发热伴血小板减少综合征疫情呈上升趋势：基于2015―2020年南京市报告病例数据

马涛; 张敏; 杜雪飞; 汪君君; 王恒学; 徐庆; 周沁易; 郑颖; 林丹; 洪镭; 刘坤

doi:10.16462/j.cnki.zhjbkz.2022.12.008

发热伴血小板减少综合征疫情呈上升趋势：基于2015―2020年南京市报告病例数据

doi: 10.16462/j.cnki.zhjbkz.2022.12.008

马涛¹,
张敏¹,
杜雪飞²,
汪君君¹,
王恒学¹,
徐庆¹,
周沁易¹,
郑颖¹,
林丹³,
洪镭^1, ,,
刘坤^4, ,

1.
210003 南京，南京市疾病预防控制中心急性传染病防制科
2.
210003 南京，南京市疾病预防控制中心微生物检验科
3.
200032 上海，复旦大学公共卫生安全教育部重点实验室
4.
211200 南京，溧水区疾病预防控制中心卫生应急办公室

基金项目:

江苏省预防医学课题 Y2018077

南京市医学重点专科 Ningwei Science and Education [2018] No.7

南京市卫生科技发展项目 YKK22190

详细信息

通讯作者:
刘坤，E-mail: chinaliukun@126.com

洪镭，E-mail: 930582@qq.com

中图分类号: R512.8
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- 被引次数: 0
出版历程
- 收稿日期: 2021-05-08
- 修回日期: 2021-07-08
- 网络出版日期: 2022-12-30
- 刊出日期: 2022-12-10

The rising trend of severe fever with thrombocytopenia syndrome: based on the data of reported cases in Nanjing from 2015 to 2020, China

1.
Department of Acute Infectious Disease Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China
2.
Department of Microbiological Laboratory, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China
3.
Key Laboratory of Public Health Safety Ministry of Education, Fudan University, Shanghai 200032, China
4.
Department of Public Health Emergency, Lishui District Center for Disease Control and Prevention, Nanjing 211200, China

Funds:

Jiangsu preventive medicine program Y2018077

Nanjing key medical specialty Ningwei Science and Education [2018] No.7

Nanjing medical science and technology development program YKK22190

More Information

Corresponding author: HONG Lei, E-mail: 930582@qq.com; LIU Kun, E-mail: chinaliukun@126.com

摘要

摘要: 目的了解南京市发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome, SFTS)的报告发病趋势、流行特征，探究重点防控人群、地区及影响因素，为指导制定防控策略、措施和采取干预行动提供科学依据。方法描述2015―2020年南京市SFTS流行趋势和季节、人群及空间分布特征，利用全局空间自相关分析、局部空间自相关分析和FleXScan扫描，探索乡镇/街道层面上报告发病的空间异质性和聚集性。结果共报告SFTS确诊病例194例，年均报告发病率为0.39/10万，年度变化百分比(annual percent change, APC)为33.43%(95% CI：5.41%~68.89%, P=0.03)，2020年相比2019年增加115%(39例)。5―8月占79.38%，7月为高峰占28.87%。平均年龄为64(54, 71)岁，≥60岁占64.43%，45~＜60岁占27.32%。农民占61.34%，家务待业占12.89%，离退休人员占11.34%。溧水区报告病例数占46.39%。全局空间自相关Moran’s I=0.58(Z=9.97, P=0.001)，局部空间自相关与FleXScan扫描结果显示，溧水区除和凤镇外的7个乡镇/街道与江宁区横溪街道为一级聚集区(LLR=150.24, P=0.001)，浦口区江浦街道、桥林街道和星甸街道为二级聚集区(LLR=17.81, P=0.001)。结论南京市SFTS报告发病率呈上升趋势，≥45岁人群和农民为重点人群，溧水区为重点防控地区。建议及时开展基于危险因素和趋势研判的专题研究，同时强化和落实综合防控干预措施。
- 发热伴血小板减少综合征 /
- 流行病学特征 /
- 空间聚集性 /
- 蜱 /
- 趋势
Abstract: Objective To understand the reported incidence trend and epidemic characteristics of severe fever with thrombocytopenia syndrome (SFTS) in Nanjing, exploring the critical prevention and control population, areas, and influencing factors, and providing scientific basis for guiding the formulation of prevention and control strategies, measures and carrying out scientific intervention actions. Methods The reported incidence trend and characteristics of seasonal distribution, population distribution and spatial distribution of SFTS in Nanjing from 2015 to 2020 were described. Global spatial autocorrelation analysis, local spatial autocorrelation analysis, and FleXScan spatial clustering scans were used to explore the spatial heterogeneity and spatial cluster at the town/street level. Results There were 194 SFTS reported confirmed cases. The annual average reported incidence was 0.39/100 000 (0.13/100 000 to 0.86/100 000), and the annual percent change (APC) was 33.43% (95% CI: 5.41 to 68.89, P=0.03). Seventy-three cases were reported in 2020, with an increased rate of 115% when compared to 2019 (39 cases). Among all reported cases, 79.38% were from May to August, and the peak was in July which accounted for 28.87%. The median age was 64 (54, 71) years, of 64.43% were aged 60 or above, and the group of 45- < 60 years was accounted for 27.32%. In terms of occupations, the proportion of farmers was 61.34%, household and unemployed workers was 12.89%, and for retirees was 11.34%. The number of reported cases in Lishui District accounted for 46.39%. Moran's I for global spatial autocorrelation analysis was 0.58 (Z=9.97, P=0.001). Additionally, local spatial autocorrelation analysis and FleXScan spatial clustering scans showed that Seven towns/streets in Lishui District except Hefeng Town and Hengxi Street in Jiangning District were first cluster areas (LLR=150.24, P=0.001). And secondary cluster areas were Jiangpu Street, Qiaolin Street, and Xingdian Street in Pukou District (LLR=17.81, P=0.001). Conclusions The trend of reported incidence of SFTS in Nanjing rise. The critical populations are those ages 45 and older and farmer. Besides, Lishui District would be critical prevention and control area. It is suggested to carry out monographic research which based on risk factors and trend judgement in time, and strengthen and implement comprehensive prevention and control interventions at the same time.
- Severe fever with thrombocytopenia syndrome /
- Epidemiologic characteristics /
- Spatial clustering analysis /
- Tick /
- Trend

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表 1 2015―2020年南京市报告SFTS病例发病与死亡情况统计

Table 1. Statistics of incidence and death of SFTS reported cases in Nanjing from 2015 to 2020

年份(年)	报告病例数(例)	报告发病率(/10万)	报告死亡数(例)	报告死亡率(/10万)	病死率(%)
2015	11	0.13	1	0.01	9.09
2016	30	0.36	1	0.01	3.33
2017	19	0.23	1	0.01	5.26
2018	27	0.32	2	0.02	7.41
2019	34	0.40	3	0.04	8.82
2020	73	0.86	11	0.13	15.07
合计	194	0.39	19	0.04	9.79

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表 2 2015―2020年南京市报告SFTS病例月分布

Table 2. Monthly distribution of SFTS reported cases in Nanjing from 2015 to 2020

月份	2015年(例)	2016年(例)	2017年(例)	2018年(例)	2019年(例)	2020年(例)	合计[n (%)]
1	0	0	0	0	0	0	0(0.00)
2	0	0	0	0	0	0	0(0.00)
3	0	0	1	0	0	0	1(0.52)
4	0	3	1	2	2	1	9(4.64)
5	6	9	2	7	8	10	42(21.65)
6	0	4	3	6	4	15	32(16.49)
7	1	8	3	8	11	25	56(28.87)
8	2	3	4	1	5	9	24(12.37)
9	0	0	1	2	1	5	9(4.64)
10	1	3	3	1	3	8	19(9.79)
11	1	0	1	0	0	0	2(1.03)
12	0	0	0	0	0	0	0(0.00)
合计	11	30	19	27	34	73	194(100.00)

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表 3 2015―2020年南京市报告SFTS病例人群分布特征[n (%)]

Table 3. Demographic characteristics of SFTS reported cases in Nanjing from 2015 to 2020 [n (%)]

变量	2015年(n=11)	2016年(n=30)	2017年(n=19)	2018年(n=27)	2019年(n=34)	2020年(n=73)	合计(N=194)
性别
男	8(72.73)	14(46.67)	9(47.37)	14(51.85)	14(41.18)	38(52.05)	97(50.00)
女	3(27.27)	16(53.33)	10(52.63)	13(48.15)	20(58.82)	35(47.95)	97(50.00)
年龄(岁)
0~＜15	0(0.00)	0(0.00)	0(0.00)	1(3.70)	0(0.00)	0(0.00)	1(0.52)
15~＜30	0(0.00)	3(10.00)	0(0.00)	2(7.41)	1(2.94)	2(2.74)	8(4.12)
30~＜45	0(0.00)	4(13.33)	0(0.00)	1(3.70)	1(2.94)	1(1.37)	7(3.61)
45~＜60	3(27.27)	7(23.33)	7(36.84)	9(33.33)	8(23.53)	19(26.03)	53(27.32)
≥60	8(72.73)	16(53.33)	12(63.16)	14(51.85)	24(70.59)	51(69.86)	125(64.43)
人群分类
农民	7(63.64)	14(46.67)	12(63.16)	19(70.37)	22(64.71)	45(61.64)	119(61.34)
家务待业	3(27.27)	7(23.33)	3(15.79)	1(3.70)	4(11.76)	7(9.59)	25(12.89)
离退休人员	1(9.09)	3(10.00)	3(15.79)	0(0.00)	5(14.71)	10(13.70)	22(11.34)
工人	0(0.00)	1(3.33)	1(5.26)	2(7.41)	3(8.82)	6(8.22)	13(6.70)
其他	0(0.00)	5(16.67)	0(0.00)	5(18.52)	0(0.00)	5(6.85)	15(7.73)

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表 4 2015―2020年南京市报告SFTS病例数和发病率地区分布(区层级)[n (/10万)]

Table 4. Spatial distribution of SFTS reported cases and incidence in Nanjing from 2015 to 2020 (District level) [n (/100 000)]

地区	2015年	2016年	2017年	2018年	2019年	2020年	合计
溧水区	6(1.40)	11(2.54)	8(1.84)	11(2.37)	13(2.75)	41(8.70)	90(3.27)
江宁区	2(0.17)	5(0.42)	4(0.34)	4(0.32)	6(0.47)	14(1.04)	35(0.46)
浦口区	1(0.14)	3(0.41)	2(0.59)	6(1.66)	5(1.33)	11(2.92)	28(1.17)
鼓楼区	0(0.00)	4(0.31)	1(0.08)	2(0.17)	5(0.45)	2(0.18)	14(0.20)
六合区	1(0.14)	2(0.28)	3(0.43)	2(0.27)	0(0.00)	2(0.27)	10(0.23)
玄武区	0(0.00)	2(0.30)	0(0.00)	0(0.00)	1(0.17)	1(0.17)	4(0.11)
江北新区	0(0.00)	1(0.45)	0(0.00)	0(0.00)	2(0.29)	0(0.00)	3(0.12)
雨花台区	0(0.00)	0(0.00)	1(0.25)	1(0.22)	0(0.00)	1(0.21)	3(0.11)
秦淮区	0(0.00)	0(0.00)	0(0.00)	1(0.10)	1(0.10)	0(0.00)	2(0.03)
栖霞区	1(0.15)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	1(0.14)	2(0.05)
高淳区	0(0.00)	1(0.23)	0(0.00)	0(0.00)	1(0.22)	0(0.00)	2(0.08)
建邺区	0(0.00)	1(0.23)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	1(0.04)
合计	11(0.13)	30(0.36)	19(0.23)	27(0.32)	34(0.40)	73(0.86)	194(0.39)

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表 5 2015―2020年南京市报告SFTS病例FleXScan空间聚集性扫描结果(乡镇/街道层级)

Table 5. Spatial scanning results of scrub typhus by FleXScan spatial clustering scans in Nanjing from 2015 to 2020 (Township/street level)

级别	聚集地区	报告病例数	LLR	P值
一级	溧水区(永阳、石湫、柘塘、东屏、洪蓝、白马、晶桥)，江宁区(横溪)	98	150.24	0.001
二级	溧水区(江浦、桥林、星甸)	27	17.81	0.001

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发热伴血小板减少综合征疫情呈上升趋势：基于2015―2020年南京市报告病例数据

doi: 10.16462/j.cnki.zhjbkz.2022.12.008

通讯作者:
刘坤，E-mail: chinaliukun@126.com

洪镭，E-mail: 930582@qq.com

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The rising trend of severe fever with thrombocytopenia syndrome: based on the data of reported cases in Nanjing from 2015 to 2020, China

Corresponding author: HONG Lei, E-mail: 930582@qq.com; LIU Kun, E-mail: chinaliukun@126.com

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发热伴血小板减少综合征疫情呈上升趋势：基于2015―2020年南京市报告病例数据

doi: 10.16462/j.cnki.zhjbkz.2022.12.008

通讯作者: 刘坤，E-mail: chinaliukun@126.com 洪镭，E-mail: 930582@qq.com

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The rising trend of severe fever with thrombocytopenia syndrome: based on the data of reported cases in Nanjing from 2015 to 2020, China

Corresponding author: HONG Lei, E-mail: 930582@qq.com; LIU Kun, E-mail: chinaliukun@126.com

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目录

通讯作者:
刘坤，E-mail: chinaliukun@126.com

洪镭，E-mail: 930582@qq.com