2004-2017年中国甲乙类自然疫源及虫媒传染病流行趋势变化特征

Changing characteristics of epidemic trends of category A and B natural focus diseases and vector-borne diseases in China during 2004-2017

目的探讨2004-2017年中国甲乙类自然疫源及虫媒传染病流行趋势特征,为完善防控措施提供参考。方法从公共卫生科学数据中心及中国人口和就业统计年鉴收集公开数据,采用Joinpoint回归模型分析全国及分地区、分年龄段甲乙类自然疫源及虫媒传染病的发病率变化趋势。结果2004-2017年全国登革热发病率呈上升趋势,平均年度变化百分比(AAPC)为22.6%。钩端螺旋体病(钩体病)和乙型脑炎(乙脑)发病率分别以AAPC11.9%、15.4%下降。流行性出血热(出血热)发病率呈"降-升-缓降"趋势,AAPC为-7.6%。布鲁菌病、血吸虫病、狂犬病和疟疾发病率呈"升-降"趋势。不同自然疫源及虫媒传染病的时空分布及年龄分布存在差异。乙脑发病季节性强。登革热发病高峰为8-10月。布鲁菌病的发病高峰为3-8月。布鲁菌病、出血热、血吸虫、狂犬病和钩体病均在40~<60岁和60~岁人群高发,乙脑发病率在0~<20岁人群最高。布鲁菌病和登革热发病率在0~<20、20~<40、40~<60、60~岁年龄层总体均呈上升趋势;狂犬病、钩体病和疟疾的发病率在0~<20、20~<40、40~<60、60~岁年龄层总体均呈下降趋势。结论中国在自然疫源及虫媒传染病的防控方面已取得长足进步,但布鲁菌病、血吸虫病和登革热的防控形势依然严峻,未来防控应进一步实践One Health理念和策略。

Objective To explore the changing characteristics of category A and B natural focus diseases and vector-borne diseases in China from 2004 to 2017,and provide reference for perfecting prevention and control measures.Methods A Joinpoint regression model was employed to analyze the incidence rate of category A and B natural focus diseases and vectorborne diseases in China and its sub regions and different age groups,from 2004 to 2017,with open data obtained from the data center of China public health science and China population and employment statistics yearbook.Results The incidence rate of dengue fever increased in 2004-2017,and the average annual percent change(AAPC)was 22.6%.The incidence rate of leptospirosis and Japanese encephalitis decreased by AAPC 11.9%and 15.4%,respectively.The incidence rate of epidemic hemorrhagic fever showed a"down-up-slowly down"trend,and the AAPC was-7.6%.The incidence rate of brucellosis,schistosomiasis,rabies and malaria experienced a trend of"up-down".The spatial and temporal and age distribution of different natural focus diseases and vector-borne diseases were dissimilar.Japanese encephalitis was seasonal.The seasonal fluctuation of dengue fever was observed with the highest peak from August to October.The seasonal trend of brucellosis was recorded with a peak during March and August.The high incidence was among people aged 40-<60 and 60-for Brucellosis,hemorrhagic fever,schistosomiasis,rabies and leptospirosis.The incidence rate of Japanese encephalitis was highest among people aged 0-<20 years old.The incidence rate of brucellosis and dengue fever increased in all four age groups.The incidence rate of rabies,leptospirosis and malaria decreased in all four age groups.Conclusions Although China has made great progress in the prevention and control of natural focus diseases and vector-borne diseases,the situation for brucellosis,schistosomiasis and dengue fever remained grave.The concept and strategy of One Health should be further implemented.