2015―2022年甘肃省传染病流行特点及趋势

康小娟; 王晓辉; 丁中航

doi:10.16462/j.cnki.zhjbkz.2024.04.002

2015―2022年甘肃省传染病流行特点及趋势

doi: 10.16462/j.cnki.zhjbkz.2024.04.002

1.
甘肃中医药大学公共卫生学院，兰州 730000
2.
甘肃省肿瘤医院, 甘肃省医学科学研究院，兰州 730050

基金项目:

甘肃省基础研究计划——软科学专项 23JRZA341

详细信息

通讯作者:
王晓辉，E-mail：13919772252@163.com

中图分类号: R183
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- 被引次数: 0
出版历程
- 收稿日期: 2023-08-07
- 修回日期: 2024-01-09
- 网络出版日期: 2024-05-17
- 刊出日期: 2024-04-10

Epidemiological characteristics and trends of infectious diseases in Gansu province from 2015 to 2022

1.
School of Public Health, Gansu University of Tradition Chinese Medicine, Lanzhou 730000, China
2.
Gansu Provincial Cancer Hospital, Gansu Provincial Academic Institute for Medical Research, Lanzhou 730050, China

Funds:

Gansu Province Basic Research Programme-Soft Science Special Project 23JRZA341

More Information

Corresponding author: WANG Xiaohui, E-mail: 13919772252@163.com

摘要

摘要: 目的分析2015―2022年甘肃省传染病发病死亡数据，了解甘肃省传染病流行特点及趋势，确定甘肃省防控重点。方法利用Excel 2021软件、JPR 4.9.10软件计算传染病发病顺位、死亡顺位、病死率、发病率和死亡率的年度变化百分比(annual percent change, APC)、年平均变化百分比(average annual percent change, AAPC)。通过Joinpoint回归模型分析传染病发病及死亡变化趋势。结果 2015―2022年甘肃省传染病发病670 992例，死亡1 127例，发病率为324.12/10万，死亡率为0.54/10万。发病顺位前5的疾病分别为其他感染性腹泻、肺结核、乙型病毒性肝炎(乙肝)、流行性感冒、手足口病；死亡顺位前2的疾病分别为艾滋病和肺结核。2019―2022年传染病发病和2017―2022年传染病死亡呈下降趋势，APC(95% CI)分别为-16.0%(-25.4%~-5.3%)和-9.1%(-13.7%~-1.2%)，其余时间段发病、死亡趋势变化不明显。肺结核、甲型病毒性肝炎(甲肝)等10种疾病发病率呈下降趋势，急性出血性结膜炎发病率呈上升趋势；肺结核死亡率呈下降趋势，艾滋病死亡率呈上升趋势。这些传染病中病死率最高的为鼠疫和狂犬病。结论甘肃省传染病防控重点为其他感染性腹泻、肺结核、乙肝、流行性感冒、手足口病；同时还应重点关注死亡风险高的艾滋病与鼠疫和发病率上升的急性出血性结膜炎、布鲁氏菌病。
- 传染病 /
- 发病率 /
- 死亡率 /
- 变化趋势
Abstract: Objective This study analyzes infectious disease morbidity and mortality data in Gansu province from 2015 to 2022, aiming to comprehend the epidemiological characteristics and trends, as well as to determine prevention and control priorities. Methods We need Excel 2021 and JPR4.9 1.0 software to calculate morbidity ranks, mortality ranks, fatality rates, annual percentage change (APC) and annual average percentage change (AAPC) in morbidity and morality rates of the infectious diseases. We also analyzed the trend in infectious diseases morbidity and mortality using the Toinpoint regression model. Results From 2015 to 2022, Gansu province reported 670 992 cases of infectious diseases and 1 127 deaths, with an incidence rate of 324.12 per 100 000 and a mortality rate of 0.54 per 100 000 cases. The top five diseases in morbidity were infectious diarrhea, tuberculosis, hepatitis B, influenza, and hand-foot-mouth disease; the top two in mortality were AIDS and tuberculosis. Morbidity (2019-2022) and mortality (2017-2022) showed a decreasing trend, with APC values of -16 (-25.4, -5.3) and -9.1 (-13.7, -1.2). No significant changes in the incidence or mortality trends were observed during the remaining periods. Ten diseases, including tuberculosis and hepatitis A, exhibited decreasing incidence, while acute hemorrhagic conjunctivitis showed an upward trend. Tuberculosis deaths declined, but AIDS-related deaths increased. Plague and rabies had the highest mortality rates. Conclusions In Gansu province, prevention and control efforts should focus on infectious diarrhea, tuberculosis, hepatitis B, influenza, and hand-foot-mouth disease. Special attention is needed for the high mortality risk of AIDS and plague, as well as the incidence of acute hemorrhagic conjunctivitis and brucellosis.
- Infectious disease /
- Morbidity /
- Death /
- Trends

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图 1 2015―2022年甘肃省法定传染病发病率及死亡率变化

Figure 1. Morbidity and mortality of statutory infectious diseases in Gansu Province, 2015-2022

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表 1 2015―2022甘肃省法定传染病发病及死亡情况

Table 1. Incidence and death of notifiable infectious diseases in Gansu province from 2015 to 2022

年份 Year	年人口数 Annual population	发病数 Number of cases	发病率/10万^-1 Morbidity/100 000^-1	死亡数 Deaths	死亡率/10万^-1 Mortality/100 000^-1
2015	25 907 800	78 960	304.77	120	0.46
2016	25 995 600	88 049	338.71	127	0.49
2017	26 100 500	88 763	340.08	179	0.69
2018	26 257 500	93 833	357.36	169	0.64
2019	26 372 600	115 383	437.51	159	0.60
2020	26 474 300	72 603	274.23	149	0.56
2021	25 019 900	71 635	304.30	113	0.45
2022	24 900 500	61 766	248.09	102	0.41
总计Total	207 028 700	670 992	324.12	1 118	0.54

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表 2 2015―2022年甘肃省法定传染病发病及死亡变化趋势

Table 2. Changing trends of incidence and death of statutory infectious diseases in Gansu province, 2015-2022

分类Classify	发病率Morbidity			死亡率Mortality
分类Classify	年度Year	APC(95% CI)/%	AAPC(95% CI)/%	年度Year	APC(95% CI)/%	AAPC(95% CI)/%
传染病总体 Overall infectious diseases	2015―2019	6.6(-0.3~13.9)	-3.7(-7.5~0.1)	2015―2017	26.5(-0.8~61.2)	-0.1(-4.8~4.9)
	2019―2022	-16.0(-25.4~-5.3)		2017―2022	-9.1(-13.7~-1.2)
甲、乙传染病合并 Class A and Class B infectious diseases	2015―2022	-4.6(-6.5~-2.6)	-4.6(-6.5~-2.6)	2015―2017	28.1(-3.8~70.6)	-0.8(-4.8~6.7)
				2017―2022	-8.4(-13.8~-2.7)
丙类传染病 Class C infectious diseases	2015―2019	19.6(0.2~42.7)	-1.3(-11.0~9.5)	―
	2019―2022	-23.6(-44.2~4.8)		―
注：1. APC, 年度变化百分比；AAPC, 年平均变化百分比。 2. “—”表示该位次无传染病死亡病例发生。 Note: 1. APC, annual percent change; AAPC, average annual percent change. 2. "—" indicates that no deaths from infectious diseases have occurred at that level.

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表 3 2015―2022年法定传染病的发病顺位及变化情况

Table 3. Incidence sequence and change of notifiable infectious diseases from 2015 to 2022

顺位 Order	病种(占比/%)Disease(proportion/%)
顺位 Order	2015年year	2016年year	2017年year	2018年year	2019年year	2020年year	2021年year	2022年year
1	肺结核Pulmonary tuberculosis(18.02)	肺结核Pulmonary tuberculosis(17.16)	其他感染性腹泻Other infectious diarrhea(20.14)	其他感染性腹泻Other infectious diarrhea(19.41)	其他感染性腹泻Other infectious diarrhea(16.06)	其他感染性腹泻Other infectious diarrhea(23.63)	其他感染性腹泻Other infectious diarrhea(22.26)	其他感染性腹泻Other infectious diarrhea(23.37)
2	其他感染性腹泻Other infectious diarrhea(15.26)	其他感染性腹泻Other infectious diarrhea(16.76)	肺结核Pulmonary tuberculosis(16.63)	手足口病Hand, foot and mouth disease(14.43)	手足口病Hand, foot and mouth disease(15.91)	乙型病毒性肝炎Hepatitis B(14.80)	手足口病Hand, foot and mouth disease(13.81)	乙型病毒性肝炎Hepatitis B(12.58)
3	乙型病毒性肝炎Hepatitis B(12.72)	乙型病毒性肝炎Hepatitis B(11.24)	乙型病毒性肝炎Hepatitis B(12.44)	乙型病毒性肝炎Hepatitis B(12.71)	流行性感冒Influenza(12.64)	肺结核Pulmonary tuberculosis(11.18)	乙型病毒性肝炎Hepatitis B(12.43)	流行性感冒Influenza(11.08)
4	手足口病Hand, foot and mouth disease(11.61)	手足口病Hand, foot and mouth disease(10.65)	手足口病Hand, foot and mouth disease(9.68)	肺结核Pulmonary tuberculosis(10.84)	流行性腮腺炎Mumps(11.48)	流行性感冒Influenza(10.44)	肺结核Pulmonary tuberculosis(10.04)	肺结核Pulmonary tuberculosis(10.39)
5	丙型病毒性肝炎Hepatitis C(8.60)	流行性感冒Influenza(9.63)	丙型病毒性肝炎Hepatitis C(8.74)	流行性感冒Influenza(8.66)	乙型病毒性肝炎Hepatitis B(10.32)	梅毒Syphilis(9.01)	梅毒Syphilis(8.92)	布鲁氏菌病Brucellosis(8.07)
6	细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(7.07)	丙型病毒性肝炎Hepatitis C(8.05)	流行性感冒Influenza(8.20)	丙型病毒性肝炎Hepatitis C(8.25)	肺结核Pulmonary tuberculosis(8.27)	丙型病毒性肝炎Hepatitis C(8.53)	流行性感冒Influenza(8.66)	梅毒Syphilis(8.04)
7	流行性感冒Influenza(6.40)	细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(7.19)	梅毒Syphilis(6.62)	梅毒Syphilis(6.93)	丙型病毒性肝炎Hepatitis C(6.41)	流行性腮腺炎Mumps(5.84)	丙型病毒性肝炎Hepatitis C(7.39)	丙型病毒性肝炎Hepatitis C(7.37)
8	梅毒Syphilis(5.51)	梅毒Syphilis(5.49)	细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(5.48)	流行性腮腺炎Mumps(5.86)	梅毒Syphilis(6.22)	布鲁氏菌病Brucellosis(4.07)	布鲁氏菌病Brucellosis(5.99)	新型冠状病毒感染Novel coronavirus infection(5.59)
9	流行性腮腺炎Mumps(3.48)	流行性腮腺炎Mumps(3.48)	流行性腮腺炎Mumps(3.46)	细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(4.31)	细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(3.03)	手足口病Hand, foot and mouth disease(3.79)	流行性腮腺炎Mumps(2.82)	手足口病Hand, foot and mouth disease(3.14)
10	布鲁氏菌病Brucellosis(2.92)	麻疹Measles(3.29)	布鲁氏菌病Brucellosis(1.85)	猩红热Scarlet fever(1.73)	布鲁氏菌病Brucellosis(1.48)	细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(3.48)	细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(2.46)	流行性腮腺炎Mumps(3.04)
合计 Total	91.59	92.94	93.24	93.13	91.82	94.76	94.78	92.62

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表 4 2015―2022年法定传染病的死亡顺位及变化情况

Table 4. Death sequence and change of notifiable infectious diseases from 2015 to 2022

顺位 Order	病种(占比/%)Disease(proportion/%)
顺位 Order	2015年year	2016年year	2017年year	2018年year	2019年year	2020年year	2021年year	2022年year
1	艾滋病Acquired immunodeficiency syndrome(47.51)	艾滋病Acquired immunodeficiency syndrome(49.22)	艾滋病Acquired immunodeficiency syndrome(45.81)	艾滋病Acquired immunodeficiency syndrome(60.95)	艾滋病Acquired immunodeficiency syndrome(82.38)	艾滋病Acquired immunodeficiency syndrome(89.26)	艾滋病Acquired immunodeficiency syndrome(89.38)	艾滋病Acquired immunodeficiency syndrome(81.37)
2	肺结核Pulmonary tuberculosis(35.83)	肺结核Pulmonary tuberculosis(32.03)	流行性乙型脑炎Japanese encephalitis(24.85)	流行性乙型脑炎Japanese encephalitis(24.85)	肺结核Pulmonary tuberculosis(12.58)	肺结核Pulmonary tuberculosis(8.73)	肺结核Pulmonary tuberculosis(9.72)	肺结核Pulmonary tuberculosis(18.63)
3	狂犬病Hydrophobia(9.17)	狂犬病、流行性感冒Hydrophobia, Influenza(6.25)	肺结核Pulmonary tuberculosis(18.99)	肺结核Pulmonary tuberculosis(8.28)	乙型病毒性肝炎、丙型病毒性肝炎Hepatitis B, Hepatitis C(1.26)	新型冠状病毒感染Novel coronavirus infection(1.34)	梅毒Syphilis(0.88)	-
4	手足口病Hand, foot and mouth disease(3.33)	流行性乙型脑炎Epidemic hemorrhagic fever(2.35)	狂犬病Hydrophobia(5.02)	手足口病Hand, foot and mouth disease(2.96)	其他感染性腹泻、鼠疫、流行性出血热、流行性脑脊髓炎Other infectious diarrhea, Plague, Epidemic hemorrhagic fever, Epidemic cerebrospinal meningitis(0.63)	狂犬病Hydrophobia(0.67)	-	-
5	乙型病毒性肝炎Hepatitis B(1.67)	手足口病、麻疹、皮肤炭疽、其他感染性腹泻、黑热病(0.78)Hand, foot and mouth disease, Measles, Cutaneous anthrax, Other infectious diarrhea, Leishmaniasis(0.78)	乙型病毒性肝炎Hepatitis B(1.68)	乙型病毒性肝炎Hepatitis B(1.78)	-	-	-	-
6	甲型病毒性肝炎、麻疹、细菌性和阿米巴性痢疾Hepatitis A, Measles, Bacillary and amoebic dysentery(0.83)		流行性感冒、手足口病、其他感染性腹泻疾病、细菌性和阿米巴性痢疾、鼠疫、新生儿破伤风、人感染H7N9禽流感Influenza, Hand, foot and mouth disease, Other infectious diarrhea, Bacillary and amoebic dysentery, Plague, Neonatal tetanus, Human infection with H7N9 avian influenza(0.56)	狂犬病、梅毒Hydrophobia, Syphilis(0.59)	-	-	-	-
注：“-”表示该位次无传染病死亡病例发生。 Note："—" Indicates that no deaths from infectious diseases have occurred at that level.

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表 5 2015―2022年甘肃省传染病各病种发病及死亡变化趋势

Table 5. Changing of morbidity and mortality trends of infectious diseases in Gansu Province by disease types, 2015-2022

趋势分类Trends classification	病种Disease	年度Year	APC(95% CI)/%	AAPC(95% CI)/%
发病趋势Incidence trends	艾滋病Acquired immunodeficiency syndrome	2015―2018	26.8(5.6~52.4)	4.9(-1.3~11.4)
		2018―2022	-9.1(-18.1~0.9)
	病毒性肝炎Viral hepatitis	2015―2019	3.2(-2.0~8.7)	-4.1(-7.0~-1.2)
		2019―2022	-13.1(-20.9~-4.6)
	甲型病毒性肝炎Hepatitis A	2015―2019	-1.7(-8.0~4.9)	-18.9(-23.1~-14.5)
		2019―2022	-37.2(-47.5~-24.9)
	乙型病毒性肝炎Hepatitis B	2015―2019	5.0(-1.0~11.5)	-2.4(-5.7~1.0)
		2019―2022	-11.5(-20.1~-1.9)
	丙型病毒性肝炎Hepatitis C	2015―2018	5.1(-3.4~14.4)	-4.5(-7.4~-1.5)
		2018―2022	-11.1(-16.3~-5.6)
	丁型肝炎Hepatitis D	2015―2022	-52.4(-67.4~-29.4)	-52.4(-67.4~-29.4)
	未分型肝炎Unclassified hepatitis	2015―2022	-24.4(-30.9~-17.3)	-24.4(-30.9~-17.3)
	麻疹Measles	2015―2022	-47.4(-76.6~18.3)	-47.4(-76.6~18.3)
	流行性出血热Epidemic hemorrhagic fever	2015―2019	102.6(-10.9~360.7)	14.1(-25.5~74.8)
		2019―2022	-46.9(-83.8~74.1)
	流行性脑脊髓膜炎Epidemic cerebrospinal meningitis	2015―2022	-13.1(-65.3~117.5)	-13.1(-65.3~117.5)
	皮肤炭疽Cutaneous anthrax	2015―2022	-1.8(-14.6~12.8)	-1.8(-14.6~12.8)
	细菌性和阿米巴性痢疾Bacillary and amoebic dysentery	2015―2022	-18.3(-22.2~-14.3)	-18.3(-22.2~-14.3)
	肺结核Pulmonary tuberculosis	2015―2022	-11.7(-15.5~-7.7)	-11.7(-15.5~-7.7)
	伤寒、副伤寒Typhoid fever, Paratyphoid fever	2015―2022	-5.0(-13.5~4.4)	-5.0(-13.5~4.4)
	新生儿破伤风Neonatal tetanus	2015―2022	-31.5(-42.7~-17.5)	-31.5(-42.7~-17.5)
	百日咳Pertussis	2015―2022	15.6(-10.4~49.1)	15.6(-10.4~49.1)
	猩红热Scarlet fever	2015―2022	-11.7(-26.6~6.2)	-11.7(-26.6~6.2)
	布鲁氏菌病Brucellosis	2015―2018	-13.6(-44.8~35.1)	14.6(-0.7~32.3)
		2018―2022	41.8(12.7~78.4)
	淋病Gonorrhea	2015―2022	-1.8(-8.5~5.5)	-1.8(-8.5~5.5)
	梅毒Syphilis	2015―2019	13.5(-2.5~32.2)	3.9(-4.2~12.7)
		2019―2022	-7.7(-26.8~16.4)
发病趋势Incidence trends	疟疾Malaria	2015―2022	-16.21(-29.1~-1.0)	-16.21(-29.1~-1.0)
	流行性感冒Influenza	2015―2022	2.1(-12.0~18.4)	2.1(-12.0~18.4)
	流行性腮腺炎Mumps	2015―2019	56.4(15.8~111.3)	-3.8(-19.7~15.3)
		2019―2022	-49.7(-7.1~-12.4)
	风疹Rubella	2015―2019	131.6(58.2~23.9)	-47.6(-61.6~-28.5)
		2019―2022	-92.8(-95.5~-79.1)
	急性出血性结膜炎Acute hemorrhagic conjunctivitis	2015―2022	7.1(0.2~4.4)	7.1(0.2~4.4)
	黑热病Leishmaniasis	2015―2017	23.6(1.4~50.6)	-15.11(-18.8~-11.2)
		2017―2022	-27.0(31.3~-22.3)
	包虫病Echinococcosis	2015―2017	7.6(21.5~47.4)	-7.21(-13.1~-0.9)
		2017―2022	-12.6(-19.3~-5.3)
	其他感染性腹泻Other infectious diarrhea	2015―2017	23.8(-5.3~61.6)	4.3(-1.0~10.0)
		2017―2022	-2.6(-7.6~2.8)
	手足口病Hand, foot and mouth disease	2015―2022	-0.6(-22.3~27.0)	-0.6(-22.3~27.0)
死亡趋势Trends in deaths	艾滋病Acquired immunodeficiency syndrome	2015―2019	26.2(18.9~33.8)	8.3(5.1~11.5)
		2019―2022	-11.7(-18.4~-4.4)
	肺结核Pulmonary tuberculosis	2015―2022	-16.0(-24.9~-6.2)	-16.0(-24.9~-6.2)

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表 6 2015―2022年部分传染病病死率

Table 6. Case fatality rate for selected infectious diseases, 2015-2022

病种Disease	发病数 Number of cases	死亡数 Number of deaths	病死率/% Case fatality rate/%
鼠疫Plague	2	2	100.000
艾滋病Acquired immunodeficiency syndrome	3 827	753	19.676
肺结核Pulmonary tuberculosis	85 981	195	0.227
甲型病毒性肝炎Hepatitis A	4 321	1	0.023
乙型病毒性肝炎Hepatitis B	82 771	10	0.012
丙型病毒性肝炎Hepatitis C	53 143	2	0.004
麻疹Measles	4 682	2	0.042
狂犬病Rabies	31	31	100.000
流行性出血热Epidemic hemorrhagic fever	796	1	0.130
细菌性和阿米巴性痢疾Bacillary and amoebic dysentery	30 528	1	0.003
皮肤炭疽Cutaneous anthrax	567	1	0.176
流行性乙型脑炎Japanese encephalitis	1 050	89	8.476
人感染H7N9禽流感Human infection with H7N9 avian influenza	5	1	20.000
梅毒Syphilis	47 031	1	0.000
新生儿破伤风Neonatal tetanus	28	1	3.571
疟疾Malaria	131	1	0.763
流行性脑脊髓膜炎Epidemic cerebrospinal meningitis	7	1	14.286
新型冠状病毒感染Novel coronavirus infection	3 810	1	0.026
其他感染性腹泻Other infectious diarrhea	129 963	3	0.002
手足口病Hand, foot and mouth disease	74 270	11	0.015
流行性感冒Influenza	64 530	9	0.013
黑热病Leishmaniasis	369	1	0.271
合计Total	587 843	1 118	0.190

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参考文献(20)

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