2011—2020年我国自然疫源性疾病流行趋势Joinpoint回归分析

Joinpoint regression analysis of the epidemic trend of natural focal diseases in China from 2011 to 2020

目的分析我国2011—2020年自然疫源性疾病的流行趋势,为部队驻训做好自然疫源性疾病防制工作提供科学依据。方法利用Joinpoint回归模型对我国2011—2020年自然疫源性疾病的年发病率数据资料进行拟合,分析我国2011—2020年自然疫源性疾病的发病趋势,计算年度变化百分比(annual percent change,APC)及其95%可信区间(95%CI)。结果2011—2020年我国报告的15种法定自然疫源性疾病,发病率居前三位的分别是布鲁杆菌病、流行性出血热、登革热;病死率居前三位的分别是狂犬病、人感染高致病性禽流感、鼠疫。2011—2020年我国鼠疫、人感染高致病性禽流感发病率逐年上升(t_(鼠疫)=2.4、t_(人感染高致病性禽流感)=14.3,P<0.05),狂犬病、钩端螺旋体病、疟疾发病率逐年下降(t_(狂犬病)=-30.7、t_(钩端螺旋体病)=-2.9、t_(疟疾)=-2.9,P<0.05);血吸虫病发病率2015年前逐年上升,之后逐年下降(t_(2011—2015)=9.9、t_(2015—2020)=-9.8,P<0.05);2017年前斑疹伤寒发病率逐年下降(t_(2011—2017)=-10.1,P<0.05)、包虫病发病率逐年上升(t_(2011—2017)=3.5,P<0.05)。结论2011—2020年我国自然疫源性疾病的发病形势依然严峻,提示重点人群特别是部队官兵进驻自然疫源地时应采取针对性防控措施。

Objective To analyze the epidemic trend of natural focal diseases in China from 2011 to 2020,and to provide a scientific basis for the prevention and control of natural focal diseases in military training.Methods A Joinpoint regression model was used to fit the annual incidence data of natural focal diseases in China from 2011 to 2020,to analyze the incidence trend of natural focal diseases in China from 2011 to 2020,and to calculate the annual percent change(APC)and its 95%CI.Results Of the 15 notifiable legally natural focal diseases reported in China from 2011 to 2020,the top three incidence rates were brucellosis,epidemic hemorrhagic fever,and dengue fever,and the top three fatality rates were rabies,human infection with the highly pathogenic avian influenza and plague,respectively.From 2011 to 2020,the incidence rates of plague and human infection with the highly pathogenic avian influenza increased year by year(t_(plague)=2.4,P<0.05;t_(human infection with the highly pathogenic avian influenza)=14.3,P<0.05)in China,while the incidence rates of rabies,leptospirosis and malaria decreased year by year(t_(rabies)=-30.7,P<0.05;t_(leptospirosis)=-2.9,P<0.05;t_(malaria)=-2.9,P<0.05).The incidence rate of schistosomiasis increased year by year before 2015,and then decreased(t_(2011-2015)=9.9,P<0.05;t_(2015-2020)=-9.8,P<0.05).Before 2017,the incidence rate of typhus decreased year by year(t_(2011-2017)=-10.1,P<0.05),while the incidence of hydatidosis increased year by year(t_(2011-2017)=3.5,P<0.05).Conclusion The incidence situation of natural focal diseases in China from 2011 to 2020 remains serious,which suggests that the focus groups,especially army officers and soldiers,should be required to take targeted prevention and control measures when they entered natural focus.