2013-2022年重庆市涪陵区手足口病流行特征及时空聚集分析

Epidemic characteristics and spatiotemporal clustering of hand,foot and mouth disease in Fuling District of Chongqing Municipality,2013-2022

目的分析2013-2022年重庆市涪陵区手足口病(hand foot and mouth disease,HFMD)流行病学特征、发病率变化趋势及时空聚集特征,为涪陵区HFMD防控提供科学依据。方法收集2013—2022年重庆市涪陵区HFMD个案信息,通过描述性流行病学方法分析三间分布特征,Joinpoint回归分析研究发病率长期变化趋势,SaTScan时空扫描分析时空聚集特征,利用ArcMap10.7实现可视化。结果2013—2022年重庆市涪陵区HFMD报告13013例,年均报告发病率112.98/10万,报告发病率呈每隔2年出现一次发病高峰的特征。总体存在4—7月和10—12月两个发病高峰。0~5岁报告发病数最多,死亡6例,分布在0~3岁年龄组。2016年后肠道病毒71型不再为优势毒株。Joinpoint回归分析显示2013—2015年重庆市涪陵区发病率呈快速增长趋势,趋势差异有统计学意义(APC=110.40%,95%CI:13.68~256.03,P<0.05),2015—2022年呈现下降趋势,但趋势变化差异无统计学意义(APC=-9.99%,95%CI:-39.03~0.34,P>0.05)。总体时空扫描显示聚集时间集中在2014—2019年,逐年时空扫描显示1类聚集区出现时间和每年发病高峰基本一致,2、3类聚集区出现在较高发、高发年份发病高峰,1类聚集区以荔枝、崇义、敦仁城区街道为主,2、3类聚集区分别以西北部、东北部为主。结论2013—2022年重庆市涪陵区HFMD存在两个发病高峰,以0~5岁婴幼儿为主,近年发病率呈一定下降趋势,聚集风险降低,随着新冠病毒感染防控政策调整及每隔两年发病高峰的到来,应加强荔枝、崇义、敦仁街道及西北部、东北部的疫情防控。

Objective To analyze the epidemiological characteristics,changing trends of the incidence rates and spatiotemporal clustering features of hand,foot and mouth disease(HFMD)in Fuling District of Chongqing Municipality from 2013 to 2022,and to provide a scientific basis for HFMD prevention and control in Fuling District.Methods We collected the information about HFMD cases in Fuling District of Chongqing Municipality from 2013 to 2022.The time,regional and population distribution characteristics were analyzed by descriptive epidemiological methods,the long-term changing trends in the incidence rates were studied by Joinpoint regression analysis,and the spatiotemporal clustering characteristics were analyzed by SaTScan spatiotemporal clustering characteristics scanning.The visualization was realized by ArcMap 10.7.Results A total of 13,013 HFMD cases were reported in Fuling District during 2013-2022,with an average annual reported incidence rate of 112.98/100,000.The reported incidence rates were characterized by a peak incidence every two years.Overall,there were two incidence peaks in April-July and October-December.The largest number of cases was reported in the group aged 0-5 years,with 6 deaths and distributing in the group aged 0-3 years.After 2016,enterovirus 71 was no longer the dominant strain.Joinpoint regression analysis displayed that the incidence rate in Fuling District during 2013-2015 showed a rapid upward trend,with a statistically significant difference in the trend(APC=110.40%,95%CI:13.68-256.03,P<0.05).The incidence rate in Fuling District during 2015-2022 showed a downward trend,but the difference in the trend change was not statistically significant(APC=-9.99%,95%CI:-39.03-0.34,P>0.05).Overall spatiotemporal scanning showed that the aggregation time was concentrated in 2014-2019.Yearly spatiotemporal scanning showed that the appearing time of type 1 aggregation area was basically consistent with the annual peak of incidence,and types 2 and 3 aggregation areas appeared in the peak incidence of the years with high incidence.Type 1 aggregation area was mainly located in urban streets like Lizhi,Chongyi and Dunren.Type 2 and 3 aggregation areas were mainly located in the northwest and northeast respectively.Conclusion There were two incidence peaks of HFMD in Fuling District from 2013 to 2022,mainly in infants and young children aged 0-5 years.The incidence rates in recent years have shown a downward trend,and the risk of aggregation has decreased.With the adjustment of the prevention and control policy for the SARS-CoV-2 infection and the arrival of the peak incidence of HFMD every two years,the epidemic prevention and control in Lizhi,Chongyi and Dunren streets,the northwest and the northeast should be strengthened.