2010-2018年荆州市江陵县手足口病流行病学特征及空间聚集性分析

Analysis on epidemiological characteristics and spatial clustering of hand-foot-mouth disease in Jiangling County of Jingzhou City from 2010-2018

目的了解荆州市江陵县手足口病流行现状,为手足口病的精准防控措施提供依据。方法收集2010-2018年荆州市江陵县手足口病个案信息,采用描述流行病学方法进行统计分析。利用季节指数法分析季节特征,运用热点分析探讨手足口病局部空间自相关性。结果2010-2018年荆州市江陵县共报告手足口病4472例,年均发病率147.31/10万。重症11例,重症发生率0.25%。手足口病病例主要集中在4-6月。手足口病人群特征为1~2岁年龄组儿童、散居儿童、男童高发。手足口病以郝穴镇及其周边乡镇发病率较高。热点分析结果显示,郝穴镇及其周边2个乡镇为手足口病高发聚集区。手足口病病原学监测阳性率为77.33%,2011、2014和2016年以肠道病毒71型(EV71)阳性为主,2018年以柯萨奇病毒A16型(CoxA16)阳性为主,2012、2013、2015和2017年以其他肠道病毒阳性为主。重症病例以EV71型为主。结论荆州市江陵县手足口病疫情呈现一定的三间分布特征及空间聚集性,应进一步加强疫情监测和病原学检测,流行季节对重点地区、重点人群采取针对性防控措施以控制手足口病疫情。

Objective To understand the epidemic situation of hand-foot-mouth disease(HFMD) in Jiangling County of Jingzhou City, provide evidence for precise prevention and control measures of HFMD. Methods The case data of HFMD in Jiangling County of Jingzhou City from 2010-2018 were collected. Descriptive epidemiological methods were used for statistical analysis.The seasonal index was used to analyze seasonal characteristics. Hot spot analysis was used to explore the spatial autocorrelation of HFMD. Results From 2010-2018, a total of 4 472 HFMD cases in Jiangling County of Jingzhou City were reported, with an average annual incidence of 147.31/lakh, and there were 11 severe cases, with a severe ratio of 0.25%. The peak season appeared April to July. HFMD was characterized by a high incidence among children in the 1-2 age group, scattered children,and boys. The incidence of HFMD was higher in Haoxue Town and its surrounding townships. The results of hot spot analysis showed that Haoxue Town and its two surrounding towns were high risk areas for HFMD. The positive rate of pathogenic monitoring of HFMD was 77.33%, EV71 was predominant in 2011, 2014 and 2016, Cox A16 was predominant in 2018, and other enterovirus was predominant in 2012, 2013, 2015 and 2017. Severe cases were mainly infected by EV71. Conclusion The characteristics of spatial, temporal and population distribution and spatial clustering of HFMD are observed in Jiangling County of Jingzhou City. It is necessary to further strengthen epidemic surveillance and etiological detection of HFMD,and take the comprehensive HFMD prevention and control measures in key season,area and population during the epidemic season,to control the epidemic situation of HFMD.