发热伴血小板减少综合征疫情呈上升趋势:基于2015―2020年南京市报告病例数据  

The rising trend of severe fever with thrombocytopenia syndrome: based on the data of reported cases in Nanjing from 2015 to 2020,China

作　　者：马涛[1] 张敏[1] 杜雪飞[2] 汪君君 王恒学 徐庆[1] 周沁易 郑颖[1] 林丹 洪镭[1] 刘坤 MA Tao;ZHANG Min;DU Xue-fei;WANG Jun-jun;WANG Heng-xue;XU Qing;ZHOU Qin-yi;ZHENG Ying;LIN Dan;HONG Lei;LIU Kun(Department of Acute Infectious Disease Control and Prevention,Nanjing Municipal Center for Disease Control and Prevention,Nanjing 210003,China;Department of Microbiological Laboratory,Nanjing Municipal Center for Disease Control and Prevention,Nanjing 210003,China;Key Laboratory of Public Health Safety Ministry of Education,Fudan University,Shanghai 200032,China;Department of Public Health Emergency,Lishui District Center for Disease Control and Prevention,Nanjing 211200,China)

机构地区：[1]南京市疾病预防控制中心急性传染病防制科,南京210003 [2]南京市疾病预防控制中心微生物检验科,南京210003 [3]复旦大学公共卫生安全教育部重点实验室,上海200032 [4]溧水区疾病预防控制中心卫生应急办公室,南京211200

出　　处：《中华疾病控制杂志》2022年第12期1407-1413,共7页Chinese Journal of Disease Control & Prevention

基　　金：江苏省预防医学课题(Y2018077);南京市医学重点专科(宁卫科教[2018]7号);南京市卫生科技发展项目(YKK22190)。

摘　　要：目的 了解南京市发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome, SFTS)的报告发病趋势、流行特征,探究重点防控人群、地区及影响因素,为指导制定防控策略、措施和采取干预行动提供科学依据。方法 描述2015―2020年南京市SFTS流行趋势和季节、人群及空间分布特征,利用全局空间自相关分析、局部空间自相关分析和FleXScan扫描,探索乡镇/街道层面上报告发病的空间异质性和聚集性。结果 共报告SFTS确诊病例194例,年均报告发病率为0.39/10万,年度变化百分比(annual percent change, APC)为33.43%(95%CI:5.41%~68.89%,P=0.03),2020年相比2019年增加115%(39例)。5―8月占79.38%,7月为高峰占28.87%。平均年龄为64(54, 71)岁,≥60岁占64.43%,45~<60岁占27.32%。农民占61.34%,家务待业占12.89%,离退休人员占11.34%。溧水区报告病例数占46.39%。全局空间自相关Moran’s I=0.58(Z=9.97,P=0.001),局部空间自相关与FleXScan扫描结果显示,溧水区除和凤镇外的7个乡镇/街道与江宁区横溪街道为一级聚集区(LLR=150.24,P=0.001),浦口区江浦街道、桥林街道和星甸街道为二级聚集区(LLR=17.81,P=0.001)。结论 南京市SFTS报告发病率呈上升趋势,≥45岁人群和农民为重点人群,溧水区为重点防控地区。建议及时开展基于危险因素和趋势研判的专题研究,同时强化和落实综合防控干预措施。Objective To understand the reported incidence trend and epidemic characteristics of severe fever with thrombocytopenia syndrome(SFTS) in Nanjing, exploring the critical prevention and control population, areas, and influencing factors, and providing scientific basis for guiding the formulation of prevention and control strategies, measures and carrying out scientific intervention actions. Methods The reported incidence trend and characteristics of seasonal distribution, population distribution and spatial distribution of SFTS in Nanjing from 2015 to 2020 were described. Global spatial autocorrelation analysis, local spatial autocorrelation analysis, and FleXScan spatial clustering scans were used to explore the spatial heterogeneity and spatial cluster at the town/street level. Results There were 194 SFTS reported confirmed cases. The annual average reported incidence was 0.39/100 000(0.13/100 000 to 0.86/100 000), and the annual percent change(APC) was 33.43%(95% CI:5.41 to 68.89, P=0.03). Seventy-three cases were reported in 2020, with an increased rate of 115% when compared to 2019(39 cases). Among all reported cases, 79.38% were from May to August, and the peak was in July which accounted for 28.87%. The median age was 64(54,71) years, of 64.43% were aged 60 or above, and the group of 45-<60 years was accounted for 27.32%. In terms of occupations, the proportion of farmers was 61.34%, household and unemployed workers was 12.89%, and for retirees was 11.34%. The number of reported cases in Lishui District accounted for 46.39%. Moran’s I for global spatial autocorrelation analysis was 0.58(Z=9.97, P=0.001). Additionally, local spatial autocorrelation analysis and FleXScan spatial clustering scans showed that Seven towns/streets in Lishui District except Hefeng Town and Hengxi Street in Jiangning District were first cluster areas(LLR=150.24, P=0.001). And secondary cluster areas were Jiangpu Street, Qiaolin Street, and Xingdian Street in Pukou District(LLR=17.81, P=0.001). Conclusions The trend of reported in

关 键 词：发热伴血小板减少综合征 流行病学特征 空间聚集性 蜱 趋势 

分 类 号：R512.8[医药卫生—内科学]