2008~2019年湖南省手足口病流行特征及空间流行病学分析

Epidemiological characteristics and spatial epidemiology of hand-foot-mouth disease in Hunan Province,China,from 2008 to 2019

目的分析2008~2019年湖南省手足口病疫情及空间自相关特征与时空聚集性,为湖南省手足口病的防控提供参考依据。方法采用空间自相关及时空聚集性分析方法对湖南省2008~2019年手足口病的监测数据进行分析。结果2008~2019年湖南省手足口病疫情呈明显季节性分布,每年1~3月为低发期,高发季节为4~7月。主要的高发人群集中在0~5岁儿童,年平均发病率为2197.784/10万,占总发病人数的95.89%(1460391/1522910);以散居儿童最多,占发病病例数的82.59%(1257739/1522910)。全局自相关分析显示湖南省手足口病发病呈显著的聚集性分布,局部自相关分析显示手足口病高-高聚集区主要集中在长沙市、株洲市、岳阳市等地区的区县。通过时空扫描统计可得聚集时间多为4~7月,2008~2010年聚集在湖南省的东北部,2011~2019年主要集中在湘中部地区。结论湖南省手足口病疫情高发季节为4~7月,高发人群为0~5岁的儿童,且疫情存在时空聚集性,主要集中在湖南省东北部及中部地区。建议以此为指导,确定湖南省手足口病的重点防控区域,优化卫生资源配置。

Objective To investigate the epidemic situation of hand-foot-mouth disease(HFMD)in Hunan Province,China,from 2008 to 2019,as well as its spatial autocorrelation characteristics and spatial-temporal clustering,and to provide a reference for the prevention and control of HFMD in Hunan Province.Methods Spatial autocorrelation and spatial-temporal clustering analyses were used to analyze the monitoring data of HFMD in Hunan Province from 2008 to 2019.Results The epidemic situation of HFMD in Hunan Province from 2008 to 2019 showed obvious seasonal distribution,with a low incidence rate in January to March and a high incidence rate in April to July.As for population distribution,children aged 0-5 years had the highest number of HFMD cases and accounted for 95.89%(1460391/1522910)of all cases,with a mean annual incidence rate of 2197.784/100000,and scattered children had the highest number of cases and accounted for 82.59%(1257739/1522910)of all cases.The global spatial autocorrelation analysis showed that the onset of HFMD in Hunan Province showed a significant clustering distribution,and the local spatial autocorrelation analysis showed that the high clustering areas of HFMD were mainly the districts and counties of Changsha,Zhuzhou,and Yueyang cities.Time-space scanning showed that clustering time was mainly April to July;the cases were clustered in the northeast of Hunan Province from 2008 to 2010 and in the central part of Hunan Province from 2011 to 2019.Conclusions The high incidence rate of HFMD is observed in April to July in Hunan Province.Children under 5 years of age are at a high risk of this disease.Spatial-temporal clustering is observed for the epidemic of HFMD,mainly clustered in the northeastern and central areas of Hunan Province.It is suggested that the results may be used as guidance to determine the key areas for HFMD prevention and control in Hunan Province and optimize the allocation of health resources.