2013-2016年南京市细菌性痢疾流行特征及时空聚集性分析  

Epidemiological characteristics and temporal-spatial clustering analysis of bacillary dysentery,Nanjing,2013-2016

作　　者：马涛[1] 谢国祥[1] 徐庆[1] 张敏[1] 许阳婷[1] 丰罗菊[1] 随海田[2] 祖荣强[3] MA Tao;XIE Guo-xiang;XU Qing;ZHANG Min;XU Yang-ting;FENG Luo-ju;SUI Hai-tian;ZU Rong-qiang(Nanjing Center for Disease Control and Prevention,Nanjing,Jiangsu 210003,China)

机构地区：[1]江苏省南京市疾病预防控制中心,江苏南京210003 [2]中国疾病预防控制中心卫生应急中心,北京102206 [3]江苏省疾病预防控制中心,江苏南京210009

出　　处：《现代预防医学》2018年第19期3643-3648,共6页Modern Preventive Medicine

基　　金：南京市卫生计生委"十三五"重大项目(ZDX16020)

摘　　要：目的了解南京市细菌性痢疾(菌痢)的流行特征,并分析时空聚集性,为菌痢的重点防控工作提供依据。方法采用描述流行病学方法,分析2013-2016年南京市报告的菌痢病例流行和病原学特征,采用时空重排扫描分析时空聚集性特征。结果 2013-2016年南京市共报告菌痢病例2 064例,年均报告516例(412~671例),年均报告发病率为6. 3/10万(5. 0/10万~8. 2/10万),报告2起暴发疫情,共发病167例。4-10月报告病例占78%;男性占54%;病例年龄中位数为21岁(0~95岁),0~3岁组报告发病率最高;散居儿童(34%)、学生(17%)和离退人员(16%)占比最高。各年全局空间自相关Moran’s I都为正值,都P <0. 05;各年均探测到1个时空聚集区域,聚集地区为城区(玄武、鼓楼、秦淮等老城区),聚集时间为4-10月,都P <0. 001。分离培养志贺氏菌株139株,福氏志贺氏菌占58%,宋内氏志贺氏菌占37%。结论南京市菌痢报告发病逐年下降,城区高发,婴幼儿童和老年人群为重点人群,应根据流行和病原学特征,在重点地区和人群开展针对性防控措施。Objective To investigate the epidemiological characteristics and temporal - spatial clustering of bacillary dysentery （BD） in Nanjing from 2013 to 2016, so as to develop the scientific evidence for prevention and control strategy. Methods We conducted a descriptive epidemiological method to analyze epidemiological and pathogenic characteristics of BD reported data collected from Nanjing from 2013 to 2016, and temporal - spatial clustering characteristics were analyzed by space - time permutation scanning. Results A total of 2064 BD cases were reported in Nanjing during the period of 2013 to 2016. The average annual number was 516 （412 - 671 ）, and the annual incidence was 6.3/100 000 （ ranged from 5.0/100 000 to 8.2/ 100 000）. Two outbreaks including 167 cases were reported. The cases reported from April to October accounted for 78% , and male accounted for 54%. The median age was 21 （ ranged from 0 to 95 ）. The highest reported incidence was in the age group of 0 - 3 years old. The highest numbers of cases for occupations were scattered children （34%）, students （ 17% ） and retired people （ 16% ）. The Moran- I values for the overall spatial autocorrelation for each year were all positive （ P 〈 0.05 ）. One spatiotemporal clustering region which was inner - city areas （ the old towns such as Xuanwu, Gulou, Qinhuai） was detected in each year, and the clustering time were from April to October （ P 〈 O. 001 ）. 139 strains of Shigella were isolated and cultured （58% for Shigella flexneri, 37% for Shigella sonnei）. Conclusion The reported BD incidence in Nanjing decreases annually. Incidence for residents liviog in the inner - city area is higher, and the key populations are young adults and elderly people. The targeted measures for prevention and control of BD should be implemented in key areas and population, according to the epidemiological and etiological characteristics.

关 键 词：志贺氏菌 细菌性痢疾 流行病学特征 空间自相关 时空聚集性 热力图 

分 类 号：R181.32[医药卫生—流行病学]