2015-2020年海口市重症手足口病流行病学特征及影响因素分析

Epidemiological Characteristics and Influencing Factors of Severe HFMD in Haikou City,China,from 2015 to 2020

海口市是手足口病的高发地区,为阐明海口市手足口病重症病例的流行病学特征及影响因素,本研究利用2015-2020年海口市所有手足口病病例资料、重症病例个案调查及病原学监测资料进行描述性统计分析。结果表明,2015-2020年海口市重症手足口病呈现明显的下降趋势(R_(趋势)^(2)=0.77);发病呈现春末夏初(4-7月)和秋末冬初(9-11月)双峰型特征;91.67%的重症病例为3岁及以下婴幼儿;男性重症率高于女性;城区病例最多(占37.12%),其次是城乡结合部(占33.33%);病原体以其他肠道病毒感染为主,但EV-A71型病毒感染致重症率更高;93.18%的重症手足口病伴有神经系统受损表现;男性、低年龄、就诊时病程短、EV-A71感染是重症手足口病的危险因素;持续加强病原学监测、健康教育等防控措施,积极推广3岁及以下重点人群EV-A71疫苗接种,有利于控制和减少重症和死亡病例的发生。

Haikou City(HC)in China has a high incidence of hand,foot and mouth disease(HFMD). We aimed to elucidate the epidemiological characteristics and risk factors of severe cases of HFMD in HC.Descriptive statistical analysis was used to assess the collective data of all HFMD cases,severe cases,and detection data in HC from 2015 to 2020. During 2015–2020,the incidence of severe HFMD in HC showed a significant downward trend(R2 trend = 0.77)as well as bimodal characteristics of late-spring and early-summer(April to July)and late-autumn and early-winter(September to November). Also,91.67% of severe cases were infants under 3 years of age. The incidence of severe HFMD in males was higher than that in females. The urban area of HC had the most cases(37.12%),followed by the urban – rural fringe area(33.33%). Other enteroviruses(EVs)were the main pathogens,and the incidence of severe HFMD due to EV-A71 infection was high. In addition,93.18% of patients with severe HFMD had nervous-system damage. Being male,young,having a rapid diagnosis,and EV-A71 infection were the main risk factors for severe HFMD. We concluded that the incidence of severe HFMD in HC showed a downward trend. Prevention-and-control measures should be strengthened continuously,including pathogen monitoring and health education. Promotion of EV-A71 vaccination for those aged ≤3 years would help to control and reduce the occurrence of severe cases.