2013-2017年陕西省手足口病的时空流行特征

白尧; 陈志军; 陈保忠; 刘昆; 邵中军

doi:10.16462/j.cnki.zhjbkz.2021.03.015

2013-2017年陕西省手足口病的时空流行特征

doi: 10.16462/j.cnki.zhjbkz.2021.03.015

白尧^{1, 2},
陈志军²,
陈保忠²,
刘昆¹,
邵中军^1, ,

1.
710032 西安，空军军医大学军事预防医学系军队防疫与流行病学教研室，特殊作业环境危害评估与防治教育部重点实验室
2.
710054 西安，西安市疾病预防控制中心传染病预防控制科

基金项目:

国家传染病防治科技重大专项 2017ZX10105011

国家自然科学基金项目 AAA

陕西省自然科学基础研究计划项目 2017JQ8015

详细信息

通讯作者:
邵中军，E-mail: 13759981783@163.com

中图分类号: R544.1
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- 被引次数: 0
出版历程
- 收稿日期: 2020-07-13
- 修回日期: 2020-12-26
- 刊出日期: 2021-03-10

The spatio-temporal characteristics of hand-foot-mouth disease in Shaanxi Province, 2013-2017

1.
Department of Epidemiology, School of Military Preventive Medicine, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Air Force Medical University, Xi'an 710032, China
2.
Department of Infection Disease Control and Prevention, Xi'an Center for Disease Prevention and Control, Xi'an 710054, China

Funds:

China Special Grant for the Prevention and Control of Infection Diseases 2017ZX10105011

Surface project of National Natural Science Foundation AAA

Shaanxi Provincial Basic project of Natural Science Foundation 2017JQ8015

More Information

Corresponding author: SHAO Zhong-jun, E-mail: 13759981783@163.com

摘要

摘要: 目的探讨陕西省手足口病疫情的时空演变规律，为优化手足口病的防控策略提供科学依据。方法陕西省2013-2017年手足口病疫情个案数据来源于中国疾病预防控制信息系统，同期人口数据来源于陕西省统计年鉴，采用R 3.4.1、ArcGIS 10.2和SaTScan 9.2软件进行时空流行病学特征分析。结果陕西省2013-2017年累计报告手足口病284 225例，年均发病率150.45/10万；历年4-7月病例数占总病例数的70.69%，高发病率区县主要分布在关中地区的中东部区域。重症病例、死亡病例分布与总病例的空间分布基本一致。时空扫描分析显示，全省2013-2017年手足口病存在4个高发热点区域；疫情的一类聚集区固定在以西安市为中心的全省中部和东南部区县(RR=2.25, 95% CI: 2.18~3.11, P < 0.001)，但二类聚集区位置不固定。全省2013-2017年手足口病的优势流行病原为其他肠道病毒。结论陕西省手足口病疫情存在显著的时空聚集性特征，近年来病原以其他肠道病毒为主，呈现多病原交替流行；应针对不同时段和地区采取针对性的措施，以有效控制发病。
- 手足口病 /
- 空间流行病学 /
- 时空扫描统计
Abstract: Objective To obtain the spatial-temporal dynamical features of hand-foot-mouth disease(HFMD) in Shaanxi Province, so as to provide evidence for the development of relative prevention and control programs on HFMD. Methods Surveillance data of HFMD was collected from the China Information System for Diseases Control and Prevention from 2013 to 2017. Related data on population was obtained from Shaanxi Statistical Yearbook. Statistical tools as R 3.4.1, ArcGIS 10.2 and Satscan 9.2 software were used to analyse the spatial-temporal characteristics of the disease. Results A total of 284 225 cases of HFMD were reported in Shaanxi Province from 2013 to 2017, with an average annual incidence as 150.45 per 100 000. 70.69% of the total cases were identified between April and July. Counties with high incidence were mainly distributed in the mid-east parts of Guanzhong area(Central Shaanxi Plain). The spatial distribution of severe as well as death cases were basically consistent with the total cases. Through temporal and spatial scan statistics, we identified that there were four hot spots in Shaanxi Province, the most likely clustering area was fixed to the central and southeast counties of Shaanxi province which were around Xi'an City from 2013 to 2017 (RR=2.25, 95% CI: 2.18-3.11, P < 0.001), but the location of the secondary clustering area was not fixed. The predominant epidemic pathogen of HFMD was other enteroviruses from 2013 to 2017. Conclusions Significant spatial-temporal aggregation of HFMD was seen in Shaanxi Province. In recent years, other enteroviruses have became the main pathogeny, and multiple pathogens have been circulating alternately. Specific measures should be taken for different periods and regions to control the disease effectively.
- Hand-foot-mouth disease /
- Spatial epidemiology /
- Spatial-temporal scan statistics

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图 1 2013-2017年陕西省手足口病时间分布曲线

Figure 1. The time distribution curve of HFMD in Shaanxi Province from 2013 to 2017

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图 2 2013-2017年陕西省手足口病发病率空间分布(区县层级)

Figure 2. The spatial distribution of HFMD incidence in Shaanxi Province from 2013 to 2017 (District and county level)

下载: 全尺寸图片幻灯片

图 3 2013-2017年陕西省手足口病重症及死亡病例空间分布(区县层级)

Figure 3. The regional distribution of severe and death cases of HFMD in Shaanxi Province from 2013 to 2017 (District and county level)

下载: 全尺寸图片幻灯片

图 4 2013-2017年陕西省手足口病时空聚集性扫描图

Figure 4. The space-time clustering scanning of HFMD in Shaanxi Province from 2013 to 2017

下载: 全尺寸图片幻灯片

图 5 2013-2017年陕西省手足口病病原学时空分布

Figure 5. The space-time distribution of the etiology of pathogen of HFMD in Shaanxi Province from 2013 to 2017

下载: 全尺寸图片幻灯片

表 1 2013-2017年陕西省手足口病疫情概况

Table 1. The overall prevalence of HFMD in Shaanxi Province from 2013 to 2017

指标	2013年	2014年	2015年	2016年	2017年	合计/平均
总病例数	52 610	70 215	68 738	52 827	39 835	284 225
重症数	545	1 327	700	416	374	3 362
死亡数	9	20	6	9	2	46
发病率(/10万)	140.18	186.53	182.08	139.28	104.2	150.45
重症构成比(%)	1.04	1.89	1.02	0.79	0.94	1.18
死亡率(/10万)	0.02	0.05	0.02	0.02	0.01	0.02
病死率(%)	0.02	0.03	0.01	0.02	0.01	0.02

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表 2 2013-2017陕西省年手足口病时空聚集性扫描结果

Table 2. The results of space-time scanning of HFMD in Shaanxi Province from 2013 to 2017

年份(年)	聚集区类型	聚集中心	半径(km)	位置	聚集时间段	包含区县个数	RR值	P值
2013	一类聚集区	阎良	93.30	关中中部	4月10日-6月7日	43	2.57	< 0.001
	二类聚集区	-	-	不固定	5月10日-6月3日	4	1.94	< 0.001
2014	一类聚集区	华阴	41.70	全省中东部	4月25日-5月31日	21	2.73	< 0.001
	二类聚集区	-	-	不固定	4月30日-5月30日	9	1.46	< 0.001
2015	一类聚集区	商州	40.90	全省东南部	4月18日-6月11日	27	3.08	< 0.001
	二类聚集区	-	-	不固定	4月30日-5月11日	4	2.13	< 0.001
2016	一类聚集区	莲湖	15.60	关中中部	4月11日-6月12日	16	2.80	< 0.001
	二类聚集区	-	-	不固定	4月23日-6月8日	5	1.68	< 0.001
2017	一类聚集区	华阴	39.30	全省东南部	4月8日-6月6日	26	2.18	< 0.001
	二类聚集区	-	-	不固定	4月29日-6月10日	10	2.20	< 0.001

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表 3 2013-2017年陕西省手足口病病原学检测结果

Table 3. The results of pathogenic test of HFMD in Shaanxi Province from 2013 to 2017

年份(年)	实验室诊断病例数	EV71		CoxA16		其他肠道病毒
年份(年)	实验室诊断病例数	病例数	占比(%)	病例数	占比(%)	病例数	占比(%)
2013	3 707	856	23.09	1 887	50.91	964	26.00
2014	2 998	1064	35.49	921	30.72	1 013	33.79
2015	3 906	1 297	33.21	791	20.25	1 818	46.54
2016	3 754	1 387	36.95	1 053	28.05	1 314	35.00
2017	2 484	1 001	40.30	666	26.81	817	32.89
合计	16 849	5 605	33.27	5 318	31.56	5 926	35.17

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参考文献(12)

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