2008-2011年中国5岁以下儿童手足口病流行特征分析

Epidemiology of hand,foot and mouth disease in children aged ≤5 years in China,2008-2011

目的以手足口病易感人群(≤5岁儿童)为研究对象,旨在探讨手足口病在此人群中的分布规律,为手足口病重点防控提供依据。方法利用描述性研究方法和地理信息系统对2008-2011年≤5岁儿童手足口病监测数据进行分析和可视化展示。结果 2008年5月至2011年12月期间,≤5岁儿童总发病例数为414 412例,主要病原体为肠道病毒71型(51.04%)、柯萨奇病毒A组16型(27.32%),其他肠道病毒(21.63%);≤5岁儿童年均发病率达139.63/万,男女性发病比为1.573∶1,≤5岁儿童发病人数占总发病人数的89.50%。4年间≤5岁儿童手足口病高发地区主要集中在东经105°以东,北纬18°～41°之间的地区。结论绝大多数病例发生于较低年龄段;男性人群的手足口病发病率均高于女性人群;发病人群主要以散居儿童为主;2008-2011年手足口病发病率呈现逐年升高的趋势,不同经纬度地区发病强度不同,呈现明显的地区差异,发病高发大多数集中在发达地区,总体态势呈北部向南部(特别是沿海地区)、东部向西部扩散的趋势,疫情的高发可能与当地的气候、人口密度、病原体构成变化等有关。

Objective To understand the epidemiological characteristics of hand, foot and mouth disease （HFMD） in children aged ≤5 years in China and provide scientific evidence for HFMD prevention and control. Methods Descriptive research methods and the visualization technology based on the geographic information system （GIS） were used to conduct systematic analysis on the HFMD surveillance data in China during 2008-2011. Results The total number of HFMD cases in children aged ≤5 years was 414 412 during this period, the average annual incidence was 139.63/10 000. The male to female ratio of the cases was 1. 573： 1. The cases in children aged ≤5 years accounted for 89.50% of the total. The cases were mainly distributed in region at 105.00-east longitude and 18.00-41.00 north latitude. The major pathogens were EV71 （51.04%）, Cox A16 （27.32%） and other entericviruses （21.63%）. Conclusion Population-based studies have shown that most cases occurred in children aged ≤5 years. The incidence in boys was higher than that in girls. Most cases were children outside child care settings. The incidence of HFMD increased with year and the regional specific difference was obvious. The areas with high incidences were mainly in eastern part of China, and the disease mainly spread from north to south （ especially the costal area）, from east to west. The area specific difference in HFMD incidence might be related with local climate, population density and pathogen constituent.