2014-2018年广西柳州市手足口病流行病学特征及病原学监测分析

Epidemiological and etiological characteristics of hand foot and mouth disease in Liuzhou,Guangxi,2014-2018

目的分析2014—2018年广西壮族自治区柳州市手足口病的流行病学特征和病原学检测结果,为柳州市手足口病的防控提供依据。方法采用描述性和空间流行病学方法分析手足口病的流行病学特征,利用全局和局部空间自相关分析手足口病的空间聚集性,利用趋势面分析手足口病的空间分布趋势,并对各年度的病原学检测结果进行分析。结果2014—2018年柳州市手足口病的平均发病率为821.59/10万,主要为0~5岁儿童(95.90%),以散居儿童居多(64.58%)。2014—2018年手足口病发病率及重症病例数总体呈下降趋势,其高发季节在4—7月和9—11月。病原学检测结果显示,2014年主要病原为肠道病毒71型(EV71)和其他肠道病毒,2015和2017年以其他肠道病毒为主(>80%),2016和2018年以柯萨奇病毒A组16型(Cox A16)为主,其次为其他肠道病毒,EV71占比较低。手足口病存在高度空间聚集性,热点区域集中在柳州市南部地区,冷点区域集中在融水苗族自治县;高发地区集中在柳南区城区、鱼峰区城区、柳北区城区、城中区、拉堡镇、鹿寨镇、雒容镇、三都镇、进德镇、成团镇、沙塘镇、四排乡和古宜镇。趋势面分析显示,手足口病发病率总体呈由北向南逐渐升高、东西两边向中间逐渐升高趋势。结论柳州市手足口病以<5岁散居儿童多见,有明显夏、秋季的发病高峰和地区聚集性,不同年份主导病原不同,应加强高发地区的危险因素研究,为防控策略的制定和公共卫生资源的优化配置提供科学依据。

Objective To understand the epidemiological and etiological characteristics of hand foot and mouth disease(HFMD)in Liuzhou,Guangxi,from 2014 to 2018,and provide evidences for the prevention and control of HFMD.Methods Descriptive and spatial analyses were used to analyze the epidemiological characteristics of HFMD in Liuzhou.Global and local spatial autocorrelation analysis was used to analyze the spatial clustering of HFMD.The trend surface analysis was used to evaluate the spatial distribution trend of HFMD,and the annual etiological test results of HFMD were analyzed.Results The annual average incidence rate of HFMD was 821.59/100000 in Liuzhou from 2014 to 2018.Most cases were aged 0–5 years(95.90%),and 64.58%of them were children outside child care settings.The incidence rate and severe case number of HFMD showed decline trends from 2014 to 2018(P<0.01),and the epidemic season was from April to July and September to November.EV71 and other enteroviruses were the main pathogens in 2014.Other enteroviruses were the main pathogens in 2015 and 2017(>80%).Cox A16 was the main pathogen in 2016 and 2018,followed by other enteroviruses,and EV71 accounted for a relatively low proportion.There was spatial clustering with hot spots in the southern part of Liuzhou and cold spots in Rongshui Miao autonomous county.The high-incidence areas were in Liunan,Yufeng,Liubei,Chengzhong districts,and Labao,Luzhai,Luorong,Sandu,Jinde,Chengtuan,Shatang,Sipai and Guyi townships.The trend surface analysis showed that the incidence of HFMD increased gradually from north to south,and from east and west to central area.Conclusion HFMD mainly occurred in children under 5 years old in Liuzhou with the seasonal incidence peaks in summer and autumn,and had obviously spatial clustering distribution.The predominant pathogens were different in different years.It is necessary to further explore the risk factors in high-risk areas to provide scientific evidences for the development of HFMD prevention and control strategies and the allocation of public health resources.