2005至2021年北京市海淀区60岁及以上老年人法定传染病流行特征及趋势分析

Epidemic characteristics and trends of notifiable infectious diseases among the elderly aged 60 and over in Haidian District of Beijing from 2005 to 2021

目的分析2005至2021年北京市海淀区60岁及以上老年人法定传染病发病水平和流行趋势,为老年人传染病防控提供依据。方法采用描述性分析、置换检验和秩和检验对疾病流行特征进行分析;应用Joinpoint回归(Joinpoint regression,JPR)模型计算年度变化百分比(annual percent change,APC)和平均年度变化百分比(average annual percent change,AAPC),对乙丙类传染病和重点传染病进行区间和全局流行趋势的分析。结果2005至2021年北京市海淀区老年人乙丙类传染病报告发病率为437.02/10万,报告死亡率为2.38/10万,报告病死率为0.54%。乙类传染病报告死亡率和病死率均高于丙类传染病(P均<0.01);男性老年人乙类传染病的发病率、死亡率和病死率均高于女性(P均<0.01);≥80岁组老年人各类传染病发病率、乙类传染死亡率最高(校正P均<0.05);乙类传染病报告发病率和报告死亡率的AAPC分别为-7.20(t=-7.802,P=0.000)和-5.31(t=-3.063,P=0.008)。报告发病率居前6位的传染病分别为其它感染性腹泻病(147.90/10万)、流行性感冒(82.32/10万)、痢疾(71.04/10万)、肺结核(54.56/10万)、隐性梅毒(25.43/10万)和乙肝(22.91/10万)。痢疾、乙肝和其它感染性腹泻病发病率AAPC分别为-12.79(t=-21.772,P=0.000)、-14.16(t=-4.672,P=0.000)和-10.61(t=-10.744,P=0.000),肺结核、流行性感冒发病率AAPC分别为1.15(t=2.977,P=0.009)和38.36(t=4.093,P=0.000);男性老年人肺结核、隐性梅毒、乙肝、其它感染性腹泻病和流行性感冒总体标准化发病率均高于女性。结论北京市海淀区老年人乙类传染病发病率和死亡率呈下降趋势;肺结核和流行性感冒是老年人群重点防控的传染病;肺结核和乙肝在男性老年人群中的流行不容忽视。

Objective To analyze the trends and characteristics of notifiable infectious diseases among people≥60 years old in Haidian District of Beijing,from 2005 to 2021,and to provide references for the prevention and control of these diseases.Methods Descriptive methods,Permutation test and Rank sum test were used to analyze the epidemiologic features of diseases.Joinpoint Regression(JPR)was employed to calculate the annual percent change(APC)and average annual percent change(AAPC)for Category B and Category C infectious diseases and major infectious diseases.Results From 2005 to 2021,the reported incidence of Category B and C infectious diseases among the elderly population in Haidian District of Beijing was 437.02/100000,the reported mortality was 2.38/100000,and the reported case fatality rate was 0.54%;The reported mortality and case fatality rate of Category B infectious diseases were higher than those of Category C infectious diseases(P<0.01).The incidence,mortality and case fatality rate of Category B infectious diseases in the male elderly were higher than those in the female(P<0.01);The≥80 year old group had the highest incidences of Category B and Category C infectious diseases and the highest mortality rate of Category B infectious diseases(P<0.05);The AAPCs corresponding to the reported incidence and mortality of Category B infectious diseases were-7.20(t=-7.802,P=0.000)and-5.31(t=-3.063,P=0.008)respectively.The six notifiable infectious diseases with top reported incidences were other infectious diarrhea diseases(147.90/100000),influenza(82.32/100000),dysentery(71.04/100000),tuberculosis(54.56/100000),recessive syphilis(25.43/100000)and hepatitis B(22.91/100000).The incidence AAPCs of dysentery,hepatitis B and other infectious diarrhea diseases were-12.79(t=-21.772,P=0.000),-14.16(t=-4.672,P=0.000)and-10.61(t=-10.744,P=0.000),respectively;The incidence AAPCs of pulmonary tuberculosis and influenza were 1.15(t=2.977,P=0.009)and 38.36(t=4.093,P=0.000),respectively.The overall age-standardized incidences of pulmonary tuberculosis,recessive syphilis,hepatitis B,other infectious diarrhea and influenza in the elderly male were higher than those in the female.Conclusions The incidence and mortality of Category B infectious diseases among the elderly population in Haidian District of Beijing showed a downward trend.Tuberculosis and influenza were the key infectious diseases to be prevented and controlled among elderly population.The prevalence of pulmonary tuberculosis and hepatitis B in the male elder ly population shouldn’t be ignored.