2009—2021年青海省猩红热流行病学特征分析

Analysis of epidemiologic features of scarlet fever in Qinghai Province from 2009 to 2021

目的分析青海省2009—2021年猩红热病例的流行病学特征,为该省科学防控猩红热提供依据。方法从传染病监测信息系统、突发公共卫生事件信息系统和预警监测信息系统中,以月/年为单位导出猩红热发病例数(率)、聚集性(突发)疫情信息和预警信号数等数据,描述分析青海省2009—2021年猩红热的流行病学特征。结果2009—2021年青海省累计报告4681例猩红热病例,男女性别比为1.37∶1,发病率为2.22/10万~13.39/10万,其中2009年发病率最低,2021年发病率最高;不同年份、各市州猩红热发病率在0.24/10万(2019年玉树州)~22.75/10万(海东市),年均发病率最高为海东市(9.99/10万),最低为黄南州(1.07/10万),发病呈双峰,6月主高峰,11月次高峰;10岁以下儿童发病例数占总病例数的91.73%(4294/4681),5~<10岁儿童发病例数占10岁以下儿童的80.32%(3449/4294),年龄中位数为5岁,以托幼儿童、学生和散居儿童为主,占总病例数的98.70%,其中95.15%为临床诊断病例,3.01%为确诊病例;87.20%由医院报告,7.61%由疾控中心报告。结论2009—2021年青海省猩红热发病率呈现上升趋势,2014年后陡然上升,防控地区以西宁市和海东市为主,5~<10岁为高发年龄组;应侧重猩红热病原学研究,以强化医疗机构对猩红热病例报告的准确性和诊断能力,以弥合医防裂痕。

Objective To analyze the epidemiologic features of scarlet fever cases in Qinghai Province from 2009 to 2021,and to provide a basis for scientific prevention and control of scarlet fever in the province.Methods A descriptive analysis was performed to determine the epidemiologic features of scarlet fever in Qinghai Province from 2009 to 2021 by deriving data on the number of cases(rate)of scarlet fever,information on aggregated(emergency)outbreaks and the number of warning signals from the Infectious Disease Surveillance Information System,the Information System for Public Health Emergencies and the Early Warning and Monitoring Information System on a monthly/yearly basis.Results From 2009 to 2021,4681 cumulative cases of scarlet fever were reported in Qinghai Province,with a male to female ratio of 1.37∶1.The incidence rate was form 2.22/100000 to 13.39/100000,with the lowest rate in 2009 and the highest rate in 2021.The incidence rate of scarlet fever in different years and cities and states ranged from 0.24/100000(Yushu Prefecture in 2019)to 22.75/100000(Haidong City),with the highest annual average incidence rate in Haidong City(9.99/100000)and the lowest in Huangnan Prefecture(1.07/100000).The incidence showed a bimodal peak with a main peak in June and a secondary peak in November.The number of cases in children under 10 years old,accounting for 91.73% of the total number of cases(4294/4681).The number of cases in children 5-<10 years old,accounting for 80.32% of the cases in children under 10 years old(3449/4294).The median age was 5 years old,with children living in childcare,students and children living in the diaspora,accounting for 98.70% of the total number of cases,of which 95.15% were clinically diagnosed cases and 3.01% were confirmed cases.Eighty-seven point two percent were reported by hospitals,and 7.61% were reported by the CDC.Conclusion The incidence of scarlet fever in Qinghai Province shows an upward trend from 2009 to 2021,and the incidence rate is steeply rise after 2014.The prevention and control areas are mainly Xining City and Haidong City,with 5-<10 years old as the high prevalence age group.Pathogenetic studies of scarlet fever should be emphasized in order to strengthen the accuracy and diagnostic capacity of healthcare institutions in reporting cases of scarlet fever,with a view to bridging the healthcare-prevention rift.