湖北省2008-2021年斑疹伤寒流行病学特征分析

Epidemiological characteristics of typhus fever in Hubei,China,2008-2021

目的分析2008-2021年湖北省斑疹伤寒流行病学特征,为制定斑疹伤寒防治策略和控制措施提供科学依据。方法利用Excel 2013、SPSS 20.0和Joinpoint 4.9.0软件对湖北省2008-2021年网络直报的斑疹伤寒病例发病率、人群分布、时间及地区分布、发病就诊情况、病例种类等进行分析,χ^(2)检验用于比较发病率的差异。结果湖北省2008-2021年共报告斑疹伤寒病例623例,包括临床诊断病例438例(占70.30%)、确诊病例13例、疑似病例172例,无死亡病例报告;2008-2015年全省斑疹伤寒年均发病率为0.005/10万,自2016年开始发病率不断升高,到2021年发病率达0.388/10万,是2008年的215.56倍,整体发病呈散发态势;14年间全省累计有12个市(州)28个县(市、区)有病例报告,疫情有一定的地域集中性,发病率排前3位的县(区)分别是英山(93.038/10万)、宣恩(19.765/10万)和建始县(12.054/10万);发病时间主要集中在4-11月,呈双峰分布。发病人群主要集中在40~<70岁年龄组(占76.73%),男女性别比为1∶2.2;职业以农民为主(占87.16%)。从发病至诊断所需时间的中位数为4 d;病例主要来自县级综合性医院。结论湖北省斑疹伤寒流行呈逐年上升趋势,有明显的地区性和季节性,农民为高发人群,建议在夏秋季节对高发地区重点人群加强健康教育,减少感染机会,预防和控制斑疹伤寒的发生和流行。

Objective To investigate the epidemiological characteristics of typhus fever in Hubei Province,China,in 2008 to 2021,so as to provide a scientific basis for formulating prevention and control strategies for typhus fever.Methods Excel 2013,SPSS 20.0,and Joinpoint 4.9.0 were used to analyze the incidence rate,population distribution,temporal and regional distribution,onset and presentation,and type of typhus fever cases reported directly via the network in Hubei Province in 2008-2021.The Chi-squared test was used to compare the differences of incidence rates.Results A total of 623 cases of typhus fever were reported in Hubei Province in 2008-2021,among which there were 438 clinically diagnosed cases with percentage of 70.30%,13 confirmed cases,and 172 suspected cases,and no cases of death were reported.The mean annual incidence rate of typhus fever in Hubei Province was 0.005/100000 in 2008-2015,and it continued to increase in 2016 and reached 0.388/100000 in 2021,which was 215.56 times that in 2008.The onset of the disease showed a sporadic trend.In the past 14 years,a total of 12 cities(prefectures)and 28 counties(districts)in Hubei Province reported the cases of typhus fever,with the feature of a certain degree of geographical concentration,and the top 3 counties(districts)in terms of incidence rate were Yingshan County(93.038/100000),Xuan’en County(19.765/100000),and Jianshi County(12.054/100000).The onset time was mainly from April to November,showing a pattern of bimodal distribution.The patients aged 40-<70 years accounted for the highest proportion of 76.73%,and the male/female ratio was 1:2.2.Most patients were farmers in terms of occupation(87.16%).The median time from onset to diagnosis was 4 days,and the cases mainly came from county-level general hospitals.Conclusions The prevalence of typhus fever in Hubei Province is increasing year by year,with obvious regional and seasonal characteristics,and farmers are the population with a relatively high incidence rate of typhus fever.It is recommended to strengthen health education for key populations in high-incidence regions in summer and autumn to reduce the chance of infection and control the onset and prevalence of typhus fever.