2004-2021年云南省肾综合征出血热流行特征分析  

Epidemiological characteristics of hemorrhagic fever with renal syndrome in Yunnan,2004−2021

作　　者：杜珊珊 邓雪飞 黄晓霞[1] 李阿茜 王芹[1] 李川[1] 冯云[2] 李建东[1] Du Shanshan;Deng Xuefei;Huang Xiaoxia;Li Aqian;Wang Qin;Li Chuan;Feng Yun;Li Jiandong(Key Laboratory of Medical Virology,Ministry of Health,National Institute for Viral Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Yunnan Institute of Endemic Diseases Control And Prevention,Dali 671000,Yunnan,China)

机构地区：[1]中国疾病预防控制中心病毒病预防控制所,卫生部医学病毒和病毒病重点实验室,北京102206 [2]云南省地方病防治所,云南大理671000

出　　处：《疾病监测》2023年第11期1357-1362,共6页Disease Surveillance

摘　　要：目的对2004—2021年云南省肾综合征出血热(HFRS)报告病例进行流行病学分析,了解HFRS流行特征。方法从国家法定传染病监测系统获得了2004—2021年云南省HFRS报告病例数据,采用描述性流行病学方法对全省2004—2021年HFRS时间、地区和人群分布和诊断类别资料进行统计分析,并以县级为单位进行空间聚集分析。结果2004—2021年全省共报告HFRS病例2556例,年均发病率为0.30/10万,死亡病例17例,病死率为0.67%;每年主要以3—8月(春夏季)为发病高峰,70.81%患者为男性,16~60岁患者占76.72%,77.11%病例为农民;全局空间自相关分析Moran’s I系数0.010~0.319,仅2011—2021年有相关性(P<0.05),高-高聚集区主要集中在大理白族自治州、楚雄彝族自治州和丽江市,实验室确诊病例和病死率存在较强的负相关(r=-0.720,P=0.019),疑似病例和病死率存在较强的正相关(r=0.649,P=0.042),报告病例数少的地区病死率高。结论云南省HFRS在2012—2021年间处于相对高发期,波及地理范围有扩大趋势,但仍呈现明显的时空聚集特征,累及人群逐渐向高龄人群偏移,应推动高发地区落实综合防控措施,提高病例诊断与实验室检测能力。Objective To understand the epidemiological characteristics of hemorrhagic fever with renal syndrome(HFRS)in Yunnan province from 2004 to 2021.Methods The incidence data of HFRS reported in Yunnan from 2004 to 2021 were obtained from National Notifiable Infectious Diseases Surveillance System for a descriptive epidemiological analysis on the time,area and population distributions of HFRS,and classification of the cases.The spatiotemporal clustering analysis was carried out at county level in the province.Results From 2004 to 2021,a total of 2556 HFRS cases,including 17 deaths,were reported in Yunnan,with an average annual incidence rate of 0.30/100000 and a case fatality rate of 0.67%.The annual incidence peaked during March-August(spring and summer),Up to 70.81%of the cases were men,76.72%were aged 16–60 years,and 77.11%were farmers.The global spatial autocorrelation analysis showed that the Moran's I coefficient ranged from 0.010 to 0.319,and only the cases reported during 2011–2021 showed a significant correlation(P<0.05).High-high clustering areas were mainly in Dali,Chuxiong and Lijiang.In addition,there was a strong negative correlation between the laboratory-confirmed cases and the case fatality rate(r=−0.72,P=0.019),and there was a strong positive correlation between the suspected cases and the case fatality rate(r=0.649,P=0.042),and the case fatality rate was high in areas with less cases.Conclusion The incidence of HFRS in Yunnan reached a relative high level during 2012–2021,the affected areas expanded with obvious spatiotemporal clustering.Population affected became older gradually.It is necessary to promote the implementation of comprehensive prevention and control measures in high-risk areas and improve the cases diagnosis and laboratory testing.

关 键 词：肾综合征出血热 流行特征 疾病监测 汉坦病毒 

分 类 号：R211[医药卫生—中医学] R512.8