中国斑疹伤寒病例发病至确诊时间间隔及影响因素分析
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摘要
目的了解我国斑疹伤寒病例发病至确诊时间间隔分布特征及其影响因素,为我国斑疹伤寒的精准防控提供理论依据。方法采用描述性统计学方法分析斑疹伤害病例发病至确诊时间间隔分布特征,采用Kruskal-Wallis H检验进行统计学差异分析,采用多因素logistic回归分析其影响因素。结果 2005-2017年全国共报告29 211例斑疹伤寒病例,分布在29个省(自治区、直辖市),发病至确诊时间间隔中位数为7 d,92.20%的斑疹伤寒病例发病至确诊时间间隔集中在0～20 d。男性发病至确诊时间间隔中位数为6 d,女性为7 d,女性发病至确诊时间间隔大于男性;学生与散居儿童发病至确诊时间间隔较长;河北、广东和山东省病例发病至确诊时间间隔较短,四川和辽宁省病例发病至确诊时间间隔较长。结论我国斑疹伤寒病例发病至确诊时间间隔较长,需采取针对性措施进行精准诊疗和防控。
Objective To understand distribution patterns and influencing factors for the interval between onset and diagnosis of typhus in China, and to provide a scientific basis for accurate prevention and control of typhus. Methods Descriptive statistical methods were used to analyze the distribution patterns of the interval between onset of disease and diagnosis. The Kruskal-Wallis H test was conducted for statistical difference analysis. Multivariate logistic regression was used to analyze the influencing factors. Results A total of 29 211 typhus cases were reported in China from 2005 to 2017.Those cases were from 29 provinces(autonomous regions and centrally administered municipalities). The median interval between onset of disease and diagnosis was 7 days. The interval was between 0 and 20 days for 92.20% of the cases. The median interval between onset of disease and diagnosis was 6 days for males and 7 days for females. Students and scattered children had longer time intervals between onset of disease and diagnosis than others. Hebei, Guangdong, and Shandong provinces had shorter time intervals, while Sichuan and Liaoning provinces had longer time intervals. Conclusion There is a long interval between onset and diagnosis of typhus in China. To accurately diagnose, treat, prevent, and control typhus,action should be taken to specifically address this issue.
Objective To understand distribution patterns and influencing factors for the interval between onset and diagnosis of typhus in China, and to provide a scientific basis for accurate prevention and control of typhus. Methods Descriptive statistical methods were used to analyze the distribution patterns of the interval between onset of disease and diagnosis. The Kruskal-Wallis H test was conducted for statistical difference analysis. Multivariate logistic regression was used to analyze the influencing factors. Results A total of 29 211 typhus cases were reported in China from 2005 to 2017.Those cases were from 29 provinces(autonomous regions and centrally administered municipalities). The median interval between onset of disease and diagnosis was 7 days. The interval was between 0 and 20 days for 92.20% of the cases. The median interval between onset of disease and diagnosis was 6 days for males and 7 days for females. Students and scattered children had longer time intervals between onset of disease and diagnosis than others. Hebei, Guangdong, and Shandong provinces had shorter time intervals, while Sichuan and Liaoning provinces had longer time intervals. Conclusion There is a long interval between onset and diagnosis of typhus in China. To accurately diagnose, treat, prevent, and control typhus,action should be taken to specifically address this issue.
引文
[1]翟云丽,宗红,章绍能,等.西安市1950-2005年斑疹伤寒流行特征及诊疗效益评价[J].职业与健康,2008,24(11):1065-1068. DOI:10.3969/j.issn.1004-1257.2008.11.028.
[2] Rauch J,Eisermann P,Noack B,et al. Typhus group rickettsiosis,Germany,2010-2017[J]. Emerg Infect Dis,2018,24(7):1213-1220. DOI:10.3201/eid2407.180093.
[3]高捷,余亮科,韩秀红.儿童斑疹伤寒的临床特点及误诊分析[J].临床儿科杂志,2010,28(9):858,863. DOI:10.3969/j.issn.1000-3606.2010.09.016.
[4]亚红祥,张云智,习严梅.云南省2005-2014年斑疹伤寒流行特征分析[J].中国媒介生物学及控制杂志,2017,28(4):359-361. DOI:10.11853/j.issn.1003.8280.2017.04.013.
[5]张丽娟,付秀萍,贺金荣.我国近十年斑疹伤寒疫情概况及分析[J].中国预防医学杂志,2005,6(5):415-418.
[6]亚红祥,张海林,周济华,等.云南省保山市一起地方性斑疹伤寒暴发的调查[J].中华流行病学杂志,2011,32(1):47-50.
[7]王庆新,李育民,刘继政.某村地方性斑疹伤寒暴发的调查[J].现代预防医学,2006,33(6):1010. DOI:10.3969/j.issn.1003-8507.2006.06.075.
[8] Carr SB,Bergamo DF,Emmanuel PJ,et al. Murine typhus as a cause of cognitive impairment:case report and a review of the literature[J]. Pediatr Neurol,2014,50(3):265-268. DOI:10.1016/j.pediatrneurol.2013.09.017.
[9] Stephens BE,Thi M,Alkhateb R,et al. Case report:fulminant murine typhus presenting with status epilepticus and multi-organ failure:an autopsy case and a review of the neurologic presentations of murine typhus[J]. Am J Trop Med Hyg,2018,99(2):306-309. DOI:10.4269/ajtmh.18-0084.
[10] Stockdale AJ,Weekes MP,Kiely B,et al. Case report:severe typhus group rickettsiosis complicated by pulmonary edema in a returning traveler from Indonesia[J]. Am J Trop Med Hyg,2011,85(6):1121-1123. DOI:10.4269/ajtmh.2011.11-0340.
[11] Chang K,Chen YH,Lee NY,et al. Murine typhus in southern Taiwan during 1992-2009[J]. Am J Trop Med Hyg,2012,87(1):141-147. DOI:10.4269/ajtmh.2012.11-0465.
[12] Adjemian J,Parks S,McElroy K,et al. Murine typhus in Austin,Texas,USA,2008[J]. Emerg Infect Dis,2010,16(3):412-417. DOI:10.3201/eid1603.091028.
[2] Rauch J,Eisermann P,Noack B,et al. Typhus group rickettsiosis,Germany,2010-2017[J]. Emerg Infect Dis,2018,24(7):1213-1220. DOI:10.3201/eid2407.180093.
[3]高捷,余亮科,韩秀红.儿童斑疹伤寒的临床特点及误诊分析[J].临床儿科杂志,2010,28(9):858,863. DOI:10.3969/j.issn.1000-3606.2010.09.016.
[4]亚红祥,张云智,习严梅.云南省2005-2014年斑疹伤寒流行特征分析[J].中国媒介生物学及控制杂志,2017,28(4):359-361. DOI:10.11853/j.issn.1003.8280.2017.04.013.
[5]张丽娟,付秀萍,贺金荣.我国近十年斑疹伤寒疫情概况及分析[J].中国预防医学杂志,2005,6(5):415-418.
[6]亚红祥,张海林,周济华,等.云南省保山市一起地方性斑疹伤寒暴发的调查[J].中华流行病学杂志,2011,32(1):47-50.
[7]王庆新,李育民,刘继政.某村地方性斑疹伤寒暴发的调查[J].现代预防医学,2006,33(6):1010. DOI:10.3969/j.issn.1003-8507.2006.06.075.
[8] Carr SB,Bergamo DF,Emmanuel PJ,et al. Murine typhus as a cause of cognitive impairment:case report and a review of the literature[J]. Pediatr Neurol,2014,50(3):265-268. DOI:10.1016/j.pediatrneurol.2013.09.017.
[9] Stephens BE,Thi M,Alkhateb R,et al. Case report:fulminant murine typhus presenting with status epilepticus and multi-organ failure:an autopsy case and a review of the neurologic presentations of murine typhus[J]. Am J Trop Med Hyg,2018,99(2):306-309. DOI:10.4269/ajtmh.18-0084.
[10] Stockdale AJ,Weekes MP,Kiely B,et al. Case report:severe typhus group rickettsiosis complicated by pulmonary edema in a returning traveler from Indonesia[J]. Am J Trop Med Hyg,2011,85(6):1121-1123. DOI:10.4269/ajtmh.2011.11-0340.
[11] Chang K,Chen YH,Lee NY,et al. Murine typhus in southern Taiwan during 1992-2009[J]. Am J Trop Med Hyg,2012,87(1):141-147. DOI:10.4269/ajtmh.2012.11-0465.
[12] Adjemian J,Parks S,McElroy K,et al. Murine typhus in Austin,Texas,USA,2008[J]. Emerg Infect Dis,2010,16(3):412-417. DOI:10.3201/eid1603.091028.