基于移动流行区间法建立乌鲁木齐市手足口病流行强度阈值

Using the moving epidemic method to establish the hand-foot-mouth disease epidemic monitoring threshold and to evaluate the intensity level in Urumqi

目的 利用移动流行区间法(moving epidemic method,MEM)评估乌鲁木齐市手足口病流行强度,建立手足口病监测阈值,为分级防控提供科学依据。方法 利用MEM对2012—2020年乌鲁木齐市第5~40周手足口病监测发病数据建模,筛选指标包括灵敏度、特异度、阳性预测值、阴性预测值、马修系数及约登指数,评价2021年乌鲁木齐市手足口病流行状况。结果 剔除2019—2020年数据,利用剩余年份数据重新建模后,最优参数值为2.4,灵敏度、特异度和约登指数分别为0.93、0.93、0.86,表明模型拟合效果较好。2021年乌鲁木齐市手足口病从第5周开始发病数逐渐增加,在第24~29周达到最高发病水平,流行阈值为58例,纳入模型周数均未达到流行阈值。考虑到2019—2021年乌鲁木齐市受新型冠状病毒感染疫情防控影响,使得2021年手足口病数与既往年份相比全年处于较低水平。结论 利用MEM建立手足口病流行预警模型,可计算手足口病的流行开始时间及流行强度,预测疾病流行至高峰期的时间,在手足口病的预警中效果较好。

Objective To establish the monitoring threshold of hand-foot-mouth disease(HFMD)using moving epidemic method(MEM)and to evaluate the prevalence intensity of HFMD in Urumqi,in order to provide scientific evidence for hierarchical prevention and control.Methods MEM was used to model the surveillance incidence data of HFMD in Urumqi during the 5-40 weeks from 2012 to 2020.Screening indicators included sensitivity,specificity,positive predictive value,negative predictive value,Matthew′s coefficient and Jordan′s index.The epidemic situation of HFMD in Urumqi in 2021 was assessed.Results Since the results of cross-validation showed poor quality of data in 2019 and 2020,these data were excluded.After re-modeling with the data of the remaining years,the optimal parameter value was 2.4,and the sensitivity,specificity,and Jordan index were 0.93,0.93 and 0.86,respectively,which indicated a nice fitting effect of the model.In 2021,HFMD cases started to increase from the 5th week and peaked around 24th to 29th week and all the cases in the city did not enter the epidemic period.Considering the impact of the COVID-19 prevention and control in the past three years,the incidence of HFMD in 2021 was at a lower level compared with that in the previous year.Conclusions Using moving epidemic method to establish an epidemic warning model of HFMD can calculate the onset time and epidemic intensity,and predict the time from the beginning to the peak,which is effective in the early warning of HFMD.