2004-2018年中国布鲁氏菌病流行特征及趋势变化分析

Epidemic characteristics and trend of brucellosis in China from 2004 to 2018

目的分析2004-2018年全国布鲁氏菌病(布病)流行特征,了解布病发展趋势。方法自公共卫生科学数据中心收集2004-2018年全国布病监测资料。采用joinpoint回归分析全国和各省份布病发病率趋势变化,总体趋势采用平均年度变化百分比(AAPC)进行估计;采用局部回归季节分解法分析全国和各省份布病季节特征;同时绘制各年龄发病率随年份变化热力图。结果2004-2018年全国累计报告布病524980例,死亡16例,发病率为2.61/10万,病死率为(3.05×10-3)%。全国布病发病率呈上升趋势(AAPC=11.58%,95%CI:7.91%~15.25%,P<0.001);内蒙古自治区、山西省和陕西省未见明显变化趋势(均P>0.05);西藏自治区呈下降趋势(AAPC=-55.19%,P<0.001);其他省份均呈上升趋势(均AAPC>0,均P<0.05)。全国发病高峰出现在4-6月;按省份划分,海南省、四川省、贵州省、福建省、安徽省发病高峰以4-8月为主,重庆市、上海市发病高峰出现在6-8月,其他省份发病高峰基本在4-6月。全国各年龄组均有布病病例报告,年龄分布呈倒"V"形;发病高峰出现在50~54岁年龄组(5.43/10万),其次为60~64岁年龄组(4.94/10万)。2004-2018年,发病率前3位年龄组由2004年的40~44、50~54和35~39岁转变为2018年的50~54、60~64和55~59岁。结论2004-2018年全国及大部分省份布病发病呈上升趋势,高发年龄逐渐向高年龄组转变。

Objective To analyze the epidemic characteristics of brucellosis in China from 2004 to 2018,in order to understand the development trend of brucellosis.Methods The surveillance data of brucellosis in China from 2004 to 2018 were collected from National Public Health Science Data Center.Joinpoint regression was used to analyze the trend of brucellosis incidence in China and various provinces.Overall trends were estimated by the average annual percentage change(AAPC).Seasonal and trend decomposition using loess(STL)was used to analyze the seasonal characteristics of brucellosis in China and various provinces.The age-related thermodynamic diagram of incidence rate was used to analyze the characteristics of age-onset changes.Results From 2004 to 2018,a total of 524980 brucellosis cases and 16 deaths were reported nationwide,with a incidence rate of 2.61/100000 and a case fatality rate of(3.05×10-3)%.The incidence of brucellosis in China was on the rise(AAPC=11.58%,95%CI:7.91%-15.25%,P<0.001).There was no significant trend of change in Inner Mongolia Autonomous Region,Shanxi and Shaanxi provinces(P>0.05).Tibet Autonomous Region showed a downward trend(AAPC=-55.19%,P<0.001).All other provinces were showing an upward trend(AAPC>0,P<0.05).The peak incidence in China occurred from April to June.In terms of provinces,the peak incidence in Hainan,Sichuan,Guizhou,Fujian and Anhui provinces occurred from April to August,the peak incidence in Chongqing and Shanghai cities occurred from June to August,and the peak incidence in other provinces was generally from April to June.There were reports of brucellosis cases in all age groups nationwide,and the age distribution showed an inverted"V"shape.The peak incidence occurred in the 50-54 years old(5.43/100000),followed by the 60-64 years old(4.94/100000).From 2004 to 2018,the top 3 age groups of incidence rate changed from 40-44,50-54 and 35-39 years old in 2004 to 50-54,60-64 and 55-59 years old in 2018.Conclusions The incidence of brucellosis is on the rise nationwide and in most provinces from 2004 to 2018.The high incidence age is gradually changing to the elderly population.