2014年全国伤寒/副伤寒流行病学特征及西南5个省份空间聚类分析
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摘要
目的分析2014年全国伤寒/副伤寒流行病学特征,探索西南5个省份疫情聚集区域。方法采用描述性流行病学分析方法对大疫情报告系统的2014年伤寒/副伤寒疾病信息进行统计分析,使用ArcGis 10.5软件绘制病例地理分布特征图,采用SaTScan时空聚类方法扫描分析云南、贵州、湖南、广西和广东5个省(自治区)的伤寒/副伤寒疫情的时空聚集性。结果 2014年我国共报告伤寒/副伤寒病例13 768例,总发病率为1.02/10万,与2013年相比,总发病率下降1.92%,无死亡病例,其中伤寒10 460例(75.97%),副伤寒3 308例(24.03%),发病数与2013年相比,伤寒降低了2.44%,副伤寒降低了3.10%;伤寒/副伤寒的发病高峰为6—9月,占全年病例数的46.23%;伤寒/副伤寒病例均以农民为主,其次为散居儿童和在校学生。西南5省(区)时空扫描分析显示,一类和二类聚集区主要分布在相邻省份的县(市、区)。结论我国伤寒/副伤寒发病率逐年降低,高发省份伤寒/副伤寒的防控不能放松,尤其是非监测点的疫情上升应引起重视,调查并探索危险因素,根据风险因素采取针对性的综合防控策略。高发省相邻省份之间病例聚集明显,可能存在跨地域传播。
Objective To understand the epidemiological characteristics of typhoid and paratyphoid fever in China and its spatial temporal clustering in five provinces of China in 2014.Methods Descriptive statistical analysis was conducted by using the incidence data of typhoid and paratyphoid collected from Disease Surveillance Information Reporting System in2014.ArcGis 10.5 was used to show the geographic distribution of typhoid and paratyphoid cases.SaTScan statistics was used to identify spatial and temporal clustering areas of typhoid and paratyphoid in Yunnan,Guizhou,Hunan,Guangxi and Guangdong provinces.Results A total of 13 768 typhoid and paratyphoid cases were reported without death in 2014,the overall incidence rate was 1.02/100 000,a decline of 1.92% compared with 2013.There were 10 460 typhoid cases(75.97%)and 3 308 paratyphoid cases(24.03%),a decline of 2.44% and 3.10% respectively compared with 2013.The peak of incidence was in summer(June-September),accounting for 46.23% of the annual cases.Most cases were farmers,followed by students and children outside child care settings.Spatial clustering analysis of typhoid and paratyphoid fever in five provinces indicated the first and second class clustering areas were mainly distributed in bordering areas of these provinces.Conclusion The incidence of typhoid and paratyphoid decreased with year in China,but the prevention and control of typhoid and paratyphoid should not be neglected in provinces with high incidence.Close attention should be paid to the increased incidence of typhoid and paratyphoid and related factors in non-surveillance areas.It is necessary to take targeted prevention and control measures according to the risk factors identified.The case clustering was obvious in some neighboring provinces,suggesting the possible transmission across the province border.
Objective To understand the epidemiological characteristics of typhoid and paratyphoid fever in China and its spatial temporal clustering in five provinces of China in 2014.Methods Descriptive statistical analysis was conducted by using the incidence data of typhoid and paratyphoid collected from Disease Surveillance Information Reporting System in2014.ArcGis 10.5 was used to show the geographic distribution of typhoid and paratyphoid cases.SaTScan statistics was used to identify spatial and temporal clustering areas of typhoid and paratyphoid in Yunnan,Guizhou,Hunan,Guangxi and Guangdong provinces.Results A total of 13 768 typhoid and paratyphoid cases were reported without death in 2014,the overall incidence rate was 1.02/100 000,a decline of 1.92% compared with 2013.There were 10 460 typhoid cases(75.97%)and 3 308 paratyphoid cases(24.03%),a decline of 2.44% and 3.10% respectively compared with 2013.The peak of incidence was in summer(June-September),accounting for 46.23% of the annual cases.Most cases were farmers,followed by students and children outside child care settings.Spatial clustering analysis of typhoid and paratyphoid fever in five provinces indicated the first and second class clustering areas were mainly distributed in bordering areas of these provinces.Conclusion The incidence of typhoid and paratyphoid decreased with year in China,but the prevention and control of typhoid and paratyphoid should not be neglected in provinces with high incidence.Close attention should be paid to the increased incidence of typhoid and paratyphoid and related factors in non-surveillance areas.It is necessary to take targeted prevention and control measures according to the risk factors identified.The case clustering was obvious in some neighboring provinces,suggesting the possible transmission across the province border.
引文
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[16]阳波,闫梅英,阚飙.伤寒副伤寒传播的风险因素及防控措施[J].疾病监测,2012,27(6):492-496,500.DOI:10.3784/j.issn.1003-9961.2012.6.022.Yang B,Yan MY,Kan B.Risk factors for the transmission of typhoid and paratyphoid fevers and prevention and control measures[J].Dis Surveill,2012,27(6):492-496,500.DOI:10.3784/j.issn.1003-9961.2012.6.022.
[17]王鲁茜,闫梅英,方立群,等.云南省伤寒副伤寒空间分布特征及其气候影响因素研究[J].中华流行病学杂志,2011,32(5):485-489.DOI:10.3760/cma.j.issn.0254-6450.2011.05.015.Wang LX,Yan MY,Fang LQ,et al.Typhoid and paratyphoid fever in Yunnan province:distributional patterns and the related meteorological factors[J].Chin J Epidemiol,2011,32(5):485-489.DOI:10.3760/cma.j.issn.0254-6450.2011.05.015.
[18]Vollaard AM,Ali S,van Asten HA,et al.Risk factors for typhoid and paratyphoid fever in Jakarta,Indonesia[J].JAMA,2004,291(21):2607-2615.DOI:10.1001/jama.291.21.2607.
[2]Bhan MK,Bahl R,Bhatnagar SJ.Typhoid and paratyphoid fever[J].Lancet,2005,366(9497):749-762.DOI:10.1016/S0140-6736(05)67181-4.
[3]Buckle GC,Walker CLF,Black RE.Typhoid fever and paratyphoid fever:systematic review to estimate global morbidity and mortality for 2010[J].J Glob Health,2012,2(1):010401.DOI:10.7189/jogh.02.010401.
[4]卫生部疾病预防控制局,中国疾病预防控制中心.伤寒/副伤寒防治手册[M].2版.北京:人民卫生出版社,2006.Burea of Disease Control of Ministry of Health,Chinese Center for Disease Control and Prevention Ed i.Handbook on prevention and control of typhoid and paratyphoid[M].2nd ed.Beijing:People′s Medical Publishing House,2006.
[5]常昭瑞,张伟东,闫梅英,等.2009年全国伤寒和副伤寒监测分析[J].疾病监测,2011,26(4):256-260.DOI:10.3784/j.issn.1003-9961.2011.04.003.Chang ZR,Zhang WD,Yan MY,et al.Surveillance of typhoid and paratyphoid in China,2009[J].Dis Surveill,2011,26(4):256-260.DOI:10.3784/j.issn.1003-9961.2011.04.003.
[6]Kulldorff M.SaTScan TM v9.6:software for the spatial,temporal,and space-time scan statistics[EB/OL].(2018-03-01)[2018-04-01].http://www.satscan.org/.
[7]蒋征刚,谢雨豪,顾华,等.中国大陆地区2011年伤寒/副伤寒疫情GIS空间分析[J].中国公共卫生,2015,31(11):1437-1439.DOI:10.11847/zgggws2015-31-11-21.Jiang ZG,Xie YH,Gu H,et al.Spatial distribution of typhoid and paratyphoid fever in mainland China,2011:a GIS analysis[J].Chin J Public Health,2015,31(11):1437-1439.DOI:10.11847/zgggws2015-31-11-21.
[8]郭海强,刘红波,曲波,等.全国伤寒/副伤寒发病的季节趋势模型研究[J].实用预防医学,2011,18(3):391-393.DOI:10.3969/j.issn.1006-3110.2011.03.003.Guo HQ,Liu HB,Qu B,et al.Study on incidence of typhoid fever and paratyphoid fever with seasonal trend model[J].Pract Prev Med,2011,18(3):391-393.DOI:10.3969/j.issn.1006-3110.2011.03.003.
[9]高金霞,张静.2004-2007年中国大陆地区伤寒/副伤寒暴发疫情流行特征及危险因素分析[J].疾病监测,2008,23(11):698-701.DOI:10.3784/j.issn.1003-9961.2008.11.012.Gao JX,Zhang J.Analysis of the epidemiological characteristics and risk factors of typhoid and paratyphoid outbreak in China,2004 to 2007[J].Dis Surveill,2008,23(11):698-701.DOI:10.3784/j.issn.1003-9961.2008.11.012.
[10]Maskey AP,Day JN,Tuan PQ,et al.Salmonella enterica serovar Paratyphi A and S.enterica serovar Typhi cause indistinguishable clinical syndromes in Kathmandu,Nepal[J].Clin Infect Dis,2006,42(9):1247-1253.DOI:10.1086/503033.
[11]黄艳萍,姚光海,聂炜,等.2005-2012年贵州省伤寒副伤寒监测分析[J].医学动物防制,2015,31(7):732-734.DOI:10.7629/yxdwfz201507009.Huang YP,Yao GH,Nie W,et al.Typhoid and paratyphoid surveillance analysis of Guizhou province during 2005-2011[J].JMed Pest Control,2015,31(7):732-734.DOI:10.7629/yxdwfz201507009.
[12]秦淑文,凌锋,缪梓萍,等.浙江省1953-2013年伤寒副伤寒暴发疫情分析[J].中国预防医学杂志,2015,16(4):257-261.DOI:10.16506/j.1009-6639.2015.04.015.Qin SW,Ling F,Miao ZP,et al.Epidemiological analysis of outbreaks of typhoid and paratyphoid in Zhejiang province in1953-2013[J].Chin Prev Med,2015,16(4):257-261.DOI:10.16506/j.1009-6639.2015.04.015.
[13]李方,马合木提,木合亚提·胡塞英,等.2006-2016年新疆伤寒和副伤寒调查分析[J].疾病预防控制通报,2017,32(4):10-13.DOI:10.13215/j.cnki.jbyfkztb.1701022.Li F,Ma HM,Mu HY,et al.Investigation and analysis of typhoid and Paratyphoid fever from 2006 to 2016 years in Xinjiang[J].Bull Dis Control Prev,2017,32(4):10-13.DOI:10.13215/j.cnki.jbyfkztb.1701022.
[14]杨进,廖和壮,李永红,等.桂林地区学校伤寒副伤寒干预效果分析[J].应用预防医学,2013,19(6):321-324.Yang J,Liao HZ,Li YH,et al.Analysis of the interventional effect for typhoid and paratyphoid in Guiling area[J].J Appl Prev Med,2013,19(6):321-324.
[15]孙军玲,张静,马会来,等.2012年全国和高发省份伤寒/副伤寒流行特征分析[J].中华流行病学杂志,2013,34(12):1183-1188.DOI:10.3760/cma.j.issn.0254-6450.2013.012.007.Sun JL,Zhang J,Ma HL,et al.Epidemiological features of typhoid/paratyphoid fever in provinces with high incidence rate and in the whole country,in 2012[J].Chin J Epidemiol,2013,34(12):1183-1188.DOI:10.3760/cma.j.issn.0254-6450.2013.012.007.
[16]阳波,闫梅英,阚飙.伤寒副伤寒传播的风险因素及防控措施[J].疾病监测,2012,27(6):492-496,500.DOI:10.3784/j.issn.1003-9961.2012.6.022.Yang B,Yan MY,Kan B.Risk factors for the transmission of typhoid and paratyphoid fevers and prevention and control measures[J].Dis Surveill,2012,27(6):492-496,500.DOI:10.3784/j.issn.1003-9961.2012.6.022.
[17]王鲁茜,闫梅英,方立群,等.云南省伤寒副伤寒空间分布特征及其气候影响因素研究[J].中华流行病学杂志,2011,32(5):485-489.DOI:10.3760/cma.j.issn.0254-6450.2011.05.015.Wang LX,Yan MY,Fang LQ,et al.Typhoid and paratyphoid fever in Yunnan province:distributional patterns and the related meteorological factors[J].Chin J Epidemiol,2011,32(5):485-489.DOI:10.3760/cma.j.issn.0254-6450.2011.05.015.
[18]Vollaard AM,Ali S,van Asten HA,et al.Risk factors for typhoid and paratyphoid fever in Jakarta,Indonesia[J].JAMA,2004,291(21):2607-2615.DOI:10.1001/jama.291.21.2607.