2010-2018年南京市一期与二期梅毒流行特征和时空扫描分析

Epidemiological and spatiotemporal characteristics of primary and secondary syphilis from 2010 to 2018 in Nanjing

目的了解南京市2010-2018年一、二期梅毒的流行特征,并分析时空分布特征,为梅毒的精准防控工作提供依据。方法南京市各区常住人口数来源于南京市统计年鉴,梅毒病例数据来源于传染病报告信息系统。采用描述流行病学方法,分析2010-2018年南京市一期和二期梅毒报告病例的流行病学特征,使用泊松模型方法,采用SaTScan 9.4软件进行时空扫描,采用ArcGIS 10.5将扫描结果可视化。结果2010-2018年间南京市一期、二期梅毒累计报告发病12893例,报告发病率先下降后上升,无明显变化趋势(χ^2趋势=2.32,P>0.05),发病类型二期占55.17%(7113例),家务及待业、商业服务和农民占76.27%(9834例)。病例中男性占56.36%(7276例);20~59岁占85.72%(11052例)。不同性别的发病情况有所不同,女性发病高峰在30~39岁组,随着年龄增长,年平均发病率逐渐减低;男性发病高峰在50~59岁组,此后仍维持在较高的水平。2010-2018年间,每年均探测到时空聚集区域(P均<0.05),聚集地区由中心城区向南部江宁、溧水转移,聚集时间多为3-9月。结论南京市50岁及以上男性人群的高梅毒感染率应引起重视。全市一、二期梅毒发病存在明显的时空聚集,且时空扫描分析有助于精准定位高发区域,可以为制定精准的梅毒防控措施及优化卫生资源配置提供参考依据。

Objective To study the epidemiological features of primary and secondary syphilis during 2010-2018 in Nanjing,and to explore the temporal-spatial clustering,and to provide evidence for strategy development of syphilis control and prevention.Methods The population of every district in Nanjing was derived from the Nanjing Statistical Yearbook.Descriptive epidemiological methods were used to analyze the syphilis data in Nanjing during 2010-2018 from the Chinese Disease Surveillance Information Reporting System.Retrospective method of SaTScan 9.4 was used to explore spatial characteristics.Results There was no significant change in the tendency(χ^2=2.32,P>0.05).The secondary syphilis accounted for 55.17%(7113 cases).76.27%(9834)of the most three densely-distributed occupations included house-keepers/job-seekers,the commercial service providers and farmers.56.36%(7267 cases)was male,and 85.72%(11052 cases)was the young adults aged between 20-59 years.The incidence of the disease was various between different genders.The peak of female incidence was mainly in the group aged between 30-39 years.With the increase of age,the incidence decreased gradually.The peak of male incidence was in the group of 50-59 years old and remained at a high level thereafter.The temporal and spatial clustering existed among primary and secondary syphilis cases between 2010-2018,which shifted from the centre area to the south of the city,including Jiangning and Lishui.The temporal dimension of primary and secondary syphilis was from March to September.Conclusion Great attention should be paid to the high prevalence of syphilis among men older than 50 in Nanjing.There has been a significant temporal-spatial clustering of syphilis,which can provide reference for formulation of syphilis control measures and the optimal allocation of health resources.