2012—2022年甘南藏族自治州肾综合征出血热流行特征和宿主动物监测分析

Epidemiological characteristics of hemorrhagic fever with renal syndrome and surveillance of host animals in Gannan Prefecture from 2012 to 2022

目的 分析2012—2022年甘南藏族自治州(简称“甘南州”)肾综合征出血热(HFRS)报告病例资料和宿主动物监测资料,进一步提升甘南州HFRS疫情防控能力。方法 用描述性流行病学方法分析2012—2022年甘南州HFRS报告病例三间分布特征,以及发病率与鼠密度的关联,检验水准为0.05。结果 2012—2022年甘南州报告HFRS病例236例,发病率为3.10/10万;无死亡病例。其中,2019年发病率最高(12.43/10万),随后逐年下降。10月至次年2月为发病高峰,占病例报告总数的89.83%。2012年仅2个县市报告HFRS病例,2020和2021年增至6个县市,各县市发病率差异有统计学意义(χ^(2)=46.981,P<0.001)。病例主要集中在夏河县,13个乡镇中6个乡镇有病例报告,占全州报告病例总数的62.71%。30~59岁年龄组病例数最多,男女性别比为1.88∶1,职业以牧民为主(69.92%)。2020—2022年HFRS宿主动物监测显示,优势鼠种为小家鼠(51.06%),居民区鼠密度高于野外(2.46%vs 1.01%;χ^(2)=4.876,P=0.027),鼠密度与人群报告发病率呈正相关(r=0.954,P<0.001)。结论 2012—2022年期间,甘南州HFRS报告发病率峰值出现在2019年,之后呈下降趋势,但出现疫情的县市数增加。应重点针对青壮年男性、牧民采取预防控制措施,尤其是秋冬季节。在夏河县等高发地区,应注重落实防鼠措施。

Objective To analyze the epidemiological characteristics of hemorrhagic fever with renal syndrome(HFRS) and host animal monitoring data in Gannan Tibetan Autonomous Prefecture(Gannan Prefecture) from 2012 to 2022 to further improve the ability of prevention and control of HFRS.Methods Descriptive statistics were used to analyze the incidence of HFRS by time,area and population distribution,using data from China's National Notifiable Disease Reporting System(NNDRS) reported in Gannan Prefecture from 2012 to 2022.The correlation between HFRS incidence and rodent density in surveillance areas was evaluated.The test level was α =0.05.Results A total of 236 HFRS cases were reported in Gannan Prefecture from 2012 to 2022,with an annual average incidence of 3.10 per 105population.No deaths were reported.The HFRS incidence(12.43/105) was highest in 2019,then decreased yearly.The majority(89.83%) of the reported cases occurred during October to February of the following year.The HFRS cases were reported only in 2 counties in 2012,but 6 counties in 2020 and 2021.HFRS Cases were reported in 6 townships of 13 townships in Xiahe County,accounted for 62.71% of the total cases in Gannan Prefecture.The male to female ratio of HFRS cases was 1.88∶1,and the highest number of HFRS cases was reported in those aged 30-59 years.Most(69.92%) cases were herdsmen.The dominant rodent specie in surveillance areas was house mouse(51.06%) during 2020 to 2022.The rodents density in residential areas was significantly higher than that in the wild areas(2.46% vs.1.01%;χ^(2)=4.876,P=0.027).The rodent density was positively correlated with HFRS incidence of population in surveillance areas(r=0.954,P<0.001).Conclusions During 2012 to 2022,the HFRS incidence has shown a downward trend after the peak in 2019 in Gannan Prefecture,but the number of counties with HFRS cases increased.Prevention and control measures for HFRS should focus on those who were men,middle-aged and herdsmen,especially in autumn and winter.In those areas with a high HFRS incidence like Xiahe County,it is necessary to employ effective control measures for rodents.