2013—2019年玉溪市手足口病流行特征与动态变化

Epidemiological characteristics and dynamic changes of hand-foot-mouth disease in Yuxi City from 2013 to 2019

目的 了解玉溪市手足口病流行特征及动态变化,为制定防控策略提供科学依据。方法 应用描述性流行病学对2013—2019年玉溪市手足口病病例进行分析,季节指数和年估计百分比变化(EAPC)分析季节性和变化趋势,率或构成比的比较采用χ^(2)检验,检验水准α=0.05。结果 玉溪市手足口年均发病率为611.78/10万,年均上升幅度4.29%(95%CI:-6.78%~15.18%),报告重症率0.48%,年均下降幅度-43.73%(95%CI:-84.94%~-30.06%)。发病主要集中在3岁以下散居儿童且优势血清型为其他EV。男性发病率是女性的1.31倍(OR=1.31,95%CI:1.29~1.33)。每年有1~2个流行季,主要流行季节为4-7月。CV-A16和其他EV构成比呈上升趋势,年均上升幅度分别为4.60%(95%CI:-7.85%~16.85%)和7.25%(95%CI:-7.11%~21.11%),EV-71构成比呈下降趋势,年均下降幅度-15.80%(95%CI:-30.14%~-4.26%)。重点防控地区为江川区、红塔区、通海县、华宁县、新平县和峨山县。结论 玉溪市手足口病存在人群以及地区间差异,病原谱正在发生变化,在常规监测的基础上,还应及时开展其他EV血清型监测。

Objective To understand the epidemic trend and dynamic characteristics of hand-foot-mouth disease(HFMD) in Yuxi city for setting up appropriate intervention measures.Methods Descriptive epidemiology was used for data analysis of HFMD in Yuxi city from 2013 to 2019,seasonal index and annual estimated percentage change(EAPC) were used to analyze seasonality and change trends.Chi-square test were used for comparison of rates or component ratios,and the test level was α=0.05.Results The annual average incidence rate of HFMD in Yuxi city was 611.78/105,with an average annual increase of 4.29%(95% CI:-6.78% ~15.18%).The severe rate was0.48%,and an average annual decrease of-43.73%(95%CI:-84.94%~-30.06%).The cases were mainly concentrated in scattered children under 3 years old and the serotype was mainly EV virus.The incidence rate of males was 1.31 times that of females(OR=1.31,95% CI:1.29~1.33).There were 1 or 2 epidemic seasons each year,the main epidemic season was April to July.Proportions of CV-A16 and EV increased at an average annual rate of 4.60%(95%CI:-7.85%~16.85%) and 7.25%(95% CI:-7.11% ~21.11%),but the proportions of EV-71 decreased at an average annual rate of 15.80%(95% CI:-30.14% ~-4.26%).The epidemic in different regions was different,and the focus for prevention and control areas were Jiangchuan district,Hongta district,Tonghai county,Huaning county,Xinping county and Eshan county.Conclusions It shows a population and regional differences in the epidemiological characteristics and trend of hand-footmouth disease in Yuxi city.The pathogen spectrum is changing.Based on the basis of routine surveillance,other EV serotype surveillance should be carried out in time.