行病学方法,对甲乙类肠道传染病的流行特征和趋势进行分析。采用R 4.3.0软件进行发病率地图制作和数据分析,SaTScan 10.0软件用于回顾性时空扫描统计。结果2017—2022年甲乙类肠道传染病年均发病率9.57/10万,总体发病整体呈下降趋势(Z=-31.428,P<0.001)。2020—2022年甲乙类肠道传染病发病率较2017—2019年降低了30.45%。其中痢疾发病率连续6年居甲乙类肠道传染病首位,其次是甲肝、戊肝。甲乙类肠道传染发病具有明显的季节性,发病高峰在5至9月。发病率较高年龄组为0~4岁组、50~54岁组和75~79岁组,其中痢疾、伤寒和副伤寒以0~4岁组儿童为主,甲肝、戊肝、未分型肝炎病例数以40~59岁成年人为主。男性发病率高于女性(χ^(2)=322.34,P<0.001)。职业以农民和散居儿童为主。发病率较高地区主要集中在川西地区(阿坝州、凉山州、甘孜州和攀枝花市)及自贡市、遂宁市等部分中部地区。时空扫描结果显示,2017—2022年四川省甲乙类肠道传染病存在明显的时空聚集性,一类聚集区在攀枝花市和凉山州,聚集时间2017年2与1日至2020年1月31日(扫描半径=124.84 km,LLR=75.90,RR=6.00,P<0.001)。二类聚集区分别在阿坝州、遂宁市、自贡市、雅安市和眉山市。逐年时空聚集性分析显示聚集时间有所变化。结论四川省甲乙类肠道传染病发病率近年来呈下降趋势,呈现明显的时空聚集性,新冠疫情防控期间发病率下降明显。建议加强监测,提高早期识别能力,根据时空聚集模式,对重点人群和场所制定针对性的精准防控策略。
Objective To analyze the epidemiological characteristics and temporal-spatial clustering of class A and B intestinal infectious diseases in Sichuan Province from 2017 to 2022,and to provide reference and basis for disease prevention and control.Methods Descriptive epidemiological analysis methods were conducted to analyze the epidemiological characteristics and trends of class A and B intestinal infectious diseases.Software R 4.3.0 was used for mapping morbidity and data analysis.Software SaTScan 10.0 was used for retrospective temporal-spatial scanning statistics.Results The average annual incidence of class A and B intestinal infectious diseases from 2017 to 2022 was 9.57/105,and the overall incidence showed a downward trend(Z=-31.428,P<0.001).The incidence of class A and B intestinal infectious diseases from 2020 to 2022 was reduced by 30.45%compared with the rate from 2017 to 2019.Among them,the incidence of dysentery ranked first in class A and B intestinal infectious diseases for 6 consecutive years,followed by hepatitis A and E.The incidence of class A and B intestinal infectious diseases had obvious seasonality,and the peak of the incidence was from May to September.The age groups with high incidence were 0-4 years old,50-54 years old and 75-79 years old.Dysentery,typhoid fever and paratyphoid fever were mainly in children aged 0-4 years,and hepatitis A,hepatitis E and unclassified hepatitis were mainly in adults aged 40-59 years.The incidence was higher in men than that in women(χ^(2)=322.34,P<0.001).The occupations were mainly farmers and scattered children.The areas with high incidence were mainly concentrated in western Sichuan Province(Aba Prefecture,Liangshan Prefecture,Ganzi Prefecture and Panzhihua City),Zigong City,Suining City and other central regions.The temporal-spatial scanning results showed that there was obvious temporal-spatial clustering of class A and B intestinal infectious diseases in Sichuan Province from 2017 to 2022.The first type of cluster areas were Panzhihua City and Liangshan Prefecture,and the cluster time was from February 1,2017 to January 31,2020(cluster radius=124.84 km,maximum likelihood ratio(LLR)=7855.90,relative ratio(RR)=6.00,P<0.001).The second type of cluster areas were Aba Prefecture,Suining City,Zigong City,Yaan City and Meishan City.Year-by-year temporal-spatial clustering analysis showed that the cluster time changed.Conclusions In recent years,the incidence of class A and B intestinal infectious diseases in Sichuan Province had shown a decreasing trend and obvious temporal-spatial clustering.The incidence had decreased significantly during the COVID-19 prevention and control period.It is recommended to strengthen monitoring,improve early identification ability,and formulate targeted and precise prevention and control strategies for key populations and places according to temporal-spatial clustering patterns.
作者
李羚
张云娜
李蔚
马瑶
刘燕
杜飞
吕强
LI Ling;ZHANG Yunna;LI Wei;MA Yao;LIU Yan;DU Fei;LYU Qiang(Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China)
出处
《预防医学情报杂志》
CAS
2023年第10期1163-1170,1177,共9页
Journal of Preventive Medicine Information
关键词
肠道传染病
流行特征
时空聚集
intestinal infectious diseases
epidemiological characteristics
temporal-spatial clustering
