山东省2011-2018年猩红热流行特征及空间聚集性分析

Analysis on epidemiological characteristics and spatial clusters of scarlet fever in Shandong Province from 2011 to 2018

目的探讨山东省2011-2018年猩红热流行特征及空间聚集性,为猩红热科学防控提供依据。方法收集山东省2011-2018年猩红热报告病例资料,采用描述流行病学方法和空间自相关分析方法对资料进行分析。结果山东省2011-2018年共报告猩红热病例45 936例,年均报告发病率为5.84/10万;经χ_趋势~2检验,逐年发病率呈上升趋势(χ_趋势~2=5 317.16,P<0.001)。4-6月和11月-次年1月为发病高峰期。男女性发病率比为1.62∶1;3~9岁病例数最多,占88.94%;幼托儿童(42.42%)、学生(36.94%)和散居儿童(19.50%)占比例最高。全局空间自相关结果显示,2011-2018年山东省猩红热报告发病率全局Moran’s I指数分别为0.374、0.452、0.411、0.439、0.437、0.418、0.478和0.465(均有P<0.001),提示发病存在空间聚集性。局部空间自相关结果显示"高-高"聚集区主要集中在济南和青岛两市的主城区,与高发病率地区较为一致。"低-低"聚集区则主要位于鲁西南和鲁西北地区。结论山东省2011-2018年猩红热发病存在流行和空间聚集性,应加大对高发季节、高危人群和高聚集区域的监测管理,采取针对性的防控措施,控制其传播和蔓延。

Objective To analyze the epidemiological and spatial cluster of scarlet fever in Shandong Province from 2011 to 2018,and to provide scientific evidence for the prevention and control of scarlet fever.Methods Data of scarlet fever reported cases in Shandong province from 2011 to 2018 were collected and analyzed by the descriptive epidemiological method and spatial autocorrelation method.Results A total of 45936 scarlet fever cases were reported in Shandong province from 2011 to 2018.The average annual incidence was 5.84/100000 and showed an increasing trend(χ_趋势~2=5317.16,P<0.001).There were more cases concentrated from April to June and from November to January.The ratio of male to female was 1.62∶1,with the higher prevalence(88.94%)among the total cases aged 3 to 9 years.The majority of scarlet fever cases were preschool children(42.42%),students(36.94%)and scattered children(19.50%),respectively.The global spatial autocorrelation analysis showed that the Moran’s I indexes for the incidence were 0.374,0.452,0.411,0.439,0.437,0.418,0.478 and 0.465(all P<0.001)respectively,suggesting that the incidence of scarlet fever had spatial clustering features in Shandong Province from 2011 to 2018.The local spatial auto correlation analysis showed that high-high clustering areas were mainly distributed in main urban districts of Jinan city and Qingdao city.Areas that located in the southwestern and northwestern parts of Shandong presented the low-low relation.Conclusions The epidemic and spatial clustering of scarlet fever existed in Shandong Province during 2011-2018.The surveillance and management on scarlet fever should be strengthened and the targeted prevention and control efforts should be focused on high incidence seasons,high risk populations and high clustering areas,so as to control the spread of scarlet fever.