山东省招远市发热伴血小板减少综合征流行特征及危险因素分析

Epidemic characteristics and risk factors of severe fever with thrombocytopenia syndrome in Zhaoyuan City,Shandong Province

目的:了解山东省招远市发热伴血小板减少综合征(SFTS)流行特征和发病危险因素,为预防控制策略的完善提供依据。方法:采用回顾性分析,于"中国疾病预防控制信息系统传染病报告信息管理系统"收集2011-2018年招远市SFTS监测资料及确诊病例流行病学个案调查结果,对SFTS病例的一般情况与流行病学特征、发病与就诊情况、临床表现及接触史等资料进行描述流行病学分析;利用病例-对照研究方法,选择60例SFTS确诊病例及与确诊病例同地区、同性别、同年龄组的120例健康人群进行SFTS发病危险因素分析。结果:2011-2018年招远市共报告SFTS确诊病例140例,病死率为18.57%(27/140);发病时间主要集中在5-8月,占83.57%(117/140);发病年龄主要为50~80岁,占90.00%(126/140);男女性别比为1.06∶1.00(72∶68);职业分布以农民为主,占92.14%(129/140)。在140例SFTS病例中,发病至首诊及首诊至确诊的平均时间间隔分别为4和6 d;病例发病至确诊前平均就诊史为2次;病例首诊医疗机构为乡镇医疗机构者占60.71%(85/140),确诊机构为市级医院者占86.43%(121/140),首发症状为发热者占92.86%(130/140)。logistic回归分析结果显示,家中饲养动物[比值比(OR)=9.209,95%置信区间(CI):2.064~41.083]和被蜱虫叮咬(OR=16.818,95%CI:1.553~182.164)是SFTS发病的危险因素。结论:招远市SFTS病例发病时间主要集中在5-8月,50岁以上的农民是易感人群;家中饲养动物和被蜱虫叮咬是SFTS发病的危险因素。应加强对易感人群的SFTS防控知识宣传和健康教育。

Objective To understand the epidemic characteristics and risk factors of severe fever with thrombocytopenia syndrome(SFTS)in Zhaoyuan City,and to provide basis for the improvement of prevention and control strategies.Methods Retrospective analysis was performed to collect the SFTS surveillance data and epidemiological investigation results of confirmed cases in Zhaoyuan City from 2011 to 2018 from the"Infectious Disease Report Information Management System of the China Disease Prevention and Control Information System",and the general situation and epidemiological characteristics,onset and treatment,clinical manifestations and contact history of SFTS cases were analyzed by descriptive epidemiology method;60 cases of SFTS confirmed cases and 120 healthy people in the same village,same sex,and same age group as the confirmed case were selected by case-control study to analyze the risk factors of SFTS.Results A total of 140 confirmed SFTS cases were reported in Zhaoyuan City from 2011 to 2018,with a fatality rate of 18.57%(27/140);the onset time was mainly from May to August,accounting for 83.57%(117/140);the age of onset was mainly 50-80 years old,accounting for 90.00%(126/140);the sex ratio of men to women was 1.06∶1.00(72∶68);the occupation distribution was dominated by farmers,accounting for 92.14%(129/140).In 140 cases of SFTS,the average time intervals from onset to first visit and from first visit to confirmation of diagnosis were 4 and 6 days,respectively;and the average medical visit history from onset to diagnosis was 2 times,60.71%(85/140)of the cases were first diagnosed by township medical institutions,86.43%(121/140)of the cases were diagnosed by municipal hospitals;the first symptom was fever,which accounted for 92.86%(130/140).The logistic regression analysis showed that domestic animals[odds ratio(OR)=9.209,95%confidence interval(CI):2.064-41.083]and tick bites(OR=16.818,95%CI:1.553-182.164)were risk factors for SFTS.Conclusions The onset time of SFTS is mainly from May to August in Zhaoyuan City,and farmers over 50 years old are the key population;domestic animals and tick bites are the risk factors for the onset of SFTS.The publicity and health education of SFTS prevention and control knowledge for key populations should be strengthened.