2013-2021年中国梅毒扩大筛查与疫情报告变化相关性分析  

Correlation between the expanded screening and change of reported cases of syphilis in China from 2013 to 2021

作　　者：朱文倩 吴月琳 岳晓丽[2] 李婧[2] 张家晖 龚向东 ZHU Wenqian;WU Yuelin;YUE Xiaoli;LI Jing;ZHANG Jiahui;GONG Xiangdong(School of Public Health,Nanjing Medical University,Nanjing 21l166,China;Division of Sexually Transmitted Disease Epidemiology,National Center for STD Control of Chinese Center for Disease Control and Prevention,Institute of Dermatology,Chinese Academy of Medical Sciences andPeking Union Medical College,Nanjing210042)

机构地区：[1]南京医科大学公共卫生学院,南京211166 [2]中国医学科学院北京协和医学院皮肤病研究所中国疾病预防控制中心性病控制中心流行病学室,南京210042

出　　处：《中国艾滋病性病》2022年第10期1178-1182,共5页Chinese Journal of Aids & STD

基　　金：贵州省科技计划项目(黔科合支撑[2021]一般026)。

摘　　要：目的 了解我国梅毒扩大筛查对疫情报告变化的影响,为科学研判疫情提供依据。方法 分别对2013-2021年全国梅毒病例报告资料和筛查资料进行描述性分析,对两者之间的关系进行Pearson相关性分析。结果2013-2021年,全国梅毒报告病例数由406 772例增长至480 020例,平均年度变化百分比(AAPC)为1.94%(95%CI:0.46%~3.44%,P=0.010),其中一期与二期梅毒报告病例数呈负增长,AAPC为-10.39%(95%CI:-12.06%~-8.70%,P<0.001),隐性梅毒呈增长趋势,AAPC为6.60%(95%CI:5.35%~7.78%,P<0.001)。全国梅毒血清筛查人数由2013年的14 035 193例增长至2021年82 628 470例,AAPC为23.39%(95%CI:15.53%~31.78%,P<0.001);通过梅毒扩大筛查,梅毒血清特异性抗体与非特异性抗体均阳性的例数由2013年的138 619例增加至2021年的596 448例,AAPC为18.56%(95%CI:10.88%~26.77%,P=0.001)。梅毒筛查数与全部梅毒、隐性梅毒病例报告数呈显著的正相关(Pearson相关系数r分别为0.87、0.96,P<0.001),与一期及二期梅毒病例报告数呈显著的负相关(r=-0.93,P<0.001)。结论我国梅毒扩大筛查与梅毒报告疫情增长变化密切相关,扩大筛查导致隐性梅毒增加,从而致全部梅毒报告数增长,并不反映发病增长。研判疫情时需要考虑扩大筛查的影响,应慎重使用梅毒报告疫情变化数据。Objective To understand the effect of extended syphilis screening on case reporting in China, and to provide scientific basis for epidemic situation evaluation. Methods Descriptive analysis was performed on the data of syphilis case reporting and screening data in China from 2013 to 2021. Pearson correlation analysis was performed on the relationship between the case screening and case reporting. Results From 2013 to 2021, the number of reported cases of syphilis in China increased from 406, 772 to 480, 020, with an average annual percentage change(AAPC) of 1.94%(95%CI: 0.46%-3.44%, P=0.010). The number of reported cases of primary and secondary syphilis showed a negative increase, with an AAPC of-10.39%(95%CI:-12.06%--8.70%, P<0.001). The latent syphilis showed an increasing trend,with an AAPC of 6.60%(95%CI: 5.35%-7.78%, P<0.001). The number of syphilis sero-screening increased from 14,035,193 in 2013 to 82,628,470 in 2021, with an AAPC of 23.39%(95%CI: 15.53%-31.78%, P<0.001). By extended syphilis screening, the number of syphilis sero-specific antibodies and non-specific antibodies dual positivity cases increased from138, 619 in 2013 to 596, 448 in 2021, with an AAPC of 18.56%(95%CI: 10.88%-26.77%, P=0.001). The number of syphilis screening was significantly positively correlated with the number of reports of all syphilis and latent syphilis cases(Pearson correlation coefficient r=0.87, 0.96, P<0.001, respectively), and significantly negatively correlated with the number of reports of primary and secondary syphilis cases(r=-0.93, P<0.001). Conclusions Expanded screening for syphilis is closely related to the increase of syphilis epidemic in China. Expanded screening leads to the increase of latent syphilis, resulting in the increase of all syphilis reports, which does not reflect the increase of syphilis incidence. The impact of expanded screening needs to be considered when evaluating the syphilis epidemic in the country, and changes in data of syphilis reporting epidemic should be used cautiously.

关 键 词：梅毒 流行趋势 扩大筛查 相关性 

分 类 号：R377.1[医药卫生—病原生物学]