2010—2022年深圳市福田区登革热流行病学特征

Epidemiological characteristics of dengue fever in Futian District,Shenzhen,2010-2022

目的分析2010—2022年深圳市福田区登革热流行特征和媒介伊蚊密度特点,为制定疫情防控措施提供依据。方法采用描述性流行病学分析方法,分析2010—2022年深圳市福田区登革热人群分布、时间分布、病例来源、发病到确诊时间间隔等特征,以及登革热患者首诊发现及入境发现情况,采用布雷图指数(BI)分析媒介伊蚊密度特点。结果2010—2022年深圳市福田区共报告登革热病例217例,其中确诊病例188例,占病例总数的86.64%。男女发病性别比为1.89∶1,所有病例的年龄中位数(四分位数)[M(P_(25),P_(75))]为35.0(28.0,46.5)岁,职业以商业服务(24.4%)、工人(24.0%)、家务及待业(22.6%)为主,8—11月为登革热发病高峰。本地病例124例,占57.1%,国内其他地区输入10例,国外输入病例83例,柬埔寨是境外输入性病例的主要来源,占37.4%,本地病例与输入病例的性别、年龄、职业分布差异均无统计学意义(P均>0.05)。登革热病例发病到确诊的时间间隔M(P_(25),P_(75))为5.0(3.0,8.0)d,输入病例为4.0(3.0,7.0)d,本地病例为6.0(4.0,8.0)d,输入病例发病到诊断的时间间隔短于本地病例。境外输入病例的入境发现率为22.50%,首诊发现率为54.05%,且省市级医疗机构首诊发现率高于区级医疗机构(χ^(2)=16.470,P<0.05)。2010—2022年BI年均值在1.54~17.49之间,呈现1—4月密度较低,5月开始上升,6—10月较高,11月后逐月下降的特点。结论深圳市福田区登革热疫情形势较为严峻,患者职业以商业服务为主,输入病例入境发现率较低,布雷图指数在6—10月达到相对高峰。建议加强对商业服务、工人等重点人群的健康教育,提高境外输入病例入境发现率及首诊发现率,及时开展防蚊灭蚊工作,有效防控登革热疫情传播。

Objective To analyze the epidemiological characteristics of dengue fever and the density characteristics of vector Aedes aegypti in Futian District,Shenzhen,from 2010 to 2022,and provide the evidence for formulating epidemic prevention and control measures.Methods Descriptive epidemiological methods were used to describe the characteristics of dengue fever in Futian District,Shenzhen City,from 2010 to 2022 including population distribution,temporal distribution,source of cases,and distribution characteristics of the time interval between onset of disease and confirmation of diagnosis,as well as descriptive analyses of initial diagnosis and entry detection of dengue fever patients.The Breteau index(BI)was used to describe and analyze the density of vector Aedes mosquitoes.Results From 2010 to 2022,a total of 217 cases were reported in Futian District,of which188 cases were confirmed cases,accounting for 86.64%of the total cases.The male to female ratio was 1.89∶1.Among all cases,the median age M(P_(25),P_(75))was 35.0(28.0,46.5)years.The main occupations were commercial services(24.4%),workers(24.0%),and housework and unemployed(22.6%).Dengue fever peaked from August to November.There were 124 local cases,accounting for 57.1%,10 cases imported from other domestic areas,and 83 cases imported from abroad.Cambodia was the main source of imported cases from abroad,accounting for 37.4%.The differences in the distribution of sex,age,and occupations between the local cases and the imported cases were not statistically significant(all P>0.05).The median time interval M(P_(25),P_(75))between onset and diagnosis of dengue cases was 5.0(3.0,8.0)days for all cases,4.0(3.0,7.0)days for imported cases and 6.0(4.0,8.0)days for local cases,and the time interval between onset and diagnosis for imported cases was shorter than that for local cases.The entry detection rate of imported cases from abroad was 22.50%,and the initial diagnosis detection rate was 54.05%.The initial diagnosis detection rate was higher in provincial and municipal medical institutions than that in district medical institutions(χ^(2)=16.470,P<0.05).The average annual BI values during 2010-2022 ranged from 1.54 to 17.49,and showed a low densities during January-April,starting to increase in May,reaching high level during June-October,and decreasing month by month after November.Conclusions The situation of dengue fever epidemic in Futian District is relatively serious,with occupations dominated by commercial services,and low entry detection rate of imported cases.The Breteau Index reaches a relative peak from June to October.It is recommended to strengthen health education for in the key population such as commercial service employees and workers,improve the entry detection rate of imported cases from abroad and the detection rate of initial diagnosis,and carry out mosquito prevention and elimination efforts timely so as to prevent and control the spread of dengue fever epidemic effectively.