2016-2021年云南省大理白族自治州手足口病流行特征及时空聚集性分析

Epidemiological characteristics and spatiotemporal clustering of hand foot and mouth disease in Dali,Yunnan,2016-2021

目的分析2016—2021年云南省大理白族自治州(大理州)手足口病(HFMD)的流行特征及时空聚集性,为该地区HFMD的防控提供科学依据。方法收集传染病监测系统中网络直报的大理州HFMD的发病资料,对2016—2021年HFMD的流行病学特征进行描述性分析,通过空间自相关分析与时空扫描分析相结合的方法探索大理州HFMD的时空分布特征。结果2016—2021年大理州累计报告HFMD 32476例,年均发病率为149.00/10万,多数年份为双峰流行,主高峰在7月,而少数年份为单峰流行,2020年高峰在11月,2021年高峰在1月;男女发病率性别比为1.30∶1;发病年龄主要集中在0~6岁,散居儿童占比最高;高发病率地区逐年变化。全局空间自相关分析显示,大理州仅有2017年的HFMD发病率存在空间正相关性。局部空间相关性显示,2016—2019年大理州HFMD发病率具有局部空间相关性,而2020—2021年不具有。时空扫描分析显示,大理州HFMD发病率具有时空聚集性,主集群在地理空间上均有所变化,其中2018年覆盖范围最大,相对危险度值为5.34,对数似然比值1452.77,P<0.001;聚集时间主要分布在6-7月;2016—2021年高发病率聚集区逐年发生变化,与高发病率地区变化相同。结论云南省大理州HFMD病例时空聚集主要集中在夏秋季,幼儿高发,高发地区逐年变化,应加强对大理州高发季节和人群的重点防控。

Objective To analyze the epidemiological characteristics and spatiotemporal clustering of hand foot and mouth disease(HFMD)in Dali of Yunnan province between 2016 and 2021,and provide evidence for the prevention and control of HFMD in Dali.Methods The incidence data of HFMD in Dali during this period were collected from infectious disease surveillance system for a descriptive epidemiological analysis,and the spatiotemporal distribution of HFMD in Dali was explored by combining spatial autocorrelation analysis with spatiotemporal scanning.Results A total of 32476 HFMD cases were reported in Dali cumulatively from 2016 to 2021,with the annual incidence rate of 149.00/100000.Two incidence peaks were observed in most years with the main peak in July,but only one peak was observed in November 2020 and in January 2021.The male to female ratio of the cases was 1.30∶1;The children aged 0-6 years old were mainly affected;The highest proportion was in scatteredly living children;High-incidence areas changed annually.Global spatial autocorrelation analysis showed spatial positive correlation of the incidence rate only in 2017,local spatial correlation showed that a local spatial correlation of HFMD incidence rate between 2016 and 2019,but not between 2020 and 2021.Spatiotemporal scanning 1showed a spatiotemporal clustering of HFMD incidence rate in Dali,the coverage was the largest in 2018,the RR value was 5.34,the LLR value was 1452.77(P<0.001).The clustering mainly occurred during June-July.The clusters with high HFMD incidence rate changed annually between 2016 and 2021,similar to the change in areas with high incidence.Conclusion Spatiotemporal clustering of HFMD cases in Dali mainly occurred in summer and autumn.The incidence was high in children and the high-incidence areas changed annually.The prevention and control of HFMD in high-incidence season and key population should be strengthened in Dali.