2002—2019年上海市金山区麻疹流行病学的特征分析  

Epidemiological characteristics of measles in Jinshan District of Shanghai in 2002-2019

作　　者：王晶晶[1] 周杰[1] 汤喜红[1] 李淑华[1] 姚红岑 田猛[1] 徐飚[2] WANG Jingjing;ZHOU Jie;TANG Xihong;LI Shuhua;YAO Hongcen;TIAN Meng;XU Biao(Jinshan District Center for Disease Control and Prevention,Shanghai 201599,China;School of Public Health,Fudan University,Shanghai 200032,China)

机构地区：[1]上海市金山区疾病预防控制中心,上海201599 [2]复旦大学公共卫生学院,上海200032

出　　处：《上海预防医学》2022年第2期143-146,162,共5页Shanghai Journal of Preventive Medicine

基　　金：上海市自然科学基金(17ZR1424500);上海市金山区卫生和计划生育委员会青年项目(JSKJ-KTQN-2017-09);上海市卫生和计划生育委员会面上项目(201740074)。

摘　　要：【目的】分析2002—2019年上海市金山区麻疹流行病学特征,了解麻疹发病特点。【方法】通过麻疹监测信息报告管理系统和金山区麻疹流行病学个案调查表,分析金山区2002—2019年麻疹流行病学特征,发病的时间聚集性采用集中度法。利用ArcGis 10.4以及SaTScan 9.6软件进行时空聚集性扫描分析。【结果】2002—2019年上海市金山区共报告麻疹病例289例,年平均发病率为2.24/10万。各年发病率在0/10万~11.27/10万波动,其中以2005年发病率最高(11.27/10万),随后发病率下降,但在2008年(5.26/10万)和2015年(3.30/10万)出现反弹。集中度(M)为0.62,发病时间有明显的季节性,集中在2—5月。时空扫描发现,在人口较多的街镇有空间和时间聚集性,年份以2002—2009年为主,街镇主要是朱泾镇和石化街道。人群分布年龄以<1岁婴幼儿和20~39岁组成人群为主;发病中免疫史不详者占66.78%;8月龄~4岁组病例中,外来人口含麻疹成分疫苗接种率低于本市人口(χ^(2)=4.44,P=0.035)。【结论】金山区麻疹发病率总体呈下降趋势,发病人群年龄出现"双向位移",且集中在人口较多的街镇。需要加强麻疹监测,对重点人群进行含麻疹成分疫苗补充免疫工作。[Objective]To determine the epidemiological characteristics of measles in Jinshan District of Shanghai in 2002-2019.[Methods]This study was a secondary data analysis using measles surveillance system and epidemiological case reports in Jinshan District from January2002 through December 2019. Temporal characteristics of the disease onset was determined by a concentration method. ArcGis 10.4 and SaTScan 9.6 software were used for spatiotemporal clustering scanning analysis.[Results]From 2002 through 2019,a total of 289 cases of measles were reported in Jinshan District,Shanghai,with an average annual incidence of 2.24 per 105. The annual incidence fluctuated from 0 to 11.27 per 105. The highest incidence was recorded in 2005(11.27 per 105),followed by a decline;however,there was a rebound in 2008(5.26 per 105)and 2015(3.30 per 105). The concentration M was determined to be 0.62,showing a clear seasonality concentrated in February to May. The spatiotemporal scan found that spatial and temporal clusters were more likely to occur in the areas with higher population density such as Zhujing Town and Shihua Community and between 2002 and 2009. The majority of measles cases were infants and children under the age of 1 and adults aged 20-39 years. Approximately 66.78% of measles cases reported unknown vaccination history. In addition,in children aged 8 month to 4 years,the vaccination rate of measles-containing vaccines in the domestic migrants was much lower than the local residents(χ^(2)=4.44,P=0.035).[Conclusion]The incidence of measles in Jinshan District presents a downward trend. The population affected has a "two-way displacement",which is concentrated in the more populated areas. It is necessary to strengthen measles surveillance and implement supplementary immunization programs with measles-containing vaccines for at-risk populations.

关 键 词：麻疹 流行病学特征 监测 疫苗 影响因素 

分 类 号：R181[医药卫生—流行病学]