新型冠状病毒感染对苏州市法定传染病流行的影响分析

Analysis of the impact of the COVID-19 on the prevalence of notifiable infectious diseases in Suzhou

目的了解新型冠状病毒感染(简称新冠)流行前后苏州市法定传染病流行特征的变化,探究新冠期间综合防控对法定传染病流行的影响程度。方法以我国不同阶段新冠疫情防控策略和苏州市本土疫情为基础,将2020年1月―2023年4月新冠流行期分为4个阶段,与2012―2019年法定传染病平均发病水平进行比较,并构建干预模型得到不同传播途径传染病发病率比(incidence rate ratio,IRR),预测无新冠综合防控条件下法定传染病的发病水平。结果2012年1月―2023年4月,本研究共纳入22种法定传染病,其中手足口病发病数最多(234791例);按传播途径,肠道传染病发病数最多(279326例);肠道传染病、呼吸道传染病、血源及性传播传染病在4个阶段内发病水平均呈下降趋势,IRR均<1;干预模型结果显示肠道传染病受影响最大,IRR范围为0.12(95%CI:0.07~0.22)至0.38(95%CI:0.31~0.47);假设无新冠流行,肠道传染病将于阶段Ι、阶段Ⅳ迎来发病高峰,且呼吸道传染病发病水平呈逐年上升趋势,而血源及性传播传染病发病趋势与历年相似,但高峰较高。结论苏州市新冠流行期间法定传染病发病水平呈下降趋势,而当防控措施逐渐放松,传染病发病水平可能会迎来回弹,需提前做好防控政策应对。

Objective To understand the changes in the epidemiological characteristics of notifiable infectious diseases in Suzhou before and after the COVID-19 pandemic, and to explore the impact of comprehensive preventive and control measures on these diseases during the pandemic. Methods Based on China′s different stages of COVID-19 prevention and control strategies and the local epidemic situation in Suzhou, we divided the COVID-19 epidemic period from January 2020 to April 2023 into four distinct phases. This period was compared with the monthly average incidence levels of notifiable infectious disease from January 2012 to December 2019. Then we constructed intervention models to calculate the incidence rate ratios(IRR) for different modes of transmission of infectious diseases and predict the incidence levels of infectious diseases in the absence of comprehensive COVID-19 prevention and control measures. Results From January 2012 to April 2023, 22 notifiable infectious diseases were included in this study. Among them, hand, foot, and mouth disease had the highest number of cases, totaling 234 791 cases. By the different disease transmission route, gastrointestinal or enteroviral diseases had the highest number of cases(279 326). Gastrointestinal or enteroviral diseases, respiratory diseases, and sexually transmitted or bloodborne diseases all experienced a significant decrease in incidence over the four phases, with IRR consistently below 1. From the results of intervention model, gastrointestinal or enteroviral diseases were most affected, with IRR ranging from 0.12(95% CI: 0.07-0.22) to 0.38(95% CI: 0.31-0.47). Assuming there was no COVID-19 pandemic, gastrointestinal or enteroviral diseases were projected to peak in Phases I and IV, while respiratory diseases showed an upward trend in incidence over the years. The predicted incidence trend of sexually transmitted or bloodborne diseases is similar to previous years, but with higher peaks. Conclusions During the COVID-19 pandemic in Suzhou, the incidence of notifiable infectious diseases significantly decreased. However, as prevention and control measures are gradually relaxed, there may be a rebound in infectious disease incidence, necessitating adjustments to control policies.