2008-2017年银川市手足口病流行特征的聚类分析
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摘要
目的描述和分析2008-2017年银川市手足口病流行特征,明确重点防控人群及防控时期,为制定有效的防控策略提供依据。方法采用描述流行病学方法对国家"疾病监测信息报告管理系统"报告的2008-2017年银川市手足口病疫情监测资料进行整理分析;采用系统聚类方法对发病的时间、地区、人群等进行聚类分析。结果 2008-2017年10年间银川市共报告手足口病病例31 605例,每月均有病例报告且流行季节为夏秋季,发病高峰为6月,次高峰为10月,6、7月聚为一类且10年间发病例数高达14 359例,10月聚为一类,其他聚为一类;每个县或区均有病例报告,发病率差异均有统计学意义(P <0.001),金凤区、兴庆区、西夏区高发且被聚为一类;各年龄组均有发病,1～4岁组高发被单独聚为一类,占10年内报告病例总数的76.89%;男性累计发病数多于女性,差异有统计学意义(χ~2=70.97,P <0.01)。结论银川市手足口病的发生存在明显的季节、地区、性别和年龄差异,防控工作重点应在夏秋时节,加强托幼机构的防控,将有助于更好地控制疫情。
Objective To describe and analyze the epidemiological characteristics of hand-foot-mouth disease(HFMD) in Yinchuan City from 2008 to 2017,and to identify the key population and period of prevention and control,so as to provide evidence for formulating effective prevention and control strategies.Methods Descriptive epidemiological method was used to analyze the monitoring data of hand-foot-mouth disease(HFMD) surveillance in Yinchuan from 2008 to 2017 reported by the National Diseases Reporting Information System.Systematic clustering method was used to analyze the time,area and population of HFMD.Results A total of 31 605 cases of HFMD were reported in Yinchuan from 2008 to 2017.The monthly cases were reported and the epidemic season was summer and autumn.The incidence peak was June,the second peak was October,June and July were clustered into one group,and the number of cases in June and July was as high as 14 359 in ten years.October was clustered into one group,and the others were clustered into one group.There were case reports in each county or district,and the incidence difference was statistically significant(P<0.001),Jinfeng District and Xingxing District and Xixia District have high incidence and are clustered into one group;all age groups have incidence,and the high incidence of 1 ～ 4 years old group is clustered into one group alone,accounting for 76.89% of the total reported cases in 10 years;the cumulative incidence of male is higher than that of female,the difference is statistically significant(χ~2= 70.97,P<0.01).Conclusion There are obvious seasonal,regional,gender and age differences in the occurrence of HFMD in Yinchuan City.The focus of prevention and control should be in summer and autumn,and the prevention and control of kindergartens should be strengthened,which will help to better control the epidemic situation.
Objective To describe and analyze the epidemiological characteristics of hand-foot-mouth disease(HFMD) in Yinchuan City from 2008 to 2017,and to identify the key population and period of prevention and control,so as to provide evidence for formulating effective prevention and control strategies.Methods Descriptive epidemiological method was used to analyze the monitoring data of hand-foot-mouth disease(HFMD) surveillance in Yinchuan from 2008 to 2017 reported by the National Diseases Reporting Information System.Systematic clustering method was used to analyze the time,area and population of HFMD.Results A total of 31 605 cases of HFMD were reported in Yinchuan from 2008 to 2017.The monthly cases were reported and the epidemic season was summer and autumn.The incidence peak was June,the second peak was October,June and July were clustered into one group,and the number of cases in June and July was as high as 14 359 in ten years.October was clustered into one group,and the others were clustered into one group.There were case reports in each county or district,and the incidence difference was statistically significant(P<0.001),Jinfeng District and Xingxing District and Xixia District have high incidence and are clustered into one group;all age groups have incidence,and the high incidence of 1 ～ 4 years old group is clustered into one group alone,accounting for 76.89% of the total reported cases in 10 years;the cumulative incidence of male is higher than that of female,the difference is statistically significant(χ~2= 70.97,P<0.01).Conclusion There are obvious seasonal,regional,gender and age differences in the occurrence of HFMD in Yinchuan City.The focus of prevention and control should be in summer and autumn,and the prevention and control of kindergartens should be strengthened,which will help to better control the epidemic situation.
引文
[1]李彦敏.手足口病流行与防治[J].临床荟萃,2008,23(16):1144-1145.
[2]郭青,张春曦,王晓风,等.2008-2009年中国大陆手足口病流行特征分析[J].疾病监测,2011,26(11):852-856.
[3]曹素华.实用医学多因素统计方法[M].上海:上海医科大学出版社,1998:149-160.
[4]WANG Y,FENG Z,YANG Y,et al.Hand,Foot and Mouth Disease in China:Patterns of Spread and Transmissibility during 2008-2009[J].Epidemiology,2011,22(6):781-792.
[5]孙振球.医学统计学[M].2版.北京:人民卫生出版社,2005:399-412.
[6]张瑞杰,郭政,李霞,等.主成分分析与聚类分析在民族分化研究中的应用比较[J].中国卫生统计,2002,19(4):201-203.
[7]李亮,梁祁,祁贤,等.江苏省2009年手足口病流行特征的聚类分析[J].江苏预防医学,2010,21(6):4-6.
[8]中华人民共和国卫生部.手足口病诊疗指南(2010年版)[Z].2010-04-20.
[9]马岳,李海军,李涛,等.宁夏2009-2014年手足口病流行病学特征分析[J].宁夏医科大学学报,2016,38(7):802-805,封4.
[10]ONOZUKA D,HASHIZUME M.The influence of temperature and humidity on the incidence of hand,foot,and month disease in Japan[J].Sci Total Environ,2011,410(411):119-125.
[11]姚文清,陈静乙,李鑫,等.辽宁省2009年手足口病流行病学分析[J].中国公共卫生,2010,26(12):1589-1590.
[12]阎岩,王定明,胡静,等.贵州省2009年手足口病流行病学分析[J].中国公共卫生,2011,27(3):370-371.
[13]李崇亥,赵生仓,巴卓玛,等.2017年西宁地区手足口病病原检测结果分析[J].医学动物防制,2019,35(2):137-139.
[14]CHANG LY,KING CC,HSU KH,et al.Risk factors of enterovirus 71 infection and associated hand,foot,and mouth disease/herpangina in children during an epidemic in Taiwan[J].Pediatrics,2002,109(6):e88.
[15]郭小芳,刘颖,陈伟.2009年河南省手足口病流行特征分析[J].疾病监测,2010,25(10):781-783.
[16]梁会营,康燕,陶霞,等.广州市2008-2011年手足口病流行特征动态研究[J].热带医学杂志,2011,11(12):1410-1413.
[17]ZHU Q,HAO YT,MA JQ,et al.Surveillance of Hand,Foot,and Mouth Disease in Mainland China(2008-2009)[J].生物医学与环境科学,2011,24(4):349-356.
[18]唐海丰,李芳,李晓君,等.2009-2013年上海市普陀区手足口病流行病学特征和病原学监测分析[J].现代预防医学,2015,42(11):1939-1941.
[19]杨丽春.2009-2012年我国法定报告丙类传染病疫情分析[J].内蒙古医学杂志,2013,45(11):1353-1357.
[20]杨鸿麟,龚涛,颜新秀,等.沙坪坝区私立幼儿园手足口病防控问题及对策[J].中国学校卫生,2016,37(3):468-470.
[21]黄淑琼,陈红缨,杨雯雯,等.2009-2015年湖北省手足口病流行特征分析[J].公共卫生与预防医学,2016,27(6):28-31.
[2]郭青,张春曦,王晓风,等.2008-2009年中国大陆手足口病流行特征分析[J].疾病监测,2011,26(11):852-856.
[3]曹素华.实用医学多因素统计方法[M].上海:上海医科大学出版社,1998:149-160.
[4]WANG Y,FENG Z,YANG Y,et al.Hand,Foot and Mouth Disease in China:Patterns of Spread and Transmissibility during 2008-2009[J].Epidemiology,2011,22(6):781-792.
[5]孙振球.医学统计学[M].2版.北京:人民卫生出版社,2005:399-412.
[6]张瑞杰,郭政,李霞,等.主成分分析与聚类分析在民族分化研究中的应用比较[J].中国卫生统计,2002,19(4):201-203.
[7]李亮,梁祁,祁贤,等.江苏省2009年手足口病流行特征的聚类分析[J].江苏预防医学,2010,21(6):4-6.
[8]中华人民共和国卫生部.手足口病诊疗指南(2010年版)[Z].2010-04-20.
[9]马岳,李海军,李涛,等.宁夏2009-2014年手足口病流行病学特征分析[J].宁夏医科大学学报,2016,38(7):802-805,封4.
[10]ONOZUKA D,HASHIZUME M.The influence of temperature and humidity on the incidence of hand,foot,and month disease in Japan[J].Sci Total Environ,2011,410(411):119-125.
[11]姚文清,陈静乙,李鑫,等.辽宁省2009年手足口病流行病学分析[J].中国公共卫生,2010,26(12):1589-1590.
[12]阎岩,王定明,胡静,等.贵州省2009年手足口病流行病学分析[J].中国公共卫生,2011,27(3):370-371.
[13]李崇亥,赵生仓,巴卓玛,等.2017年西宁地区手足口病病原检测结果分析[J].医学动物防制,2019,35(2):137-139.
[14]CHANG LY,KING CC,HSU KH,et al.Risk factors of enterovirus 71 infection and associated hand,foot,and mouth disease/herpangina in children during an epidemic in Taiwan[J].Pediatrics,2002,109(6):e88.
[15]郭小芳,刘颖,陈伟.2009年河南省手足口病流行特征分析[J].疾病监测,2010,25(10):781-783.
[16]梁会营,康燕,陶霞,等.广州市2008-2011年手足口病流行特征动态研究[J].热带医学杂志,2011,11(12):1410-1413.
[17]ZHU Q,HAO YT,MA JQ,et al.Surveillance of Hand,Foot,and Mouth Disease in Mainland China(2008-2009)[J].生物医学与环境科学,2011,24(4):349-356.
[18]唐海丰,李芳,李晓君,等.2009-2013年上海市普陀区手足口病流行病学特征和病原学监测分析[J].现代预防医学,2015,42(11):1939-1941.
[19]杨丽春.2009-2012年我国法定报告丙类传染病疫情分析[J].内蒙古医学杂志,2013,45(11):1353-1357.
[20]杨鸿麟,龚涛,颜新秀,等.沙坪坝区私立幼儿园手足口病防控问题及对策[J].中国学校卫生,2016,37(3):468-470.
[21]黄淑琼,陈红缨,杨雯雯,等.2009-2015年湖北省手足口病流行特征分析[J].公共卫生与预防医学,2016,27(6):28-31.