扬州市2012-2021年手足口病流行特征分析及发病趋势预测

Epidemiological characteristics analysis and incidence trend prediction of hand-foot-mouth disease in Yangzhou City from 2012 to 2021

目的分析扬州市2012—2021年手足口病(hand-foot-mouth disease,HFMD)的监测结果,描述HFMD的流行病学特征和趋势,为其防治提供依据。方法收集扬州市2012—2021年HFMD的病例信息和病原学结果,采用描述性流行病学方法分析其病例的三间分布以及病原学构成和变化,通过χ^(2)检验,进行组间比较,建立差分自回归移动平均(autoregressive integrated moving average,ARIMA)模型,预测2023年HFMD的发病趋势。结果2012—2021年扬州市累计报告HFMD病例56893例,年均发病率为129.84/10万。男女性别比为1.46∶1,不同性别人群手足口病的发病率差异有统计学意义(χ^(2)=31.900,P<0.05)。0~3岁婴幼儿的发病率最高,占病例总数的68.70%。HFMD全年均可发病且有2个发病高峰,集中在5~7月、10~12月。不同年份肠道病毒阳性检出率差异有统计学意义(χ^(2)=62.329,P<0.05)。最优拟合预测模型为SARIMAX(1,0,1)×(2,0,2,3),模型预测扬州市2023年HFMD的发病情况总体呈波动性上升。结论扬州市HFMD呈现明显的季节性和人群分布特征。ARIMA模型能较好的拟合扬州市HFMD的发病趋势,未来短期内扬州市HFMD的发病率将有所上升。提示应继续加强监测,根据扬州市HFMD的发病规律、病原学特征及预测结果,重视高发季节高发人群的防控,避免重症及死亡的发生。

Objective To analyze the surveillance results of hand-foot-mouth disease(HFMD)in Yangzhou City from 2012 to 2021,describe the epidemiological characteristics and trends of HFMD,and provide a basis for its prevention and control.Methods Case information and etiological results of HFMD in Yangzhou City from 2012 to 2021 were collected.Descriptive epidemiological methods were used to analyze the spatial,temporal,and population distribution of HFMD cases and their etiological composition and changes.The Chi-square test was used for comparison between groups.An autoregressive integrated moving average(ARIMA)model was established to predict the incidence trend of HFMD in 2023.Results From 2012 to 2021,a total of 56893 cases of HFMD were reported in Yangzhou City,with an average annual incidence rate of 129.84/100000.The male-to-female sex ratio was 1.46∶1,with statistically significant differences in the incidence of HFMD among different genders(χ^(2)=31.900,P<0.05).The highest incidence rate was among infants and children aged 0-3 years,accounting for 68.70%of cases.HFMD can occur throughout the year and there were two peaks of incidence,concentrated in May to July and October to December.There were statistically significant(χ^(2)=62.329,P<0.05)in the positive detection rate of Enterovirus in different years.The optimal fitting prediction model was SARIMAX(1,0,1)×(2,0,2,3),and the model predicted an overall fluctuating increase in the incidence of HFMD in Yangzhou City in 2023.Conclusion HFMD in Yangzhou City shows obvious seasonal and population distribution characteristics.The ARIMA model can better fit the incidence trend of HFMD in Yangzhou City,and the incidence rate of HFMD in Yangzhou City will increase in the short term in the future.It is suggested that surveillance should continue to be strengthened,and based on the incidence regularity,etiological characteristics and prediction results of HFMD in Yangzhou City,attention should be paid to the prevention and control of highincidence population in high-incidence season,to avoid the occurrence of severe disease and death.