华东地区某部恙虫病流行特征及发病趋势预测预警研究

Epidemic characteristics and forecast of scrub typhus in a certain system of eastern China

目的分析华东地区某部的恙虫病发病及流行特征,并采用时间序列模型预测恙虫病发病趋势,为进一步做好恙虫病防治工作提供依据。方法数据来源于某部疫情直报系统,收集整理华东地区某部2007年以来所有恙虫病报告病例数据,采用Excel、SPSS 25.0描述患者流行病学"三间"分布并进行统计分析;同时利用SPSS软件通过差分等方法对恙虫病月发病数序列进行平稳化,然后进行模型参数的估计、检验,最优模型的筛选,再进行回顾性评估并预测短期发病情况。结果 2007—2018年间共报告恙虫病病例347例,发病呈逐年升高趋势,有季节性高峰,发病主要集中于6—7月;发病地区分布于安徽、福建、江苏和浙江,主要集中在福建省,而在福建省内又集中于东南部地区,以厦门最高;患者以青壮年、男性、战士为主,呈现越基层越易患的特点,发病主要在野外作训期间,同时也存在营区内感染。时间序列分析显示ARIMA(0,0,0)(0,1,1)12能够较好地拟合某系统华东地区恙虫病的发病趋势,Box-Ljung统计量为15.52,P值为0.56,R^2为0.81。采用该模型预测显示恙虫病依然存在季节性,在未来的几个月内将存在少量散发病例,2019年6月开始病例数可能会增加。结论恙虫病危害依然存在,为降低恙虫病对部队官兵健康的危害,在疫区野外作训期间,尤其是疫情高发季节和地区,有必要根据发病特征情况,有针对性地加强个人防护,防恙螨叮咬。高发季节对营区进行除草和灭杀恙螨,外出作业回来后应及时换衣和洗澡。

Objective To analyze the occurrence and epidemic characteristics of scrub typhus in East China,and predict the trend of scrub typhus with time series model for prevention and control of scrub typhus.Methods Data were obtained from the epidemic reporting system in a certain system of East China.All cases with scrub typhus from 2007 were included for epidemical analysis.The sequence of monthly scrub typhus was smoothed by using SPSS software and differential method,and the parameters of the model were estimated and tested.The optimal model was selected to predict the short-term incidence of scrub typhus.Results A total of 347 scrub typhus cases were reported from 2007 to 2018,and the trend presented an increasing tendency year by year.All cases came from Anhui,Fujian,Jiangsu and Zhejiang,and mainly from Fujian Province,concentrated in the southeastern region,highest in Xiamen.The patients were mainly males,soldiers,young men,and most cases were from front-line and mainly occurred in training period.Time series predictions showed that the ARIMA(0,0,0)(0,1,1)12 model could finely predict the trend of scrub typhus,with Box-Ljung of 15.52,P value of 0.56 and R^2 of 0.81.The model showed that scrub typhus disease was still seasonal,with a small number of sporadic cases in the coming months,and the number of cases may increase from June 2019.Conclusion The harm of scrub typhus disease still exists.In order to reduce the harm of scrub typhus to officers and soldiers,it is necessary to strengthen personal protection according to the characteristics of the disease and cases during the field training in the epidemic area,especially in the high incidence seasons.It is necessary to weed and kill chigger mites in the camp of high incidence seasons,and change clothes and take a shower after field work.