广东省恙虫病流行特征时空变化趋势及死亡影响因素分析  

Epidemiological characteristics trends and death related influencing factors of scrub typhus,Guangdong

作　　者：谭小华[1] 彭志强[1] 林文青[1] 杨宇威 罗敏 TAN Xiao-hua;PENG Zhi-qiang;LIN Wen-qing;YANG Yu-wei;LUO Min(Center for Disease Control and Prevention,Guangzhou,Guangdong 511400,China)

机构地区：[1]广东省疾病预防控制中心,广东广州511400

出　　处：《现代预防医学》2022年第23期4259-4266,4293,共9页Modern Preventive Medicine

摘　　要：目的分析广东省恙虫病流行特征时空变化趋势以及死亡影响因素,为恙虫病防控提供科学依据。方法收集广东省恙虫病1952—2021年发病和死亡数据和2006—2021年病例信息,应用Joinpoint回归估算总体发病率和死亡率以及不同地区和人群发病率或构成比的年度变化百分比(APC)和平均年度变化百分比(AAPC),分析恙虫病流行特征时空变化趋势。通过logistic回归分析病例死亡的影响因素。结果广东省1952—1989年恙虫病年均发病率为0.59/10万,年均死亡率为0.003/10万,年均病死率为0.49%,年发病率呈稳定趋势(P>0.05),年死亡率、年病死率均呈下降趋势(P<0.05)。2006—2021年年均发病率为3.44/10万,年均死亡率为0.003/10万,年均病死率为0.08%,年发病率呈上升趋势(P<0.05),年死亡率、年病死率则均呈稳定趋势(均为P>0.05)。山区(6.74/10万)、≥60岁组人群(12.99/10万)年均发病率最高,所有地区和年龄组年发病率均呈上升趋势(均为P<0.05);山区和粤西病例年构成比均呈上升趋势(均为P<0.05);≥60岁组人群年构成比呈上升趋势(P<0.05)。乡镇居民(82.56%)、农民(66.59%)病例年均构成比最高,年构成比均呈上升趋势(均为P<0.05)。医院年均报告率为11.45%,医生年均报告率为0.98%,两者均呈上升趋势(均为P<0.05)。单因素logistic回归分析结果显示,恙虫病病例死亡的影响因素包括年龄、职业、乡镇居民。多因素logistic回归分析结果显示,年龄、职业是病例死亡的独立危险因素。结论广东省2006年以来恙虫病发病水平呈上升趋势,但死亡率和病死率维持在较低水平。老年人是恙虫病发病与死亡的高风险人群,应采取针对性措施加强宣传教育与管理。Objective To analyze the epidemiological characteristics trends and death related influencing factors of scrub typhus in Guangdong for prevention and control of scrub typhus.Methods The data of scrub typhus cases and death from 1952 to 2021 in Guangdong were collected.Joinpoint regression model was performed to obtain the annual percentage change(APC)and average annual percentage changes(AAPC)of rates and proportions for epidemiological characteristics trend analysis.Logistic regression model was used for influencing factors analysis of death cases.Results The average annual incidence rate,mortality and fatality of scrub typhus from 1952 to 1989 were respectively 0.59/100000,0.003/100000 and 0.49%.The annual mortality and fatality both showed decreasing trend(P<0.05),but incidence rates stable.Those of scrub typhus from 2006 to 2021 were respectively 3.44/100000,0.003/100000 and 0.08%.The annual incidence rates showed increasing trend(P<0.05),but mortality and fatality both stable.Average annual incidence rates of the mountainous areas(6.74/100000)and age group≥60 years(12.99/100000)were the highest,and annual incidence rates of all areas and age groups showed increasing trend(P<0.05).The annual cases proportions of the mountainous areas and the west areas,age group≥60 years all showed increasing trend(P<0.05).The average annual cases proportions of township residents(82.56%)and farmers(66.59%)were higher,and annual cases proportions both showed increasing trend(P<0.05).The average annual cases reporting rates of hospitals and doctors were 11.45%and 0.98%,and both showed increasing trend(P<0.05).Univariate logistic regression model analysis revealed that the influencing factors of death cases included age,occupation,and township residents.Multivariate logistic regression model analysis revealed that age and occupation was an independent risk factor.Conclusion The incidence of scrub typhus in Guangdong shows an increasing trend since 2006,but mortality and fatality maintain at a low level.The elderly people ar

关 键 词：恙虫病 流行特征 变化趋势 Jointpoint回归 

分 类 号：R513.2[医药卫生—内科学] R181.3[医药卫生—临床医学]