2009-2021年石家庄市手足口病流行特征及病原学变迁分析  

Epidemiological characteristics and etiological changes of hand-foot-mouth disease in Shijiazhuang City from 2009 to 2021

作　　者：万丽[1] 周吉坤[1] 陈慧英[1] 赵树青[1] 刘立[1] WAN Li;ZHOU Jikun;CHEN Huiying;ZHAO Shuqing;LIU Li(Shijiazhuang Center for Diseases Control and Prevention,Shijiazhuang,Hebei 050011,China)

机构地区：[1]石家庄市疾病预防控制中心,河北石家庄050011

出　　处：《公共卫生与预防医学》2023年第2期60-64,共5页Journal of Public Health and Preventive Medicine

基　　金：河北省2022年度医学科学研究课题计划——石家庄市肠道传染病流行特征及预警预测方法研究(20221692)。

摘　　要：目的了解石家庄市手足口病流行特征和病原学特征,为手足口病防控提供科学依据。方法收集石家庄市2009—2021年手足口病疫情资料及病原学资料,应用描述性流行病学方法进行分析。结果石家庄市手足口病报告发病率呈波动下降趋势,多数年份呈现隔年高发特征;重症比例和死亡率呈下降趋势(χ_(趋势重症)^(2)=282.09,P<0.001,χ_(趋势死亡)^(2)=51.33,P<0.001)。全年有两个发病高峰:春夏季主高峰和秋冬季次高峰,2015年后发病高峰月份后移。发病人群以5岁及以下儿童为主,男女性别比为1.53∶1,性别发病率差异有统计学意义(χ^(2)=4507.84,P<0.001),死亡病例以2岁及以下儿童为主(占88.89%),发病率随年龄增长而降低(t r=-2.85,P<0.05)。城区发病率最高(114.50/10万)。不同类型病例病原构成差异有统计学意义(χ^(2)=521.86,P<0.001),轻症病例病原呈多样化,重症和死亡病例以EV71为主,分别占82.77%和96.67%,重症病例中其他肠道病毒占比上升。2017—2021年全市共接种EV71疫苗630745剂次,年均接种率8.53%。实施EV71疫苗接种政策后,重症比例、年均死亡率、EV71构成比与之前相比均下降,差异有统计学意义(χ_(趋势比例)^(2)=93.71,P=0.000,χ_(死亡率)^(2)=26.62,P=0.000,X_(EV71构成比)^(2)=1060.86,P=0.000)。结论石家庄市手口病发病总体呈下降趋势,不同病例优势病原变化特征不同,应继续坚持做好病原学监测、健康教育和EV71疫苗接种等各项防控工作。Objective To understand the epidemiological and etiological characteristics of hand-foot-mouth disease(HFMD)in Shijiazhuang City from 2009 to 2021,and to provide scientific evidence for the prevention and control of HFMD.Methods The epidemic data and etiological data of HFMD in Shijiazhuang City from 2009 to 2021 were collected,and descriptive epidemiological methods were used for data analysis.Results The reported incidence of HFMD in Shijiazhuang showed a fluctuating downward trend from 2009 to 2021,with a high incidence every other year in most years.The proportion of severe cases and the mortality rate showed a decreasing trend(X_(severe cases)^(2)=282.09,P<0.001;X_(mortality)^(2)=51.33,P<0.001).There were two peaks of HFMD incidence throughout the year:the main peak occurring in spring and summer and the secondary peak occurring in autumn and winter.The peak month of incidence showed a backward trend after 2015.Cases were mainly children aged 5 years and below.The ratio of male to female was 1.53∶1,and the gender incidence rate was significantly different(χ^(2)=4507.84,P<0.001).The deaths were mainly children aged 2 years old and below,accounting for 88.89%.The incidence of HFMD decreased with age(t r=-2.85,P<0.05).The highest incidence was in urban areas(114.50/100000).The pathogenic composition of different cases was different and the difference was statistically significant(χ^(2)=521.86,P<0.001).The dominant pathogens in mild cases presented diverse characteristics.EV71 was dominant in severe cases and death cases,accounting for 82.77%and 96.67%respectively.The proportion of other enteroviruses in severe cases showed an increasing trend.A total of 630745 doses of EV71 inactivated vaccine were administered in Shijiazhuang from 2017 to 2021,with an average annual vaccination rate of 8.53%.After the implementation of EV71 vaccination,the proportion of severe cases,the mortality rate and the proportion of EV71 all decreased compared to those before,and the differences were statistically significant(X_(pro

关 键 词：手足口病 肠道病毒71型 其它肠道病毒 流行特征 病原学变迁 

分 类 号：R181[医药卫生—流行病学]