中国斑疹伤寒病例发病至确诊时间间隔及影响因素分析

Typhus in China: the interval between onset of disease and diagnosis and its influencing factors

目的了解我国斑疹伤寒病例发病至确诊时间间隔分布特征及其影响因素,为我国斑疹伤寒的精准防控提供理论依据。方法采用描述性统计学方法分析斑疹伤害病例发病至确诊时间间隔分布特征,采用Kruskal-Wallis H检验进行统计学差异分析,采用多因素logistic回归分析其影响因素。结果 2005-2017年全国共报告29 211例斑疹伤寒病例,分布在29个省(自治区、直辖市),发病至确诊时间间隔中位数为7 d,92.20%的斑疹伤寒病例发病至确诊时间间隔集中在0~20 d。男性发病至确诊时间间隔中位数为6 d,女性为7 d,女性发病至确诊时间间隔大于男性;学生与散居儿童发病至确诊时间间隔较长;河北、广东和山东省病例发病至确诊时间间隔较短,四川和辽宁省病例发病至确诊时间间隔较长。结论我国斑疹伤寒病例发病至确诊时间间隔较长,需采取针对性措施进行精准诊疗和防控。

Objective To understand distribution patterns and influencing factors for the interval between onset and diagnosis of typhus in China, and to provide a scientific basis for accurate prevention and control of typhus. Methods Descriptive statistical methods were used to analyze the distribution patterns of the interval between onset of disease and diagnosis. The Kruskal-Wallis H test was conducted for statistical difference analysis. Multivariate logistic regression was used to analyze the influencing factors. Results A total of 29 211 typhus cases were reported in China from 2005 to 2017.Those cases were from 29 provinces(autonomous regions and centrally administered municipalities). The median interval between onset of disease and diagnosis was 7 days. The interval was between 0 and 20 days for 92.20% of the cases. The median interval between onset of disease and diagnosis was 6 days for males and 7 days for females. Students and scattered children had longer time intervals between onset of disease and diagnosis than others. Hebei, Guangdong, and Shandong provinces had shorter time intervals, while Sichuan and Liaoning provinces had longer time intervals. Conclusion There is a long interval between onset and diagnosis of typhus in China. To accurately diagnose, treat, prevent, and control typhus,action should be taken to specifically address this issue.