2016—2020年深圳市南山区登革热流行特征分析

Epidemiological analysis on dengue fever in Nanshan District of Shenzhen City from 2016 to 2020

目的分析2016—2020年深圳市南山区登革热的流行特点和病例就医行为的特征,为登革热防控工作提供参考。方法收集2016—2020年南山区登革热病例资料和蚊媒监测信息,采用描述性流行病学方法分析其流行特征。结果2016—2020年南山区共报告198例登革热病例,其中本地病例110例,输入性病例88例,年均发病率为2.73/10万。全年除3月份外,其他月份均有登革热病例发生,以9、10月份病例数最多,占病例总数的65.66%(130/198)。南山区8个街道均有登革热病例发生,年均发病率最高的3个街道为蛇口、西丽和桃源,分别为4.96/10万、3.76/10万、3.16/10万。发病年龄为10~81岁,其中20~59岁病例数最多,共169例,占85.36%;男性登革热年均发病率(3.28/10万)高于女性(2.12/10万),差异有统计学意义(χ^(2)=9.041,P<0.05)。2016—2020年共发生6起暴发疫情,其中4起为工地暴发疫情。蚊媒监测发现,布雷图指数(BI)高峰为8—9月,6—10月BI均超过警戒值(5)。198例登革热病例中,初诊正确率为36.87%,住院率为70.71%,公立医院首诊率为58.59%,发病至首次就诊的间隔时间为1 d(0~3 d),发病至确诊的间隔时间为5 d(3~6 d)。公立医院首诊率输入性病例高于本地病例,发病至首次就诊间隔天数输入性病例比本地病例更长,差异均有统计学意义(χ^(2)=4.672、Z=0.493,P均<0.05)。结论南山区登革热疫情形势严峻,应对所有医疗机构开展诊疗和防控培训,加强蚊媒消杀公司培训,加强口岸入境人员和工地等高风险区域的健康教育,做到登革热的早发现、早诊断、早隔离。

Objective To analyze the epidemiological characteristics of dengue fever in Nanshan District of Shenzhen City from 2016 to 2020 and the behaviors of victims in hospital visiting for evidence in prevention and control of this infection.Methods The case data and surveillance results of the vectors dengue infection were collected in Nanshan District from 2016 to 2020,and analyzed using descriptive epidemiology for the epidemical features.Results A total of 198 dengue cases were reported in Nanshan District from 2016 to 2020,in which 110 were local infections and 88 were imported cases.The average annual incidence rate was 2.73/100000 population.Dengue fever was prevalent throughout the year except March,and the most reported in September and October,which accounted for 65.66%(130/198)of the reported cases.Dengue infection occurred in the eight communities within Nanshan District,with the highest in the community of Shekou,Xili and Taoyuan,accounting for 4.96,3.76,and 3.16 per 100000 population.The age of onset ranged from 10 to 81 years,yet population aged between 20 and 59 years were most affected(169 cases,85.36%).The average annual infection was higher in males than in females(3.28/100000 vs.2.12/100000),and the difference was statistically significant(χ^(2)=9.041,P<0.05).Six outbreaks occurred in 2016 and 2020,of which 4 were in construction sites.Mosquito monitoring indicated that Breteau index(BI)was peaked from August to September,and rose above the alert value between June and October.In the 198 cases of dengue fever,36.87%were confirmed at initial diagnosis,and 70.71%were treated on hospitalization basis.The initial diagnosis rate in public hospitals was 58.59%.The interval between onset and first visit was 1 day(0~3 d),and between onset and diagnosis was 5 day(3~6 d).Imported cases were higher than local infections in public hospitals by the first hospital visit,and the interval between onset and first visit was longer in imported cases than in local infections.The difference was significant(χ^(2)=4.672,Z=0.493,all P<0.05).Conclusion The dengue epidemic remains serious in Nanshan District.Our findings suggest that all medical institutions and organizations involved in mosquito eradication should be intensively trained for diagnosis and treatment,prevention and control.In addition,personnel returned from foreign countries and employees in construction sites should be provided with health education in order to achieve early detection,early diagnosis and early isolation of dengue fever.