2006-2012年广东省恙虫病流行特征分析

Characteristics of Scrub Typhus epidemic in Guangdong Province from 2006 to 2012

目的：分析2006-2012年广东省恙虫病流行特征和变化趋势，为制订防治策略和措施提供依据。方法从中国疾病预防控制信息系统中获得恙虫病病例个案信息，应用Cochran-Armitage趋势χ2检验分析恙虫病发病率变化趋势，利用差分自回归移动平衡模型（ARIMA）预测2013年病例数，采用描述性流行病学方法分析恙虫病的发病时间、地区和人群分布特点。结果2006-2012年，广东省共报告恙虫病病例8163例，年平均报告发病率为1.15/10万，报告发病率呈逐年升高的趋势（χ2=3191.976，P〈0.01）。总报告病例中死亡14例，病死率为1.72‰（14/8163）。ARIMA模型预测2013年报告病例3166例。恙虫病发病高峰在8月下旬（Z=2303.71，P〈0.01），流行期为5月底至10月上旬。发病率居前5位的地市分别为肇庆、广州、云浮、韶关和清远市。病例中男女性别比为1.00∶1.08，40-65岁病例占52.78%（4309/8163），农民占发病人群的59.30%（4841/8163）。结论广东省恙虫病报告病例数和发病率有逐年上升趋势，多发于夏秋季，农村人群发病率高。建议加强卫生宣教，做好个人防护，以及重点地区、重点人群的防控工作。

Objective To analyze the prevalent feature and variant tendency of Scrub Typhus in Guangdong Province from 2006 to 2012, and provide a basis of strategy and measure on prevention and protection of Scrub Typhus. Methods Clinical information of all individual cases was gained from China Information System for Disease Control and Prevention. Cochran-Armitage trend χ2 test was used to describe the variance of Scrub Typhus incidence and the clinical cases of 2013 were predicted by autoregressive integrated moving average （ARIMA） model, while descriptive epidemiological analysis was adopted to describe the endemic distribution, seasonal characteristics and population distribution of Scrub Typhus. Results A total of 8 163 Scrub typhus cases were reported in Guangdong Province from 2006 to 2012. Annual mean incidence of the disease was 1.15/100 000 with the incidence showing an upward tendency （χ2 = 3 191.976, P 〈 0.01）. There were 14 dead clinical cases reported with a fatality rate to be 1.72‰（14/8 163）. Totally 3 166 people were predicted to infect Scrub Typhus in 2013 by ARIMA model. The disease was prevalent from the end of May to early October and the peak time was in late August （Z = 2 303.71, P 〈 0.01）. The top five cities developed Scrub Typhus were Zhaoqing, Guangzhou, Yunfu, Shaoguan and Qingyuan. Male-female ratio was 1.00 ∶ 1.08 in all reported cases in which 52.78%（4 309/8 163） of them aged from 40 to 65 years old and 59.30%（4 841/8 163） of them were farmers. Conclusions The incidence of Scrub Typhus is rising in Guangdong Province, with the prevalent peak in summer and autumn, and rural populations are at high risk. The most effective preventions are strengthening health education , enhancing individual protection and protecting key populations in special districts.