2005—2012年珠海市梅毒流行趋势分析

Epidemological trend analysis of syphilis in Zhuhai City,2005-2012

目的分析珠海市梅毒流行趋势和流行特征,为防控梅毒的流行提供科学依据。方法采用分层整群抽样方法,在珠海市的各行政区抽取4个区(镇),在"疾病监测信息报告管理系统"中获取各区(镇)的梅毒发病资料,用描述性流行病学方法分析梅毒的流行趋势和流行特征。结果 2005—2012年珠海市4个区(镇)共报告梅毒486例,无死亡病例。各年发病率分别为:2.99/10万、4.10/10万、4.50/10万、9.30/10万、8.52/10万、18.25/10万、31.31/10万和33.89/10万,年均发病率为15.90/10万,发病率呈逐年上升趋势。Ⅰ、Ⅱ、Ⅲ期、胎传、隐性梅毒分别占29.21%(142例)、32.92%(160例)、1.03%(5例)、1.65%(8例)、35.19%(171例)。除胎传梅毒外,发病年龄从15岁开始,主要集中在20～49岁年龄组,占总发病数的76.95%(374例),≥60岁年龄组占9.67%(47例);梅毒的发病以商业服务、家务及待业居多,其病例构成分别为:20.08%(96例)、18.41%(88例)。隐性梅毒病例数逐年增加,2006年开始出现隐性梅毒超过Ⅰ期梅毒,2010年起病例数增加迅猛,最高占当年总病例数的55.07%(38/69);各年发病职业构成不同(P<0.01),家务及待业、离退休人员、学生人群的构成逐年增多。Ⅰ期梅毒以男性发病为多,占67.61%,而隐性梅毒则男女分别占51.46%和48.54%;隐性梅毒以家务及待业居多(占22.01%),而Ⅰ期梅毒则以商业服务居多(占22.05%)。结论珠海市被调查地区的梅毒发病率逐年升高,隐性梅毒的发病率超过Ⅰ期梅毒,且普通人群发病有增多趋势,说明该市的梅毒防治工作应深入到各行各业和各类人群。

Objective To analyze epidemiological trends and characteristics of syphilis in Zhuhai City and provide a scientific basis for the prevention and control of epidemic of syphilis. Methods Strati- fied cluster sampling method was employed in 4 administrative districts （towns） of Zhuhai City, to obtain the incidence data of syphilis from the ＂Disease Surveillance Report Management System＂. The epidemio- logical trend and characteristics of syphilis was analyzed using descriptive epidemiological method. Results There were 486 cases of syphilis and no deaths from 2005 to 2012. The annual incidence rates were 2. 99/100 000, 4. 10/100 000, 4. 50/ 100 000, 9. 30/100 000, 8.52/100 000, 18.25/100 000, 31.31/100 000, and 33.89/100 000, respectively, with average annual ineidenee rate of 15.90/100 000. The annual ineidenee rates exhibited an increasing trend. The primary, secondary, and late stages of syphi- lis as well as congenital and recessive syphilis accounted for 29.21% （142 eases）, 32.92% （160）, 1.03% （5） , 1.65% （8） , and 35. 19% （ 171 ） , respectively. Except the congenital syphilis, the age of syphilis onset began at 15, mainly between 20 to 49 years old, accounting for 76. 95% （374 eases） , and the age of 60 and over （9. 67% ）. The majority eases of syphilis were those conducting the commercial serviee, and households and the unemployed, with the proportions of 20. 08% （96 eases） and 18.41% （ 88 ）, respectively. Recessive syphilis eases increased year by year. From 2006 on, the number of reeessive syphilis cases surpassed the ones of primary stage of syphilis ; and the number of recessive syphilis ca- ses increased rapid in 2010, accounting for 55.07% （38/69）. Occupational structures of syphilis onset varied in each year （ P 〈 0.01 ） and the proportion of households and the unemployed, retirees, and students increased yearly. The number of primary syphilis cases in male accounted for 67.61%, while the recessive syphilis is similar for both men and women （51.46%, 48. 54% ）. Households and the unem- ployed related recessive syphilis accounts for 22. 01%, while commercial service related primary syphilis accounts for 22. 05%. Conclusion There is an increasing trend of syphilis being diagnosed in Zhuhai city annually, and the number of recessive syphilis has surpassed that of the primary stage of syphilis, There is evidence that the infected population is growing in numbers and this indicate a strong need and awareness to educate the general population of all walks of life on the prevention of syphilis in the city.