2009—2018年湖南省手足口病时空分布与气象因子关系研究

Relationship between temporal and spatial distribution of hand,foot and mouth disease and meteorological factors in Hunan Province,2009-2018

目的回顾性分析2009—2018年湖南省14个市州手足口病时空分布与病原学特征,开展与气象因子相关性及预测模型研究。方法采用SQLSEVER 2008、Excel 2016处理数据,ARGGIS制作图表,SPSS 22.0统计软件进行相关性分析,多元线性逐步回归法进行预测,赋值评价法进行风险区划研究。结果2009—2018年湖南省共报告手足口病患者1402027例,年发病率5.05/万~31.94/万,年均发病率20.92/万;重症患者10248例,年重症率在0.18%~1.64%,年均重症率为0.73%;死亡275例,年均死亡率0.02%;发病人群主要在6岁以下,占97.50%;男女比例1.58∶1;年发病人数与年降水量、年日照时数相关系数r_(s)=0.661、-0.661,P=0.038、0.038;月发病人数与月均气压、月均气温、月均相对湿度、月均降水量的相关系数r_(s)=-0.446、0.423、0.288、0.542,P=0.000、0.000、0.002、0.000。结论2009—2018年湖南省手足口病发病率整体呈上升趋势,偶数年高发,4—7月、9—11月为高峰期,6岁以下散居和幼托儿童为主,男性高于女性;月发病人数与月均降水量、月均气温、月均日照时数显著相关;高风险发病地区位于长沙、娄底、湘西州、湘潭、益阳、岳阳。

Objective To retrospectively analyze the temporal and spatial distribution and etiological characteristics of hand,foot and mouth disease(HFMD)in 14 cities and prefectures of Hunan Province from 2009 to 2018,and to conduct researches on their correlations with meteorological factors and the prediction model.Methods SQLSEVER 2008 and EXCEL 2016 were used to clean and process the data.The software ARGGIS was employed to make charts.SPSS22.0 software was used for correlation analysis.Multiple linear stepwise regression method was applied to prediction,and assignment evaluation method was used for risk zoning study.Results A total of 1,402,027 HFMD cases were reported in Hunan Province during 2009-2018.The annual incidence rate was 5.05/10,000-31.94/10,000,the average annual incidence rate 20.92/10,000.There were 10,248 severe cases,the annual proportion of severe cases was 0.18%-1.64%,and the average annual proportion of severe cases was 0.73%.There were 275 death cases,and the average annual mortality rate was 0.02%.The majority of the patients were under 6 years old,accounting for 97.50%.The ratio of male to female was 1.58:1.The annual number of cases was significantly correlated with annual precipitation(r_(s)=0.661,P=0.038)and annual sunshine hours(r_(s)=-0.661,P=0.038).The monthly number of cases was significantly associated with monthly mean air pressure(r_(s)=-0.446,P=0.000),temperature(r_(s)=0.423,P=0.000),relative humidity(r_(s)=0.288,P=0.002),and precipitation(r_(s)=0.542,P=0.000).Conclusion The incidence rate of HFMD in Hunan Province during 2009-2018 showed an upward trend as a whole.A high incidence was found in even-numbered years.The peak incidence of HFMD occurred from April to July as well as from September to November.Most of the cases were scattered and nursery children under 6 years old.Male patients were more than female ones.The monthly number of cases was significantly correlated with average monthly precipitation,average monthly temperature and average monthly sunshine hours.Changsha,Loudi,Xiangxi Prefecture,Xiangtan,Yiyang and Yueyang were the high-risk incidence areas of HFMD.