广州市2010-2019年肾综合征出血热流行特征及时空分布动态变化

Epidemic characteristics and dynamic changes of spatio-temporal distribution of hemorrhagic fever with renal syndrome in Guangzhou,2010-2019

目的了解2010-2019年广州市肾综合征出血热(HFRS)的流行状况及时空分布特征。方法以中国疾病预防控制信息系统HFRS报告数据和调查资料为基础,采用描述性流行病学方法进行统计分析,运用OpenGeoDa 1.2.0软件进行全局空间自相关和局部空间自相关分析,SatScan 9.6软件进行时空热点区域探测,ArcGIS 10.2软件绘制地图进行可视化呈现。结果2010-2019年广州市共报告HFRS病例1298例,死亡3例,年均报告发病率0.99/10万;21~50岁年龄组发病数占总数的70.88%,男女性发病比为2.98∶1,病例较多的职业为家务或待业(占31.28%)、商业服务(占17.33%);呈明显的冬、春两季发病高峰,春、冬两季各占全年发病数的33.74%和26.35%;各区每年均有病例报告,海珠区近10年共报告407例,占全市病例数的31.36%,年均发病率2.52/10万,病例数与年均发病率均居广州市首位。聚集性区域探测显示广州市HFRS发病存在时空聚集性,聚集区域主要集中在海珠区的万亩果园和海珠湖湿地公园所在区域以及紧邻中心城区的城中村,对数似然比值为44.08(均P<0.001)。结论2010-2019年广州市HFRS存在流行和聚集情况,冬、春两季高发,从事家务、待业和商业服务的男性青壮年为主要发病人群,移民多、卫生环境差的城乡结合部以及海珠区的万亩果园和海珠湖湿地公园是重点防控区域,应针对重点人群和地区制定防控措施,遏制HFRS疫情上升和扩散。

Objective To analyze the epidemic characteristics and spatio-temporal distribution of hemorrhagic fever with renal syndrome(HFRS)in Guangzhou from 2010 to 2019 and provide a basis for prevention and control strategies.Methods The data of HFRS was from National Disease Reporting Information System and the epidemic investigation.A descriptive analysis was used.OpenGeoDa 1.2.0 software was used for global spatial autocorrelation and local spatial autocorrelation analysis.SatScan 9.6 software was used for detecting the hot spot area in time and space.ArcGIS 10.2 software was used for map visualization.Results 1298 cases of HFRS were reported,and three patients died in Guangzhou in 2010-2019.The annual incidence rate was 0.99/100000.The proportion of 21-50 years old cases accounted for 70.88%and the male to female ratio was 2.98∶1.Most patients were house workers or unemployed,accounting for 31.28%,followed by business servants(accounting for 17.33%).The incidence peak in spring and winter accounted for 33.74%and 26.35%of the year.All districts reported cases in recent ten years.A total of 407 cases had been reported in Haizhu district,accounting for 31.36%of the total number of cases in the whole city.The annual incidence rate was 2.52/100000.The number of reported cases and the annual incidence rate were the highest in Guangzhou.The clustered area showed that there was spatio-temporal clustering in Guangzhou.The aggregation area was mainly concentrated in the urban villages adjacent to Wan-mu orchard and the Haizhu Lake Wetland Park in Haizhu district(logarithmic likelihood ratio was 44.08,P<0.001).Conclusions The prevalence and concentration of HFRS in winter and spring Guangzhou city from 2010 to 2019,showed a high incidence.Young and middle-aged men engaged in domestic and unemployed,and commercial services appeared the main risk groups.The urban-rural junction with many immigrants and low health environment,streets adjacent to Wan-mu orchard,and the Haizhu Lake Wetland Park in Haizhu district were the important regions for preventing and controlling HFRS.The government should formulate prevention and control measures to curb the rise and spread of the HFRS epidemic.