2011-2021年湛江市麻风病流行病学分析及防控预警应用

Epidemiological analysis of leprosy and early warning for leprosy prevention and control in Zhanjiang from 2011 to 2021

目的掌握湛江市麻风病流行特征及变化趋势,构建科学有效的疫情风险预测模型,提高疫情监测预警水平,为制定麻风病早期精准防控策略提供依据。方法对2011-2021年湛江市麻风病疫情数据进行描述性分析、时间序列分析及时空聚集分析。结果2011-2021年湛江市麻风新发病例共79例,最小年龄9岁;家内传播占比21.52%,主动发现占比5.06%;从发病到确诊的平均延迟期为29.06个月,确诊时2级畸残率17.72%。年均发现率为0.10/10万,处于低流行水平且呈下降趋势,每年5-7月为湛江市麻风病发病主高峰期,9-12月为次高峰期,ARIMA(0,2,2)(2,1,0)_(12)模型能较好地对湛江市麻风病发病数进行拟合和预测,2022年实际发病数均在预测值的可信区间内。2011-2013年有1个麻风病空间高值聚集区(RR=3.35,LLR=8.38,P=0.036),以麻章区民安街道为中心点。结论湛江市处于麻风病低流行状态,但诊治延迟和畸残问题较为严峻,需加强防控预警应用,为制定早期精准防控策略提供依据。

Objective To understand the epidemiological characteristics and changing trends of leprosy in Zhanjiang,build a scientific and effective risk prediction model for leprosy,and provide evidence for precise prevention and control strategies for leprosy at the early stage.Methods Descriptive analysis,time-series,and spatial-temporal clustering were conducted to analyze the data of leprosy in Zhanjiang between 2011 and 2021.Results A total of 79 new cases of leprosy were detected from 2011 to 2021 in Zhanjiang,with the youngest age of 9 years old.The intrafamilial transmission rate accounted for 21.52%and active case-finding occupied only 5.06%.The average delay between symptom onset and diagnosis of leprosy was 29.06 months and cases with gradeⅡdisability reached 17.72%.The average yearly detecting rate was below 0.10 per 100000,at a low level and in decline.There were two peaks of leprosy in Zhanjiang per year,a major one during May and July and the minor one from September to December.The ARIMA(0,2,2)(2,1,0)_(12)model had better effects on comparing the effects of fitting and prediction of the incidence of leprosy in Zhanjiang.The total number of new cases in 2022 was within the confidence interval predicted.There was a high-value clustering area of leprosy from 2011 to 2013(RR=3.35,LLR=8.38,P=0.036),with the Minan Street of Mazhang district as the center.Conclusions Leprosy in Zhanjiang was at a low endemic situation,but with a severe delay in diagnosis and abnormalities.It was necessary to strengthen the application of early warning prevention and control,and provide evidence for precise prevention and control strategies for leprosy at the early stage.