2004-2016年三峡库区宜昌监测点人群法定传染病流行特征分析

Epidemiological characteristics of notifiable infectious diseases among population at Yichang surveillance sites in the Three Gorges Reservoir area,2004-2016

目的评价三峡水库蓄水及运行期间库区人群传染病发病趋势和流行特征。方法收集2004-2016年三峡库区宜昌监测点传染病资料及人口资料,使用描述性流行病学方法描述传染病流行特征。结果三峡库区蓄水运行后,2004-2016年库区监测点累计报告传染病6 892例,年均发病率565.29/10万,报告发病率呈上升趋势(χ~2=215.88,P<0.001);传染病发病顺位蓄水期以肺结核、乙肝和其他感染性腹泻居前三位,运行期以乙肝、肺结核和手足口病居前三位;蓄水期以呼吸道传染病为主,运行期以血液及性传播疾病为主;男女性别比为1.61:1,男女发病率差异有统计学意义(χ~2=314.06,P<0.001),且35~<80岁年龄组男女性别比增大;报告传染病主要集中在0~<5岁和45~<60岁年龄组;乙类传染病发病以农民为主,丙类传染病以学生、散居儿童和农民为主。结论三峡库区宜昌监测点2004-2016年法定传染病报告发病率呈上升趋势,应结合库区发病流行病学特点针对库区乙肝、肺结核和手足口病等重点疾病以及重点人群制定和完善相应的预防控制策略。

Objective To explore the incidence trends and epidemiological features of notifiable infectious diseases among population in the Three Gorges Reservoir area（ TGRA） during the impounding period and operating period. Methods We collected the data concerning notifiable infectious diseases and demography at Yichang surveillance sites in the Three Gorges Reservoir area during 2004-2016. Descriptive epidemiology methods were used to describe the epidemiological characteristics of notifiable infectious diseases. Results After the impoundment of the Three Gorges Reservoir,there were 6,892 cases of infectious diseases accumulatively reported at Yichang surveillance sites in the Three Gorges Reservoir area during 2004-2016. The annual average incidence rate was 565.20/100,000,and the reported incidence rate showed an increasing tendency（ χ^2= 215.88,P〈0.001）. The top three infectious diseases during the impounding period were pulmonary tuberculosis,hepatitis B and other infectious diarrhea,while those during the operating period were hepatitis B,pulmonary tuberculosis and hand,foot and mouth disease. The cases occurring during the impounding period were mainly respiratory infectious diseases,while those occurring during the operating period were mainly blood and sexually transmitted diseases. The sex ratio of male and female cases was 1.61： 1. The incidence rate showed a statistically significant difference between the two genders（ χ^2= 314.06,P〈0.001）,and the sex ratios of the age groups of 35- 80 years increased. The reported cases of infectious diseases occurred most often in the age groups of 0-〈5 and 45-〈60 years. The cases of Class B infectious diseases were mainly farmers,and the cases of Class C infectious diseases students,scattered children and farmers. Conclusions The reported incidence rates of notifiable infectious diseases at Yichang surveillance sites in the Three Gorges Reservoir area during 2004-2016 showed an upward tendency. It is necessary to formulate and perfect prevention and control strategies based on the epidemiological features,the priority diseases such as tuberculosis,hepatitis B and hand,foot and mouth disease and the target population in the Three Gorges Reservoir area.