2009-2018年西藏自治区手足口病流行特征分析

Epidemiological characteristics of hand, foot and mouth disease in Tibet, 2009–2018

目的了解西藏自治区(西藏)手足口病的流行病学特征和病原学特点,为西藏手足口病的防控提供科学依据。方法收集国家疾病监测信息报告管理系统的2009-2018年西藏手足口病疫情及其病原学监测数据,进行描述性流行病学分析。结果2009-2018年西藏累计报告手足口病病例14500例,年均发病率46.62/10万,重症病例23例,无死亡病例报告;10年间发病率呈隔年高发特征。报告发病率居前3位为拉萨市(148.17/10万)、林芝市(96.39/10万)和阿里地区(76.89/10万);发病高峰为春夏季(5-7月)和秋季(9月);男女性别比为1.29∶1;发病年龄高峰集中在1~4岁年龄组,占67.18%;全区发生暴发疫情57起,病例主要分布在托幼机构及小学,占暴发疫情总数的90.18%。病原体以柯萨奇病毒A组16型(Cox A16)和肠道病毒71型(EV71)为主,分别占44.01%和36.07%。结论2009-2018年西藏手足口病发病率呈现隔年高发的周期性特点,有明显的地区、季节和人群特征。西藏手足口病防控应将春夏季和秋季作为重点时段,将学龄前儿童作为重点人群,将城市作为重点地区;提高EV71疫苗接种的宣传,预防重症病例的发生。

Objective To understand the epidemiological and etiological characteristics of hand, foot and mouth disease(HFMD) in Tibet, and provide scientific evidence for prevention and control of HFMD in Tibet. Methods Descriptive epidemiological analysis was conducted by using the incidence data of HFMD cases and surveillance data of HFMD Pathogens in Tibet from 2009 to 2018 collected from National Disease Reporting Information System. Results From 2009 to 2018, a total of 14 500 HFMD cases were reported in Tibet, with an annual incidence rate of 46.62/100 000. There were 23 severe cases, but no death case was reported. During these 10 years, the incidence rate peaked every other year. The incidence rate in Lhasa(148.17/100 000), Nyingchi(96.39/100 000) and Ngari(76.89/100 000) ranked top 3 in Tibet. The annual incidence of HFMD peaked firstly during May-July, then in September. The male to female ratio of the cases was 1.29∶1. The case number in children aged 1–4 years was highest, accounting for 67.18% of the total. There were 57 outbreaks in Tibet during this period and 90.18% of the cases were distributed in child care settings and primary schools. Cox A16 and EV71 were the main pathogens, accounting for 44.01% and 36.07% respectively. Conclusion From 2009 to 2018, incidence rate of HFMD in Tibet tended to peak every other year, showing obvious regional, seasonal and population distribution characteristics. It is necessary to strengthen the prevention and control of HFMD in spring and summer, then in autumn;in young children and in urban areas. EV71 vaccination campaign should also be carried out to prevent severe cases of HFMD.