2009-2018年陕西省手足口病时空分布规律及发病流行强度

朱妮; 周体操; 杨国婧; 李欣欣; 王舒; 张义

doi:10.16462/j.cnki.zhjbkz.2021.01.011

2009-2018年陕西省手足口病时空分布规律及发病流行强度

doi: 10.16462/j.cnki.zhjbkz.2021.01.011

710054 西安，陕西省疾病预防控制中心传染病预防控制所

基金项目:

陕西省卫生健康科研基金项目 2018D041

详细信息

通讯作者:
张义，E-mail：8826970@qq.com

中图分类号: R181
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出版历程
- 收稿日期: 2020-04-08
- 修回日期: 2020-08-22
- 刊出日期: 2021-01-10

Spatial and temporal distribution and epidemic intensity of hand, foot and mouth disease in Shaanxi Province from 2009 to 2018

Infectious Disease Prevention and Control Institute, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an 710054, China

Funds:

Health Research Fund Project of Shaanxi Province 2018D041

More Information

Corresponding author: ZHANG Yi, E-mail: 8826970@qq.com

摘要

摘要: 目的描述陕西省2009-2018年手足口病流行特征，探索其在时间、空间上的变化趋势。方法对2009-2018年陕西省手足口病疫情进行描述性分析，使用移动流行区间法(moving epidemic method, MEM)判断手足口病流行季节，使用时空扫描方法对手足口病时空聚集区域进行探索。结果 2009-2018年，陕西省手足口病年平均报告发病率为143.01/10万，男、女性别比1.47:1。患者年龄最大80岁，最小1 d，中位年龄2岁。2009-2018年疫情总体呈上升趋势，每年4月底-7月是陕西省手足口病流行高峰期。MEM模型显示，2018年陕西省手足口病在19周突破流行阈值，20周直接跨越低流行进入中流行，并持续11周，2018年31周进入低流行阶段，33周跌破流行阈值。时空扫描分析探测到时间维度为2010年4月-2010年7月，空间维度覆盖西安、咸阳和渭南部分县区的聚集区(RR=5.71, 95% CI：5.70~5.73, P < 0.001)，主要聚集区在10年中位置相对固定。结论陕西省手足口病发病存在明显时间和地区分布规律，关中地区为发病聚集区域，是手足口病的重点防控地区。
- 手足口病 /
- 流性特征 /
- 移动流行区间法 /
- 时空聚类
Abstract: Objective To describe the epidemiological characteristics of hand, foot and mouth disease (HFMD) and explore the spatial-temporal change tendency from 2009 to 2018 in Shaanxi Province. Methods The descriptive statistic method was used to describe epidemic situation of HFMD and moving epidemiological method (MEM) was used to detect the epidemic season, and possible spatial-temporal clusters of HFMD among down towns in Shaanxi Province from 2009 to 2018. Results The average morbidity from 2009 to 2018 was 143.01 per 100 000.The male-female ratio of HFMD was 1.47:1. The age of patients ranged from 1 day to 80 years old and the median age was 2 years old. The incidence of HFMD was increasing generally from 2009 to 2018, and from the end of April to July every year was the peak of HFMD in Shaanxi Province. The results from MEM model showed that the incidence of HFMD exceeded the given threshold value of low epidemic situation at 19th week, then reached to medium epidemic situation in the next week and lasted for 11 weeks. After that, the incidence rate came down back to low epidemic and normal situation at 31th and 33 th week respectively in the year of 2018. The results from the space-time scanning analysis showed that the epidemic period was from April 2010 to July 2010 from the time dimension, and some counties in Xi'an, Xianyang and Weinan (RR=5.71, 95% CI: 5.70-5.73, P < 0.001) were the main gathering areas of HFMD, and the main gathering areas were relatively fixed in 10 years. Conclusions There are significant spatial-temporal cluster patterns for the distribution of HFMD incidence in Shaanxi. The Guanzhong area is the main gathering area. The prevention and control intervention should be strengthened accordingly.
- Hand foot and mouth disease /
- Epidemiological characteristics /
- Moving epidemic method /
- Spatio-temporal cluster

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图 1 2009-2018年陕西省手足口病时空聚类结果

Figure 1. Spatio-temporal clustering results of hand-foot-and-mouth disease in Shaanxi Province from 2009 to 2018

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图 2 2009-2018年陕西省手足口病时间分布

Figure 2. Time distribution of hand, foot and mouth disease in Shaanxi Province from 2009 to 2018

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表 1 2009-2018年陕西省手足口病发病的时空聚类分析结果

Table 1. Results of temporal and spatial cluster analysis of the incidence of hand, foot and mouth disease in Shaanxi Province from 2009 to 2018

聚集区	时间	聚集区域	实际病例数	理论病例数	LLR值	RR值	P值
一类聚集区	2010年4-7月	西安、咸阳、渭南(15个县区)	22 203	4 030.94	20 040.49	5.71	< 0.001
二类聚集区	2014年4-6月	宝鸡、汉中、咸阳(30个县区)	11 441	3 478.45	5 721.99	3.34	< 0.001
二类聚集区	2014年5-7月	延安、榆林(39个县区)	11 148	3 755.19	4 791.62	3.01	< 0.001

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表 2 2018年陕西省手足口病流行强度分析

Table 2. Analysis of the prevalence of hand, foot and mouth disease in Shaanxi Province in 2018

周	流行强度	发病率(/10万)
1-18	流行前期	0.04~3.61
19	低流行期	4.56
20~	中流行期	7.56~11.70
31~	低流行期	5.29~7.03
33~52	流行后期	0.84~4.00

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参考文献(16)

[1]	张静. 2008-2017年中国手足口病流行趋势和病原变化动态数列分析[J].中华流行病学杂志, 2019, 40(2):147-154. DOI: 10.3760/cma.j.issn.0254-6450.2019.02.005. Zhang J. Trend of epidemics and variation of pathogens of hand, foot and mouth disease in China: a dynamic series analysis, 2008-2017 [J]. Chin J Epidemiol, 2019, 40(2):147-154. DOI: 10.3760/cma.j.issn.0254-6450.2019.02.005.
[2]	Zhang J, Sun J, Chang Z, et al. Characterization of hand, foot, and mouth disease in China between 2008 and 2009 [J]. Biomed environ sci, 2011, 24(3):214-221. DOI: 10.3967/0895-3988.2011.03.002.
[3]	陈琦, 吴杨, 童叶青, 等. 2013-2017年湖北省手足口病时空聚集性分析[J].公共卫生与预防医学, 2019, 30(2):42-45. DOI: 10.3969/j.issn.1006-2483.2019.02.011. Chen Q, Wu Y, Tong YQ, et al. Temporal-spatial clustering analysis of hand, foot and mouth disease in Hubei Province (2013-2017) [J]. J Pub Health and Prev Med, 2019, 30(2):42-45. DOI: 10.3969/j.issn.1006-2483.2019.02.011.
[4]	Vega T, Lozano JE, Meerhoff T, et al. Influenza surveillance in Europe: comparing intensity levels calculated using the moving epidemic method [J]. Influenza Other Respir Viruses, 2015, 9(5):234-246. DOI: 10.1111/irv.12330.
[5]	Vega T, Lozano JE, Meerhoff T, et al. Influenza surveillance in Europe: establishing epidemic thresholds by the moving epidemic method [J]. Influenza Other Respir Viruses, 2013, 7(4):546-558. DOI: 10.1111/j.1750-2659.2012.00422.x
[6]	程勋杰, 陈涛, 舒跃龙, 等.移动流行区间法在我国北方15省份流感流行阈值制定中的应用效果评价[J].中国卫生统计, 2016, 33(6):979-982. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWT201606017.htm Cheng XJ, Chen T, Shu HL, et al. Evaluation of the application effect of the mobile epidemic interval method in the formulation of influenza epidemic threshold in 15 provinces in northern my country [J]. Chin J HeaIth Stat, 2016, 33(6):979-982. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWT201606017.htm
[7]	陈琦, 邢学森, 吴杨, 等.湖北省2009-2015年手足口病流行病学和病原学分析[J].中华流行病学杂志, 2019, 38(4):441-445. DOI: 10.3760/cma.j.issn.0254-6450.2017.04.006. Chen Q, Xing XS, Wu Y, et al. Hand, foot and mouth disease in Hubei Province, 2009-2015: an epidemiological and etiological study [J]. Chin J Epidemiol, 2019, 38(4):441-445. DOI: 10.3760/cma.j.issn.0254-6450.2017.04.006.
[8]	陈思秇, 马文军.手足口病发病的危险因素研究进展[J].华南预防医学, 2016, 42(3):282-286. DOI: 10.13217/j.scjpm.2016.0282. Chen SY, Ma WJ. Advances in risk factors of hand, foot and mouth disease [J]. South China J Prev Med, 2016, 42(3):282-286. DOI: 10.13217/j.scjpm.2016.0282.
[9]	张超颖. 2013-2015年泉州市手足口病病原学检测及流行病学特征研究[J].中国预防医学杂志, 2017, 18(7):534-537. DOI: 10.16506/j.1009-6639.2017.07.012. Zhang CY. Etiology surveillance and epidemiology analysis of hand foot mouth disease in Quanzhou from 2013 to 2015 [J]. Chin Prev Med, 2017, 18(7):534-537. DOI: 10.16506/j.1009-6639.2017.07.012.
[10]	刘亚敏, 李晓勇, 刘天.湖北省荆州市2017年手足口病流行特征及时空聚集性分析[J].国际病毒学杂志, 2019, 26(4):123-126. DOI: 10.3760/cma.j.issn.1673-4092.2019.02.014. Liu YM, Li XY, Liu T. Epidemiological characteristics and temporal-spatial clustering analysis on hand, foot, and mouth disease in Jingzhou city of Hubei Province, 2017 [J]. International Journal of Virology, 2019, 26(4):123-126. DOI: 10.3760/cma.j.issn.1673-4092.2019.02.014.
[11]	祝寒松, 陈思, 王明斋, 等.厦门市2013-2017年手足口病发病与气象因素影响分析[J].中华流行病学杂志, 2019, 40(5):531-536, DOI: 10.3760/cma.j.issn.0254-6450.2019.05.008. Zhu HS, Chen S, Wang MZ, et al. Analysis on association between incidence of hand foot and mouth disease and meteorological factors in Xiamen, 2013-2017 [J]. Chin J Epidemiol, 2019, 40(5):531-536, DOI: 10.3760/cma.j.issn.0254-6450.2019.05.008.
[12]	黄丽媛, 宋佳, 曾强.天津市气象因素对手足口病发病影响研究[J].华南预防医学, 2019, 45(6):595-597, 600. DOI: 10.12183/j.scjpm.2019.0595. Huang LY, Song J, Zeng Q, et al. Impact of meteorological factors on hand, foot, and mouth disease in Tianjin [J]. South China J Prev Med, 2019, 45(6):595-597, 600. DOI: 10.12183/j.scjpm.2019.0595
[13]	Ma E, Chart KC, Cheng P, et al. The enterovirus 71 epidemic in 2008-public health implications for Hong Kong [J]. Int J Infect Dis, 2010, 14(9):775-780. DOI: 10.1016/j.ijid.2010.02.2265.
[14]	林春燕, 王明昌, 曾小平, 等.海口市2008-2015年手足口病流行病学特征分析[J].中华流行病学杂志, 2016, 37(12):1615-1618. DOI: 10.3760/cma.j.issn.0254-6450.2016.12.012. Lin CY, Wang MC, Zeng XP, et al. Epidemiologic features of hand-foot-mouth disease in Haikou city from 2008 to 2018 [J]. Chin J Epidemiol, 2016, 37(12):1615-1618. DOI: 10.3760/cma.j.issn.0254-6450.2016.12.012.
[15]	刘雅琼, 袁伟, 吕强. 2009-2016年四川省手足口病流行病学和病原学特征分析[J].中华疾病控制杂志, 2017, (10):1052-1056. DOI: 10.16462/j.cnki.zhjbkz.2017.10.020. Liu YQ, Yuan W, Lv Q, et al. Epidemiological and etiological characteristics of hand, foot and mouth disease in Sichuan Province, 2009-2016 [J]. Chin J Dis Control Prev, 2017, (10):1052-1056. DOI: 10.16462/j.cnki.zhjbkz.2017.10.020.
[16]	何继波, 罗琼梅, 彭霞, 等. 2009-2018年云南省手足口病流行病学特征分析[J].现代预防医学, 2019, 46(22):4033-4036. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201922001.htm He JB, Luo QM, Peng X, et al. Analysis of epidemiological characteristics of hand-foot -mouth disease in Yunnan Province from 2009 to 2018 [J]. Modern Prevent Med, 2019, 46(22):4033-4036. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201922001.htm