宁波市1970-2021年百日咳流行病学特征和中断时间序列分析  

Epidemiological characteristics and interrupted time series analysis of pertussis in Ningbo from 1970 to 2021

作　　者：杨天池[1] 梅秋红[1] 叶莉霞[1] 王建美 俞紫莲 高丽[3] 马瑞[1] Yang Tianchi;Mei Qiuhong;Ye Lixia;Wang Jianmei;Yu Zilian;Gaoli;Ma Rui(Ningbo Center for Disease Control and Prevention,Ningbo 315010,Zhejiang,China;Yinzhou District Center for Disease Control and Prevention,Ningbo 315100,Zhejiang,China;Xiangshan County Center for Disease Control and Prevention,Ningbo 315700,Zhejiang,China)

机构地区：[1]宁波市疾病预防控制中心,浙江宁波315010 [2]宁波市鄞州区疾病预防控制中心,浙江宁波315100 [3]宁波市象山县疾病预防控制中心,浙江宁波315700

出　　处：《中国疫苗和免疫》2023年第4期412-416,共5页Chinese Journal of Vaccines and Immunization

基　　金：宁波市医疗卫生品牌学科(PPXK2018-10)。

摘　　要：目的 分析宁波市不同时期百日咳流行病学特征和发病率变化。方法 收集宁波市1970-2021年百日咳病例监测数据,描述性分析流行病学特征。采用中断时间序列分析方法分析1970-1983年自然流行时期、1984-2006年全细胞百白破联合疫苗(DTwP)纳入免疫规划时期和2007-2021年无细胞百白破联合疫苗(DTaP)替代DTwP时期的百日咳发病率变化。结果 1970-1983年、1984-2006年、2007-2021年宁波市百日咳年均报告发病率(/10万,下同)分别为72.51(16 763例)、4.75(6 147例)、0.62(681例);0-4岁病例构成比从1983年的54.63%、1984-2006年的49.16%上升至2007-2021年的79.74%。中断时间序列分析显示,1970-1983年百日咳发病率年均升高1.046(95%CI:-5.390~7.481);1984-2006年发病率首年下降了41.306,之后年均下降1.217(95%CI:-2.383~-0.053);2007-2021年发病率首年上升了8.978,之后年均上升0.109(95%CI:0.027-0.191)。结论 宁波市百日咳发病总体呈下降趋势且向小年龄儿童转移;DTwP纳入免疫规划后发病率快速下降,DTaP替代DTwP后发病率略有回升但仍处于低流行水平。Objective To analyze epidemiological characteristics and changes in incidence of pertussis in different periods in Ningbo.Methods We obtained pertussis case reports from 1970 to 2021 in Ningbo for a descriptive epidemiological analysis.We used interrupted time series analysis to determine changes of pertussis incidences during the natural epidemic period of 1970-1983,the period of introducing diphtheria,tetanus,and whole-cell pertussis combined vaccine(DTwP)into Expanded Program on Immunization(EPI)in 1984-2006,and the period of replacing DTwP with diphtheria,tetanus,and acellular pertussis combined vaccine(DTaP)in 2007-2021.Results Average annual reported incidences per 100000 population of pertussis in Ningbo were 72.51(16763 cases),4.75(6147 cases),and 0.62(681 cases)in 1970-1983,1984-2006,and 2007-2021,respectively.Proportions of 0-4-year-old cases increased from 54.63%in 1983 and 49.16%in 1984-2006 to 79.74%in 2007-2021.Interrupted time series analysis showed that pertussis annual incidences per 100000 increased by 1.046(95%CI:-5.390~7.481)from 1970 to 1983 on average,decreased by 41.306 in 1984 and by 1.217(95%CI:-2.383~-0.053)from 1985 to 2006,and then increased by 8.978 in 2007 and by 0.109(95%CI:0.027-0.191)from 2008 to 2021.Conclusions The pertussis incidence decreased over time in Ningbo with the highest annual incidence shifting to young children.Pertussis incidence declined rapidly after introducing DTwP into EPI but increased slightly after replacing DTwP with DTaP.

关 键 词：百日咳 流行特征 含百日咳成分疫苗 国家免疫规划 中断时间序列分析 

分 类 号：R186[医药卫生—流行病学]