2007-2023年中国狂犬病流行病学特征分析

Analysis of epidemic characteristics of human rabies in China in 2007-2023

目的分析2007-2023年我国狂犬病流行病学特征,为制定促进狂犬病消除策略提供参考信息。方法从我国法定传染病报告信息系统获取2007-2023年个案信息,用描述流行病学进行发病趋势和流行病学特征分析。结果2007-2023年,全国累计报告人间狂犬病病例18751例,年均发病率为0.08/10万,发病率年均变化百分比(average annual percent change,AAPC)为-18.58%(95%CI:-21.32%~-15.75%,P<0.05),2011年、2018年、2021年存在3个有意义的转折点。根据疫情下降趋势,可将我国省份大致分为5类。疫情波及范围由2007年的23省984县(区)下降至2023年的17省101县(区),2019年后高发县(区)主要分布在湖南西南部、河南南部及安徽西部地区,14个省份已连续至少2年无病例报告。病例以男性(70.24%)、务农人群(72.18%)为主,65岁及以上病例构成比由2007年的17.43%上升至2023年的36.07%。结论我国狂犬病水平已由多地区流行转为散发态势,主要集中在长江中下游部分地区。中老年务农人群为主要脆弱人群。现行综合防控策略与措施可有效控制疫情,但目前疫情下降已趋缓。

ObjectiveTo analyze the epidemiological characteristics of rabies in China from 2007 to 2023,and to provide reference evidence for tailoring strategies to facilitate the elimination of rabies in the country.MethodsCase data from 2007 to 2023 were obtained from China′s National Notifiable Infectious Disease Reporting Information System,and the spatial,temporal,and demographic features of cases were analyzed.ResultsFrom 2007 to 2023,a total of 18751 human rabies cases were reported in China,with an average annual incidence rate of 0.08 per 100000.The average annual percentage change(AAPC)in incidence rate was-18.58%(95%CI:-21.32%to-15.75%,P<0.05),with three significant turning points in 2011,2018,and 2021.Based on the trend of the epidemic,Chinese provinces can be roughly divided into five categories.The geographical range affected by rabies has decreased from 23 provinces and 984 counties(districts)in 2007 to 17 provinces and 101 counties(districts)in 2023.Since 2019,the high-incidence counties(districts)have been mainly concentrated in the southwestern part of Hunan,the southern part of Henan,and the western part of Anhui.Fourteen provinces have reported no cases for at least two consecutive years.Males(70.24%)and farmers(72.18%)were the main affected groups,and the proportion of cases aged 65 and above increased from 17.43%in 2007 to 36.07%in 2023.ConclusionsThe incidence of rabies in China has changed from endemic in many areas to sporadic,with the remaining endemic regions mainly located in parts of the middle and lower reaches of the Yangtze River.The main vulnerable groups are middle-aged and elderly farmers.The current prevention and control measures can effectively curb the transmission of rabies,but the decline of cases has slowed down recently.