2009-2018年不同时期湖北省荆州市肾综合征出血热流行特征比较分析

Preliminary comparative analysis of epidemic characteristics of hemorrhagic fever with renal syndrome in Jingzhou City in different periods from 2009 to 2018

目的分析荆州市不同时期肾综合征出血热(HFRS)发病特征变化。方法收集2009-2018年荆州市HFRS疫情资料,根据发病率高低,将荆州市HFRS疫情分为2009-2012年(低)、2013-2016年(中)、2017-2018年(高)3个时期,采用描述性流行病学、标准差椭圆和时空扫描3种方法分析3个时期HFRS疫情时间、地区、人群分布以及时空上的变化趋势。结果荆州市在3个时期HFRS发病具有明显季节性,呈双峰型特点,发病高峰包括春夏季高峰(5-7月)和秋冬季高峰(1月,11-12月),两个高峰峰值相当。3个时期荆州市HFRS病例均集中在监利县、江陵县和洪湖市,发病率分别为0.48/10万、1.98/10万、0.84/10万,0.89/10万、1.88/10万、1.20/10万,4.82/10万、13.37/10万、4.58/10万。3个时期男性HFRS的发病率高于女性(χ2=43.38,P<0.05);3个时期HFRS病例职业均以农民为主,分别为56.26%(69/122)、69.61%(126/181)、74.94%(293/391),职业为农民的病例以种植水稻[48.28%(56/116)]和虾稻[27.59%(32/116)]居多。从年龄来看,2009-2017年发病以55~64岁居多;2018发病以60~69岁居多。标准差椭圆分析结果显示,荆州市HFRS流行地区扩大趋势不明显,重心均位于监利县或江陵县辖区内。时空扫描发现,3个时期的一类时空聚集区分别为江陵县2个乡镇,聚集时间为2010年12月7日-2011年1月2日;江陵县和沙市区的部分乡镇,聚集时间为2016年12月7日-2017年2月28日;江陵县全县乡镇及其周边县(市、区)部分乡镇,聚集时间为2018年4月27日-2018年7月16日。结论不同时期荆州市HFRS流行季节基本一致;高发地区基本一致,但存在局部波动;人群以男性农民为主,高发年龄有后移现象。应因地制宜,制定科学合理的综合防治措施。

Objective To analyze the changes of the characteristics of Hemorrhagic fever with renal syndrome(HFRS)in Jingzhou City in different periods.Methods According to the HFRS epidemic data of Jingzhou City in 2009-2018,based on the incidence rate,the HFRS epidemic situation in Jingzhou City was divided into three periods:2009-2012(low),2013-2016(middle),and 2017-2018(high).Descriptive epidemiological methods,standard deviation ellipse and spatio-temporal scanning analysis were used to analyze the time,region,population distribution and temporal and spatial trends of HFRS epidemic in the three periods.Results The incidence of HFRS in Jingzhou City in the three periods was seasonal and bimodal.The peak incidence included spring and summer peaks(May-July)and autumn-winter peaks(January,November-December).The HFRS cases in Jingzhou City were concentrated in Jianli County,Jiangling County and Honghu City in the three periods.The incidence rates were 0.48/100000,1.98/100000,0.84/100000,0.89/100000,1.88/100000,1.20/100000;4.82/100000,13.37/100000,and 4.58/100000.The incidence of HFRS in males was higher than that in females in the three periods(χ2=43.38,P<0.05);the occupations of HFRS in the three periods were mainly farmers,which were 56.26%(69/122),69.61%(126/181),74.94%(293/391),respectively.In 116 farmers,growing rice[48.28%(56/116)]and shrimp rice[27.59%(32/116)]were mostly.From the age point of view,the incidence rate in 2009-2017 was 55 to 64 years old;the incidence rate of 2018 was 60 to 69 years old.The results of standard deviation ellipse analysis showed that the expansion trend of HFRS epidemic areas in Jingzhou City was not obvious,and the center of gravity was located in Jianli County or Jiangling County.Spatio-temporal scans revealed that the first-class spatial-temporal clustering areas in the three periods were 2 towns and villages in Jiangling County,and the gathering time was from December 7,2010 to January 2,2011;in some townships in Jiangling County and Shacheng District,the gathering time was from December 7,2016 to February 28,2017;some townships in Jiangling County and surrounding counties,gathered from April 27,2018 to July 16,2018.Conclusions The HFRS epidemic season in Jingzhou City in different periods is basically the same;the high-incidence areas are basically the same,but there are local fluctuations;the population is mainly male farmers,and the age of high-incidence has shifted back.We should adapt to local conditions and formulate scientific and reasonable comprehensive prevention and control measures.