Epidemiological characteristics of seven notifable respiratory infectious diseases in the mainland of China:an analysis of national surveillance data from 2017 to 2021

Background Respiratory infectious diseases(RIDs)remain a pressing public health concern,posing a signifcant threat to the well-being and lives of individuals.This study delves into the incidence of seven primary RIDs dur‑ing the period 2017-2021,aiming to gain deeper insights into their epidemiological characteristics for the purpose of enhancing control and prevention strategies.Methods Data pertaining to seven notifable RIDs,namely,seasonal infuenza,pulmonary tuberculosis(PTB),mumps,scarlet fever,pertussis,rubella and measles,in the mainland of China between 2017 and 2021 were obtained from the National Notifable Disease Reporting System(NNDRS).Joinpoint regression software was utilized to analyze temporal trends,while SaTScan software with a Poisson probability model was used to assess seasonal and spatial patterns.Results A total of 11,963,886 cases of the seven RIDs were reported during 2017-2021,and yielding a fve-year aver‑age incidence rate of 170.73 per 100,000 individuals.Among these RIDs,seasonal infuenza exhibited the highest aver‑age incidence rate(94.14 per 100,000),followed by PTB(55.52 per 100,000),mumps(15.16 per 100,000),scarlet fever(4.02 per 100,000),pertussis(1.10 per 100,000),rubella(0.59 per 100,000),and measles(0.21 per 100,000).Males experi‑enced higher incidence rates across all seven RIDs.PTB incidence was notably elevated among farmers and individu‑als aged over 65,whereas the other RIDs primarily afected children and students under 15 years of age.The inci‑dences of PTB and measles exhibited a declining trend from 2017 to 2021(APC=−7.53%,P=0.009;APC=−40.87%,P=0.02),while the other fve RIDs peaked in 2019.Concerning seasonal and spatial distribution,the seven RIDs displayed distinct characteristics,with variations observed for the same RIDs across diferent regions.The proportion of laboratory-confrmed cases fuctuated among the seven RIDs from 2017 to 2021,with measles and rubella exhibit‑ing higher proportions and mumps and scarlet fever showing lower proportions.Conclusions The incidence of PTB and measles demonstrated a decrease in the mainland of China between 2017 and 2021,while the remaining fve RIDs reached a peak in 2019.Overall,RIDs continue to pose a signifcant public health challenge.Urgent action is required to bolster capacity-building eforts and enhance control and prevention strategies for RIDs,taking into account regional disparities and epidemiological nuances.With the rapid advancement of high-tech solutions,the development and efective implementation of a digital/intelligent RIDs control and pre‑vention system are imperative to facilitate precise surveillance,early warnings,and swift responses.

Spatial-temporal analysis of hepatitis B in Fujian Province,China in 2012-2021

Background:Fujian Province has one of the highest reported incidences of hepatitis B virus infection in China.This study aimed to provide a theoretical framework for preventing and controlling hepatitis B in Fujian Province,and to assess the trends and the spatial-temporal distribution patterns of hepatitis B in this region.Methods:Data on hepatitis B cases were extracted from the National Notifiable Infectious Disease Surveillance System.Spatial autocorrelation analysis,trend surface analysis,and spatial-temporal scanning statistics were used to identify the spatial and aggregation patterns at the county level.The Joinpoint was used to assess the reported incidence trends.Results:The average reported incidence of hepatitis B in Fujian from 2012 to 2021 was 14.46/10,000 population,with 583,262 notified cases.The age-adjusted reported incidence of hepatitis B decreased from 17.44/10,000 population in 2012 to 11.88/10,000 population in 2021,with an average reduction in the annual percentage change of 4.5%.There were obvious spatial-temporal aggregation characteristics in hepatitis B cases,and a high-incidence area was located in eastern Fujian.Spatio-temporal scanning statistics revealed four levels of aggregation of hepatitis B reporting rates.The first level of aggregation area included Minhou,Gulou,Jin’an,Taijiang,and nine other districts and counties.Conclusions:The incidence of hepatitis B is declining in Fujian Province.Spatial clusters of hepatitis B cases in Fujian Province were identified,and high-risk areas in eastern Fujian still exist.Closely monitoring the gen-eral patterns in the occurrence of hepatitis B and implementing focused control and preventative strategies are important.

Epidemiological characteristics of tuberculosis incidence and its macro-influence factors in Chinese mainland during 2014-2021

Background Tuberculosis(TB)remains a pressing public health issue,posing a significant threat to individuals'well-being and lives.This study delves into the TB incidence in Chinese mainland during 2014-2021,aiming to gain deeper insights into their epidemiological characteristics and explore macro-level factors to enhance control and prevention.Methods TB incidence data in Chinese mainland from 2014 to 2021 were sourced from the National Notifiable Disease Reporting System(NNDRS).A two-stage distributed lag nonlinear model(DLNM)was constructed to evaluate the lag and non-linearity of daily average temperature(℃,Atemp),average relative humidity(%,ARH),average wind speed(m/s,AWS),sunshine duration(h,SD)and precipitation(mm,PRE)on the TB incidence.A spatial panel data model was used to assess the impact of demographic,medical and health resource,and economic factors on TB incidence.Results A total of 6,587,439 TB cases were reported in Chinese mainland during 2014-2021,with an average annual incidence rate of 59.17/100,000.The TB incidence decreased from 67.05/100,000 in 2014 to 46.40/100,000 in 2021,notably declining from 2018 to 2021(APC=-8.87%,95%CI:-11.97,-6.85%).TB incidence rates were higher among males,farmers,and individuals aged 65 years and older.Spatiotemporal analysis revealed a significant cluster in Xinjiang,Qinghai,and Xizang from March 2017 to June 2019(RR=3.94,P<0.001).From 2014 to 2021,the proportion of etiologically confirmed cases increased from 31.31%to 56.98%,and the time interval from TB onset to diagnosis shortened from 26 days(IQR:10-56 days)to 19 days(IQR:7-44 days).Specific meteorological conditions,including low temperature(<16.69℃),high relative humidity(>71.73%),low sunshine duration(<6.18 h)increased the risk of TB incidence,while extreme low wind speed(<2.79 m/s)decreased the risk.The spatial Durbin model showed positive associations between TB incidence rates and sex ratio(β=1.98),number of beds in medical and health institutions per 10,000 population(β=0.90),and total health expenses(β=0.55).There were negative associations between TB incidence rates and population(β=-1.14),population density(β=-0.19),urbanization rate(β=-0.62),number of medical and health institutions(β=-0.23),and number of health technicians per 10,000 population(β=-0.70).Conclusions Significant progress has been made in TB control and prevention in China,but challenges persist among some populations and areas.Varied relationships were observed between TB incidence and factors from meteorological,demographic,medical and health resource,and economic aspects.These findings underscore the importance of ongoing efforts to strengthen TB control and implement digital/intelligent surveillance for early risk detection and comprehensive interventions.

Laboratory-based Surveillance and Clinical Profile of Sporadic HEV Infection in Shanghai,China

The study aimed to describe the epidemiological,virological and clinical features of sporadic HEV infection in eastern China.A total of 6112 patient sera were tested for anti-HEV IgG or anti-HEV IgM during one consecutive year(between August 2018 and July 2019).HEV RNA presence was evaluated by RT-PCR and HEV sequences were phylogenetically analyzed.Clinical features of confirmed HEV-infected patients were delineated.The sero-positivity rate of anti-HEV IgG maintained stable around 40%,while an obvious winter spike of anti-HEV IgM prevalence was observed.A total of 111 patients were confirmed of HEV viremia by molecular diagnosis.Subtype 4d was predominant.Phylogenetic analyses suggest that certain strains circulate across species and around the country.Subjects with confirmed current HEV infection had a high median age(58 years)and males were predominant(62.2%).Most patients presented with jaundice(75.7%)and anorexia(68.0%).Significantly elevated levels of liver enzymes and bilirubin were observed.Remarkably,the baseline bilirubin level was positively correlated with illness severity.Pre-existing HBV carriage may deteriorate illness.The clinical burden caused by locally acquired HEV infection is increasing.Surveillance should be enforced especially during the transition period from winter to spring.Patients with higher level of bilirubin at disease onset had slower recovery from HEV infection.

Current impact of viral hepatitis on liver cancer development: The challenge remains

Chronic infections due to hepatitis B and hepatitis C viruses are responsible for most cases of hepatocellular carcinoma(HCC)worldwide,and this association is likely to remain during the next decade.Moreover,viral hepatitis-related HCC imposes an important burden on public health in terms of disability-adjusted life years.In order to reduce such a burden,some major challenges must be faced.Universal vaccination against hepatitis B virus,especially in the neonatal period,is probably the most relevant primary preventive measure against the development of HCC.Moreover,considering the large adult population already infected with hepatitis B and C viruses,it is also imperative to identify these individuals to ensure their access to treatment.Both hepatitis B and C currently have highly effective therapies,which are able to diminish the risk of development of liver cancer.Finally,it is essential for individuals at high-risk of HCC to be included in surveillance programs,so that tumors are detected at an early stage.Patients with hepatitis B or C and advanced liver fibrosis or cirrhosis benefit from being followed in a surveillance program.As hepatitis B virus is oncogenic and capable of leading to liver cancer even in individuals with early stages of liver fibrosis,other high-risk groups of patients with hepatitis B are also candidates for surveillance.Considerable effort is required concerning these strategies in order to decrease the incidence and the mortality of viral hepatitis-related HCC.

2017至2021年河北省监测哨点医院伤害病例流行特征分析

目的了解河北省哨点医院伤害病例流行特征,为制定相应的伤害防控和干预措施提供依据。方法收集并分析2017年1月至2021年12月在河北省3个国家伤害监测点9家哨点医院门急诊首次就诊的伤害病例资料。结果2017至2021年河北省监测哨点医院报告伤害病例共248001例,男女性别比为1.49∶1,伤害发生年龄以25~64岁年龄组(58.46%)为主。伤害发生原因前5位分别是跌倒/坠落(48.52%)、机动车车祸(13.05%)、钝器伤(12.50%)、刀/锐器伤(11.33%)、非机动车车祸(6.43%)。跌倒/坠落是所有年龄组最主要的伤害原因。伤害发生时间具有一定规律性。结论跌倒/坠落、机动车车祸、钝器伤、刀/锐器伤和非机动车车祸是河北省年居民伤害主要原因,青壮年是高发人群。应针对不同人群、不同原因采取针对性的伤害防控措施,减少伤害发生。

2011—2021年广西戊型病毒性肝炎流行病学特征分析

目的分析广西戊型病毒性肝炎(简称戊肝)的发病情况和流行趋势,为制定戊肝防控策略提供依据。方法通过中国疾病预防控制信息系统传染病监测系统,收集发病时间为2011—2021年、现住址为广西的戊肝病例资料,并采用描述流行病学方法对报告病例的时间、地区、人群等分布特征进行分析。结果2011—2021年广西累计报告戊肝病例14699例,年均报告发病率2.75/10万,2020年报告发病率最低,为1.73/10万,2016年报告发病率最高,为3.27/10万。年均报告发病率前5位的地区分别为玉林市(5.22/10万)、防城港市(4.23/10万)、梧州市(3.94/10万)、贵港市(3.93/10万)、桂林市(3.48/10万)。报告病例数最多的月份是3月(1854例,占12.61%),上半年报告病例数(8498例)稍多于下半年(6201例)。男性病例10309例,女性4390例,性别比为2.35∶1;男性、女性的年均报告发病率分别为3.76/10万、1.73/10万。各年龄段均有发病,发病率随年龄的升高呈上升趋势,发病数最多的是50~59岁组(3507例,占23.86%)。职业分布中,农民发病人数最多(9726例,占66.17%)。结论近年来广西戊肝发病率总体呈先上升后下降趋势,玉林等地是高发地区,男性、农民、中老年群体是高发人群。应进一步加强对重点地区和重点人群的监测,积极开展健康宣传,以降低戊肝对群众的危害。

2017—2021年柳州市食源性疾病监测结果分析

目的了解2017—2021年柳州市食源性疾病监测情况,分析其流行病学特征,为进一步提高食源性疾病监测能力策略的制订提供科学依据。方法收集2017—2021年柳州市食源性疾病监测点报告系统中数据,并对采集的粪便/肛拭子标本进行病原体检测,采用描述性流行病学方法进行统计分析。结果2017—2021年柳州市共监测病例13721例,男性6569例,女性7152例;年龄以0~4岁组病例最多(3490例,25.44%),职业以散居儿童居多(3147例,22.94%);发病高峰期为每年的7—9月(3999例,29.15%);病例的主要暴露食品为水果及其制品(2854例,20.80%),可疑暴露食品的包装方式以散装为主(4309例,31.40%),暴露场所以家庭为主(10127例,73.81%)。共采集生物标本3517份,其中致病菌检出率为11.57%,主要为沙门菌(6.11%),集中在5—10月(80.84%),诺如病毒检出率为8.94%,主要集中在1—3月(3.57%),年龄、职业、季节组内病原体检出率差异有统计学意义(P<0.001)。结论柳州市食源性疾病发病高峰期为7—9月,高危人群为0~4岁儿童,主要暴露场所以家庭为主,相关部门应在高峰期加强对以上高危人群食源性疾病的监测和预防,加强对家庭食品加工安全的宣教;生物标本检测主要检出的病原体为沙门菌和诺如病毒,提示相关部门应加强此类微生物易污染食品的监督监测,做出及时预警和宣传。

2014-2022年山西省百日咳流行病学特征

目的 分析山西省百日咳的流行病学特征,探索不同年龄人群百日咳免疫策略。方法 收集2014-2022年山西省百日咳发病数及发病率资料,采用描述性流行病学方法分析百日咳流行特征。结果 2014-2022年山西省累计报告百日咳病例3 878例,年均报告发病率为1.18/10万,报告发病率从2014年的0.17/10万上升至2019年的1.26/10万,2020年下降至0.40/10万,2021和2022年大幅上升,分别为1.28/10万和6.19/10万。0~<5岁、5~<10岁、10~<15岁和≥15岁分别占63.82%(2 475例)、32.08%(1 244例)、3.12%(121例)和0.98%(38例),0~<1岁、1~<2岁、2~<3岁、3~<4岁和4~<5岁分别占36.18%(1 403例)、8.05%(312例)、4.82%(187例)、7.84%(304例)和6.94%(269例),在0~<1岁病例中,0~<3月龄、3~<6月龄和6~<12月龄分别占20.24%(284例)、43.83%(615例)和35.92%(504例)。实验室诊断病例为1 646例(占42.44%)。结论 2014-2022年山西省百日咳报告发病率处于低水平,但总体呈上升趋势,8月为发病高峰,人群以小年龄儿童尤其是婴儿为主。建议继续加强百日咳监测,做好百日咳疫苗的常规免疫接种,做好医务人员培训,提高病例报告意识,优化不同年龄人群百日咳免疫策略。

武汉市HIV/AIDS合并HBV/HCV感染的流行特征和影响因素分析

目的分析HIV/AIDS患者合并HBV、HCV感染的流行特征和影响因素,为制定防治措施提供依据。方法调查武汉市HIV/AIDS患者队列相关信息和HBV、HCV感染状况,运用卡方检验、非条件Logistic回归模型、Kaplan-Meier生存分析等方法对HIV合并HBV、HCV感染的流行特征和影响因素进行分析。结果 2615例HIV/AIDS患者纳入研究,其中,男性占90.2%,未婚占52.9%,平均年龄(37.1±13.9)岁,感染途径以男男同性传播为主,占68.1%;HIV合并HBV/HCV感染呈逐年增加态势,HIV-HBV、HIV-HCV、HIV-HBV-HCV合并感染率分别为9.6%(251/2615)、4.5%(117/2615)、0.6%(16/2615);HIV-HBV合并感染的主要影响因素包括年龄(≥50岁与<25岁比较,OR=2.067,95%CI:1.172～3.644)、婚姻(已婚与未婚比较,OR=1.480,95%CI:1.007～2.177,离异或丧偶与未婚比较,OR=1.554,95%CI:1.077～2.243)、近3个月性行为是否用安全套(未用者与使用者比较,OR=1.922,95%CI:1.045～3.535),HIV-HCV合并感染的主要影响因素为感染途径(注射吸毒与同性传播比较,OR=53.985,95%CI:24.704～117.972)和HIV确证至抗病毒治疗(ART)间隔天数(>360 d与≤90 d比较,OR=1.754,95%CI:1.058～2.907);HIV合并HBV/HCV感染者抗病毒治疗后5年生存率小于无合并肝炎病毒感染者(Log Rankχ~2=11.947,P=0.008)。结论≥50岁、离异/丧偶、已婚男性以及无保护性行为、注射吸毒行为和延迟治疗,HIV/AIDS合并HBV/HCV感染的风险较高,针对性地预防干预、早期HBV/HCV筛查和个体化的ART提供可作为防治合并感染的重要措施。

肝移植受者戊型肝炎病毒感染

戊型肝炎病毒感染是急性病毒性肝炎的常见病因。近年来,戊型肝炎发病率呈上升趋势,逐渐成为世界范围内急性病毒性肝炎的重要病因。年龄、性别、免疫抑制强度、经济社会因素均是戊型肝炎病毒感染的危险因素。肝移植受者术后需长期应用免疫抑制药进行抗排斥反应治疗,处于免疫抑制状态,易感染戊型肝炎病毒且有引起肝纤维化及肝硬化的风险。因此,在临床工作中应重点关注肝移植受者,同时应进一步明确相关危险因素,以便辅助诊断和采取更严格的预防措施。本文根据现有文献对戊型肝炎病毒病原学特点以及肝移植受者戊型肝炎病毒感染的流行病学特征、临床表现、诊断及治疗进行综述,以期在临床上更好地对肝移植受者戊型肝炎病毒感染进行监测、治疗及预防,改善肝移植受者的预后。

泉州市扩大国家免疫规划前后甲型病毒性肝炎流行病学特征分析

目的:了解福建省泉州市扩大免疫规划前后甲型病毒性肝炎的流行病学特征,为相关部门制定防控措施提供参考依据。方法:收集整理中国疾病预防控制信息系统中2004—2022年泉州市报告的甲型病毒性肝炎病例数据资料,采用描述性研究方法分析泉州市甲型病毒性肝炎病例的流行病学特征。结果:2004—2022年泉州市共报告甲型病毒性肝炎2610例,年均报告发病率为1.71/10万,发病率由2004年的2.32/10万下降至2022年的1.25/10万,报告发病率呈下降趋势;年均报告发病率居前3位的县(市、区)为南安市、晋江市、鲤城区,泉州台商投资区年均报告发病率最低;0~14岁、15~29岁、30~44岁年龄段人群发病均呈下降趋势,45~59岁、60~74岁年龄段人群发病均呈上升趋势;报告发病人数最多的职业为农民。结论:2008年泉州市将甲型病毒性肝炎疫苗纳入免疫规划后,甲型病毒性肝炎总体报告发病率呈下降趋势,0~14岁年龄段人群发病例数显著下降。相关部门应继续开展甲型病毒性肝炎监测工作,加大疫苗接种宣传教育力度,针对重点人群制定防控策略,从而进一步降低泉州市甲型病毒性肝炎的发病率。

2014—2023年佳木斯市肾综合征出血热流行特征及宿主动物监测分析

目的:掌握佳木斯市肾综合征出血热(Hemorrhagic fever with renal syndrome,HFRS)疫情特征,分析鼠密度、鼠带毒率和鼠感染率情况,为HFRS疫情防控提供依据。方法:采用描述性流行病学方法对HFRS流行特征及宿主动物资料进行分析,率的比较用χ^(2)检验。结果:2014—2023年佳木斯市共报告HFRS病例1 299例,年均发病率为5.58/10万;每年的5—7月、10—12月为HFRS发病高峰。2014—2023年佳木斯市各市(县、区) HFRS年均发病率比较,差异有统计学意义(χ^(2)=403.33,P<0.01),其中抚远市(16.60/10万)和同江市(9.33/10万)最高。HFRS病例主要以青壮年、男性、农民为主。2014—2023年佳木斯市鼠密度为7.94%、带毒率为7.62%、感染率为9.42%。结论:2014—2023年佳木斯市HFRS主要为散发,发病率总体呈下降趋势;呈春夏季小高峰和秋冬季大高峰的双峰分布;抚远市和同江市年均发病率较高;男性年均发病率高于女性;50~54岁年龄组年均发病率最高;职业以农民为主。鼠种主要为黑线姬鼠和褐家鼠,鼠密度较高。

2013—2022年济南市市中区布鲁氏菌病病例流行病学特征分析

目的:分析2013—2022年济南市市中区布鲁氏菌病流行特点,为疫情防控提供科学依据。方法:用描述性流行病学方法对市中区近10年的布鲁氏菌病病例疫情资料进行分析。结果:2013—2022年市中区共报告布鲁氏菌病病例142例,年均报告发病率2.17/10万,不同年份发病率差异有统计学差异(χ^(2)=32.82,P<0.05)。城郊发病率高于城区,差异有统计学差异(χ^(2)=148.57,P<0.05)。发病时间以2—5月为主。男性病例居多,不同性别发病率差异有统计学意义(χ^(2)=15.85,P<0.05);发病年龄集中在41~70岁,不同年龄段发病率差异有统计学意义(χ^(2)=25.29,P<0.05);职业以农民为主。临床表现以发热、多汗、肌肉关节酸痛、乏力为主。病例流行病学接触史以饲养羊、给羊接生、屠宰售卖羊肉、食用疑似不熟羊肉为主。结论:布鲁氏菌病发病率逐年波动,城郊发病率明显高于城区,提示今后防控工作应多部门联动,加强监测,将重点职业、重点地区人群作为防控对象,做好宣教和必要的筛查,严防疫情蔓延。

2014-2022年德州市德城区乙型病毒性肝炎流行病学特征分析

为了制定德城区乙型病毒性肝炎(简称“乙肝”)的预防控制策略,文章对2014—2022年的乙肝流行病学资料进行了描述性统计分析。结果显示,2014—2022年德州市德城区共报告了2843例乙肝病例,年均报告发病率为41.59/10万。值得注意的是,自2019年以来,乙肝的年均报告发病率呈现出逐年下降的趋势。城区的乙肝发病率(75.83/10万)明显高于农村地区(35.92/10万),男性的年均报告发病率(53.12/10万)也高于女性(29.28/10万)。在职业分布上,农民是发病人群的主体,占比达到了43.33%。这些数据表明,近年来德城区在乙肝防控方面取得了显著成效,但仍需要继续加强儿童乙肝疫苗接种工作,并进一步提高成人乙肝疫苗接种率。同时,应重点关注城区居民及男性人群的乙肝防控工作。

2013—2022年天津市西青区百日咳流行病学特征分析

目的:分析2013—2022年天津市西青区百日咳流行病学特征,以期为百日咳防控措施的制定和免疫规划策略的优化提供参考依据。方法:利用中国疾病预防控制信息系统,收集2013—2022年天津市西青区百日咳报告病例,描述性分析百日咳流行特征。结果:2013—2022年天津市西青区共报告百日咳病例413例,年均发病率为4.14/10万,2017年、2018年、2019年年均发病率较前4年有明显上升,年均发病率分别为10.07/10万(89例)、9.40/10万(82例)、6.60/10万(66例);全年均有百日咳病例报告,发病呈季节性双峰分布,发病高峰在7—8月和10—11月,高峰时间共报告百日咳病病例171例,占全部病例数的39.58%;发病人群中1岁以下儿童发病最多,占总发病数的49.39%;14岁以下未完成全程疫苗接种人群中鸡鸣音和发绀的发生率均高于已完成全程接种的人群。结论:2013—2019年天津市西青区百日咳发病率呈上升趋势,2020—2021年发病率明显下降,2022年有所上升,发病人群以婴幼儿为主,需加强百日咳主动监测,并且提高实验室检测能力,优化儿童及高危成年人百日咳免疫策略。

2011—2020年武威市丙型病毒性肝炎流行病学特征分析

目的对2011-2020年武威市丙型病毒性肝炎(简称丙肝)流行病学特征进行分析,为武威市丙肝的预防控制提供依据。方法采用描述性流行病学研究方法,对武威市2011-2020年丙型病毒性肝炎报告发病资料进行分析。计算丙肝报告发病率及不同人群、地区及时间报告发病的构成比,采用χ^(2)检验对不同人群特征及地区的丙肝报告发病率进行比较。结果武威市2011-2020年丙肝报告发病18318例,年平均报告发病率100.92/10万;其中2013年报告发病率最高(126.06/10万),2020年报告发病率最低(63.47/10万)。10年间各月均有病例报告,无明显的季节分布。报告病例年龄分布以40~69岁为主,占65.60%;女性病例数及发病率均高于男性;职业分布以农民为主,占总发病人群的69.35%。凉州区报告发病16631例,平均发病率为164.62/10万,报告发病例数及发病率均高于其他3县;其次为古浪县、民勤县、天祝县,发病人数依次为642例(平均发病率16.52/10万)、546例(平均发病率22.63/10万)、499例(平均发病率28.55/10万)。10年间武威市一区三县丙肝报告发病率差异具有统计学意义(χ^(2)=918.03,P<0.001)。结论2011-2020年武威市丙肝发病有明显的先上升后下降的趋势,同时具有地区和人群差异。应该对重点地区和人群的监测和健康教育进行加强,并制定相应的措施对丙肝进行有效预防。

2018-2022年章丘区3916例乙型病毒性肝炎流行病学特征分析

目的通过分析2018—2022年章丘区3916例乙型病毒性肝炎(乙肝)流行病学特征,为疾病防控措施制定提供依据。方法收集2018—2022年章丘区乙肝病例资料,采用描述性方法进行疾病流行病学特征分析。结果2018—2022年,章丘区乙肝确诊病例3916例,无死亡病例,以2022年发病率最高;主要以30~<60岁年龄段、男性、农民、待业/家务以及服务业为主要发病人群,4~6月为病发高峰季,地区集中于农村。结论2018—2022年,章丘区乙肝发病率整体较高,主要发病于30~<60岁、男性以及农民人群,相关部门应针对高风险地区与人群进行重点布控,以防控疾病的发生与流行。

Epidemiology, clinical-treatment patterns and outcome in 256 hepatocellular carcinoma cases

AIM: To analyze the epidemiology, clinical characteristics, treatment patterns and outcome in hepatocellular carcinoma (HCC) patients. METHODS: We analyzed clinical, pathological and therapeutic data from 256 consecutive patients, examined at S. Croce Hospital in Cuneo-Piedmont, with a diagnosis of HCC between 30th June 2000 and 1st July 2010. We analyzed the hospital imaging database and examined all medical records, including the diagnosis code for HCC (155.0 according to the ICD-9M classification system), both for inpatients and outpatients, and discovered 576 relevant clinical records. After the exclusion of reports relating to multiple admissions for the same patient, we identified 282 HCC patients. Moreover, from this HCC series, we excluded 26 patients: 1 patient because of an alternative final diagnosis, 8 patients because of a lack of complete clinical data in the medical record and 17 patients because they were admitted to different health care facilities, leaving 256 HCC patients. To highlight possible changes in HCC patterns over the ten-year period, we split the population into two five-year groups, according to the diagnosis period: 30 th June 2000-30th June 2005 and 1st July 2005-1st July 2010. Patients underwent a 6-mo follow up. RESULTS: Two hundred and fifty-six HCC patients were included (male/female 182/74; mean age 70 years), 133 in the first period and 123 in the second. Hepatitis C virus (HCV) infection was the most common HCC risk factor (54.1% in the first period, 50.4% in the second;P = 0.63); in the first period, 21.8% of patients were alcoholics and 15.5% were alcoholics in the second period (P > 0.05); the non-viral/non-alcoholic etiology rate was 3.7% in the first period and 20.3% in the second period (P < 0.001). Child class A patients increased significantly in the second period (P < 0.001). Adjusting for age, gender and etiology, there was a significant increase in HCC surveillance during the second period (P = 0.01). Differences between the two periods were seen in tumor parameters: there was an increase in the number of unifocal HCC patients, from 53 to 69 (P = 0.01), as well as an increase in the number of cases where the HCC was < 3 cm [from 22 to 37 (P = 0.01)]. The combined incidence of stage Barcelona Clinic Liver Cancer 0 (very-early) and A (early) HCC was 46 (34.6%) between 2000-2005, increasing to 62 (50.4%) between 2005-2010 (P = 0.01). Of the patients, 62.4% underwent specific treatment in the first group, which increased to 90.2% in the second group (P < 0.001). Diagnosis period (P < 0.01), Barcelona-Clinic Liver Cancer stage (P < 0.01) and treatment per se (P < 0.05) were predictors of better prognosis; surveillance was not related to survival (P = 0.20).CONCLUSION: This study showed that, between 2000-2005 and 2005-2010, the number of HCV-related HCC decreased, non-viral/non alcoholic etiologies increased and of surveillance programs were more frequently applied.

2018—2022年安徽省突发公共卫生事件流行特征分析

目的分析安徽省突发公共卫生事件流行特征,为制定防控策略提供科学依据。方法通过中国疾病预防控制信息系统突发公共卫生事件管理信息系统收集安徽省报告日期为2018年1月至2022年12月,且已结案的突发公共卫生事件相关信息,应用描述流行病学方法对事件的级别、类型、传播途径及三间分布等进行分析。结果2018—2022年安徽省共报告突发公共卫生事件1275起,发病36119例,死亡60例。事件级别以未分级和一般事件为主,分别占77.65%和20.94%;事件类别以传染病为主(1200起,占94.12%),主要为呼吸道传染病,占73.25%(879/1200),新冠病毒感染、水痘和流行性感冒为传染病事件的主要报告病种,分别占29.33%(352/1200)、26.75%(321/1200)和12.50%(150/1200);其次为突发中毒事件(66起,占5.18%),以食物中毒为主,占60.61%(40/66)。致死原因前三位的是发热伴血小板减少综合征(8例,占13.33%)、出血热(5例,占8.33%)、误食野生毒蕈和磷化铝中毒(各4例,各占6.67%)。时间分布呈现2个高峰,主高峰为10月至次年2月,次高峰为4—6月;报告事件起数居前三位的地市为合肥市(145起,占11.37%)、芜湖市(138起,占10.82%)和马鞍山市(135起,占10.59%);高发场所为学校,共报告764起(占59.92%),发病31457例,报告病种主要为水痘(321起,占42.02%),其次为社区/自然村及家庭,报告445起,发病3621例,以新冠病毒感染聚集性疫情为主(251起,占56.40%)。传染病事件和突发中毒事件的报告时间与事件持续时间均呈正相关(rs=1.000、0.998,P均<0.001)。结论安徽省突发公共卫生事件以传染病为主,学校是防控重点场所。同时需加强对发热伴血小板减少综合征、食物中毒等突发公共卫生事件的监测、预警和处置,减少死亡病例的发生。