海南省2008—2023年恙虫病流行病学特征及趋势预测

Epidemiological characteristics and trend prediction of scrub typhus in Hainan Province from 2008 to 2023

目的分析海南省2008—2023年恙虫病的流行特征,对2024年的流行趋势进行预测,为制定海南省恙虫病的防控措施提供科学依据。方法收集2008—2023年海南省报告的恙虫病病例资料,采用描述性流行病学方法分析海南省恙虫病的三间分布,采用简单移动平均、季节性分解和季节性自回归移动平均(seasonal autoregressive integrated moving average,SARIMA)模型对海南省2008—2023年恙虫病的流行规律进行逐步拆解分析并预测其2024年的发病趋势。结果2008—2023年海南省共报告恙虫病病例4300例,年均报告发病率为2.75/10万,年度报告发病率总体呈现上升趋势(Z=0.517,P=0.006)。人群分布特征以50~<70岁、农林渔牧业为主,差异均有统计学意义(均P<0.001);时间分布上存在较为明显的季节性,发病主要集中在4—11月,峰值在10月;地区分布上,累积报告数排在前4位的市县分别是琼海市(826例)、文昌市(558例)、澄迈县(486例)和海口市(452例),占总病例数的54.00%,不同市县累计报告发病率差别有统计学意义(χ^(2)=7755.55,P<0.01)。SARIMA(1,0,2)(0,1,1)12模型较好地拟合了2008—2023年海南省恙虫病的发病规律,并预测了2024年发病数为364例,基本与2023年持平。结论海南省恙虫病发病率总体呈上升趋势,50~<70岁、农林渔牧业人群为高危人群,发病高峰时间持续较长,预测2024年发病例数将与2023年持平。发病高峰来临之前对高危人群进行科学干预以提高恙虫病的防控效果。

Objective To analyze the epidemiological characteristics of scrub typhus in Hainan Province from 2008 to 2023,forecast the epidemic trend in 2024,and provide a scientific basis for the prevention and control measures of scrub typhus in Hainan Province.Methods The data of scrub typhus cases reported in Hainan Province from 2008 to 2023 were collected.Descriptive epidemiological methods were employed to analyze the temporal,spatial,and population distribution characteristics of scrub typhus.The simple moving average,seasonal decomposition,and seasonal autoregressive moving average(SARIMA)models were used to progressively deconstruct and analyze the epidemic patterns of scrub typhus in Hainan Province from 2008 to 2023 and predict its incidence trend in 2024.Results A total of 4300 scrub typhus cases were reported in Hainan Province from 2008 to 2023,with an average annual reported incidence of 2.75/100000,and the annual reported incidence showed an increasing trend(Z=0.517,P=0.006).The population distribution characteristics were mainly among individuals aged 50-<70 years and those engaged in agriculture,forestry,fishery,and animal husbandry,with statistically significant differences(all P<0.001).There was an obvious seasonality in the temporal distribution,with cases primarily occurring from April to November,and peaking in October.In terms of regional distribution,the top four cities and counties with the highest cumulative reported cases were Qionghai City(826 cases),Wenchang City(558 cases),Chengmai County(486 cases),and Haikou City(452 cases),accounting for 54.00%of the total number of cases,and there were statistically significant differences in the number of reported cases among different cities(χ^(2)=7755.55,P<0.001).The SARIMA(1,0,2)(0,1,1)12 model fitted the incidence of scrub typhus in Hainan Province from 2008 to 2023 and predicted 364 cases in 2024,roughly equivalent to the number of cases in 2023.Conclusions The incidence of scrub typhus in Hainan Province shows an overall increasing trend.Individuals aged 50-<70 years and those engaged in agriculture,forestry,fishery,and animal husbandry are the high-risk populations,with a prolonged peak incidence period.The number of predicted cases for 2024 is expected to remain consistent with 2023.Therefore,scientific interventions targeting high-risk populations before the peak incidence may improve the effectiveness of scrub typhus prevention and control.