The epidemiological characteristics of rash and fever syndrome in Gansu Province from 2009 to 2019
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摘要:
目的 了解2009―2019年甘肃省发热伴出疹症候群(rash and fever syndrome, RFS)的病原构成及季节流行性分布特征，为进一步疾病监测和科学防控提供参考。 方法 采用描述性流行病学方法分析2009―2019年甘肃省RFS病原构成及主要病原的季节性变化特征。 结果 甘肃省RFS病原构成以病毒为主，主要是肠道病毒(56.04%)、麻疹病毒(19.14%)、水痘-带状疱疹病毒(16.85%)和风疹病毒(7.33%)；主要病原在不同年龄段、不同季节间的阳性率差异均有统计学意义(均有P＜0.05)。肠道病毒在0~＜5岁和5~＜15岁组阳性率较高(χ2 =393.04, P＜0.001)，麻疹病毒在35~＜50岁组阳性率最高(χ2 =150.13, P＜0.001)，风疹病毒在15~＜35岁组阳性率最高(χ2 =327.89, P＜0.001)，而水痘-带状疱疹病毒在0~＜5岁组最低(χ2 =221.53, P＜0.001)；冬季肠道病毒阳性率低于其他季节(χ2 =173.97, P＜0.001)；春季麻疹病毒(χ2 =164.46, P＜0.001)和风疹病毒(χ2 =68.90, P＜0.001)阳性率较高；而冬季水痘-带状疱疹病毒阳性率高于其他季节(χ2 =32.90, P＜0.001)。 结论 2009―2019年甘肃省RFS病原构成以病毒为主，且主要病原具有明显的季节性特征，应对重点人群采取季节性针对性预防措施。 Abstract:Objective To understand the compositions of pathogens and seasonal distribution characteristics of rash and fever syndrome (RFS) in Gansu Province from 2009 to 2019, so as to provide references for further disease surveillance and scientific prevention and control. Methods Descriptive epidemiological methods were used to analyze the composition of pathogens of RFS in Gansu Province from 2009 to 2019 and the seasonal variation characteristics of the main pathogens. Results The compositions of pathogens of RFS in Gansu Province were dominated by viruses, mainly enterovirus (56.04%), measles virus (19.14%), varicella-zoster virus (16.85%) and rubella virus (7.33%). The differences of positive rate of the main pathogens in different age groups and different seasons were statistically significant (all P < 0.05). The positive rate of enterovirus was higher in the 0-year-old and 5-year-old groups (χ2 =393.04, P < 0.001). The positive rate of measles virus was the highest in the 35-year-old group (χ2 =150.13, P < 0.001). The positive rate of rubella virus was the highest in the 15-year-old group (χ2 =327.89, P < 0.001), while the varicella-zoster virus had the lowest positive rate in the 0-year-old group (χ2 =221.53, P < 0.001). The positive rate of enterovirus in winter was lower than those in other seasons (χ2 =173.97, P < 0.001). The positive rate of measles virus (χ2 =164.46, P < 0.001) and rubella virus (χ2 =68.90, P < 0.001) were higher in spring, and the positive rate of varicella-zoster virus in winter was higher than those in other seasons (χ2 =32.90, P < 0.001). Conclusions From 2009 to 2019, the compositions of pathogens of RFS in Gansu Province were mainly viruses and the main pathogens have obvious seasonal characteristics. Seasonal and targeted proventive methods should be adopted for high-risk populations. -
图 1 2009―2019年甘肃省不同年龄段病原构成
Figure 1. Compositions of pathogens in different age groups in Gansu Province from 2009 to 2019
图 2 2009―2019年甘肃省主要病原季节流行特征
Figure 2. Epidemic characteristics of major pathogens in different seasons in Gansu Province from 2009 to 2019
表 1 2009―2019年甘肃省RFS病例病原检出情况
Table 1. Pathogenic detection results of RFS cases in Gansu Province from 2009 to 2019
病原 阳性数(例) 检测数(例) 阳性率(%) 构成比(%) 肠道病毒 1 666 3 514 47.41 56.04 麻疹病毒 569 3 244 17.54 19.14 风疹病毒 218 3 206 6.80 7.33 水痘-带状疱疹病毒 501 1 877 26.69 16.85 人类小DNA病毒B19 15 1 154 1.30 0.50 登革病毒 2 808 0.25 0.07 A组链球菌 2 380 0.53 0.07 
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表 2 2009―2019年甘肃省主要病原分年龄组检出情况
Table 2. The detection results of main pathogens in different age groups in Gansu Province from 2009 to 2019
病原 年龄组(岁) χ2值 P值 0~＜5 5~＜15 15~＜35 35~＜50 ≥50 肠道病毒 2 430(57.41) a 756(32.28) a 270(8.15) 46(8.70) 39(2.56) 393.04 ＜0.001 麻疹病毒 1 617(21.77) 792(5.43) 557(20.29) 133(37.59) b 10(7.59) 150.13 ＜0.001 风疹病毒 1 591(1.76) 785(9.81) 553(19.53) c 132(3.03) 145(0.69) 327.89 ＜0.001 水痘-带状疱疹病毒 854(11.65) d 209(36.30) 311(44.69) 25(46.30) 27(51.92) 221.53 ＜0.001 注：检出情况以n(%)表示，n为检测数，%为阳性率; a经Bonferroni法校正，0~＜5岁、5~＜15岁组与其他年龄组两两比较均有P＜0.05; b经Bonferroni法校正，35~＜50岁组与其他年龄组两两比较均有P＜0.05; c经Bonferroni法校正，15~＜35岁组与其他年龄组两两比较均有P＜0.05; d经Bonferroni法校正，0~＜5岁组与其他年龄组两两比较有P＜0.05。
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表 3 2009―2019年甘肃省主要病原季节检出情况
Table 3. The detection results of main pathogens in different seasons in Gansu Province from 2009 to 2019
病原 季节 χ2值 P值 春季 夏季 秋季 冬季 肠道病毒 1 035(41.45) 1 437(58.73) 753(42.76) 316(22.47) a 173.97 ＜0.001 麻疹病毒 1 117(27.31) b 905(12.60) 627(4.63) 595(20.34) 164.46 ＜0.001 风疹病毒 1 094(11.06) c 897(7.02) 623(0.96) 592(4.73) 68.90 ＜0.001 水痘-带状疱疹病毒 504(27.78) 647(23.96) 405(20.49) 321(38.32) d 32.90 ＜0.001 注：检出情况以n(%)表示，n为检测数，(%)为阳性率; a经Bonferroni法校正，冬季肠道病毒阳性率与春、夏、秋季两两比较均有P＜0.05; b经Bonferroni法校正，春季麻疹病毒阳性率与夏、秋、冬季两两比较均有P＜0.05; c经Bonferroni法校正，春季风疹病毒阳性率与夏、秋、冬季两两比较均有P＜0.05; d经Bonferroni法校正，冬季水痘-带状疱疹病毒阳性率与春、夏、秋季两两比较均有P＜0.05。
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