2016-2019年重庆市江津区感染性腹泻病流行特征及疾病负担分析

Epidemiologic characteristics and disease burden of infectious diarrhea in Jiangjin, Chongqing, 2016–2019

目的 分析2016-2019年重庆市江津区感染性腹泻病流行特征及疾病负担,为疫情防控提供依据与支持。方法 从“中国疾病预防控制信息系统”中导出2016-2019年重庆市江津区感染性腹泻监测数据,采用描述性流行病学研究方法分析疾病流行特征,并采用发病率和伤残调整寿命年估算疾病负担;采用时空扫描统计量探索其时空聚集性,运用ArcMap 10.2软件进行疫情的图形可视化。结果 2016-2019年重庆市江津区累计报告感染性腹泻病4 670例,死亡1例,年平均报告发病率为84.72/10万,男女性别比为1.174∶1,<5岁年龄组发病率最高(1 128.69/10万),散居儿童占比最大(73.30%),11月至次年3月为发病高峰。聚集区域主要集中在几江、鼎山、双福、德感4个街道(最大似然比=281.73,相对危险度=4.44,P<0.01);有明确病原学诊断病例占比5.89%,以轮状病毒感染为主(87.91%)。归因于感染性腹泻的寿命损失年(YLL)为22.53人年,健康寿命损失年(YLD)为9.42人年;<5岁儿童是感染性腹泻病的高危人群,其YLD为7.21人年(76.54%),>60岁老年人亦是感染性腹泻病的发病的重要人群,YLD为0.82人年(8.70%)。结论 重庆市江津区应作为感染性腹泻病的重点防控区域,相关部门应进一步提高病原学诊断能力并结合疾病季节性高发、病原谱特点对<5岁儿童、散居儿童等人群采取针对性措施以控制疾病的传播与流行。

Objective To analyze the epidemiiologic characteristics of infectious diarrhea in Jiangjin district, Chongqing,from 2016 to 2019, and provide scientific basis and support for infectious diarrhea prevention and control. Methods The incidence data of infectious diarrhoea in Jiangjin from 2016 to 2019 were collected from National Disease Control and Prevention Information System. The descriptive epidemiology method was used to analyze the characteristics of infectious diarrhoea. The disability adjusted life year(DALY) was estimated to evalaute the disease burden caused by infectious diarrhea in each year. The spatiotemporal scan statistic was used to explore the spatiotemporal clustering of cases, and ArcMap10.2 was used to visualize the analysis results. Results From 2016 to 2019, a total of 4 670 cases of infectious diarrhoea were reported in Jiangjin, including 1 death, and the annual average incidence rate was 84.72/100 000. The male to female ratio of infectious diarrhea cases was 1.174∶1, and the incidence rate was highest in the age group <5 years(1 128.69/100 000). The cases in children outside child care settings accounted for the highest proportion(73.30%). The incidence peak was during November-March. Spatiotemporal scanning further found that the most likely clustering areas were 4 streets including Jijiang,Dingshan, Shuangfu and Degan(LLR=281.73, RR=4.44, P<0.01). The cases with definite etiological diagnosis accounted for 5.89%, most cases were rotavirus infections(87.91%). The years of life lost(YLL) due to infectious diarrhoea was22.53 person-years, and the years lived with disability(YLD) was 9.42 person-years. Children aged <5 years were at high risk for infectious diarrhea with cumulative YLD of 7.21 person-years(76.54%). People aged >60 years old were also a risk group for infectious diarrhea with YLD of 0.82 person-years(8.70%). Conclusion The main urban area of Jiangjin should be regarded as the key area for the prevention and control of infectious diarrhea. The relevant departments should further improve the etiological diagnosis and take targeted measures to control the incidence and spread of infectious diarrhea in children aged<5 years and children outside child care settings according to the epidemilogic and etilogic characterisrics of infectious diarrhea.