上海社区自然人群急性传染病前瞻性随访研究方法的建立与应用  

Establishment and application of a prospective follow-up research method for acute infectious diseases in Shanghai community residents

作　　者：郑雅旭 俞晓 吴寰宇 吴立明[4] 陈健 肖文佳[3] 黄卓英[3] 林声[3] 方绮雯[3] 刘锐 张浩 陈昕 ZHENG Yaxu;YU Xiao;WU Huanyu;WU Liming;CHEN Jian;XIAO Wenjia;HUANG Zhuoying;LIN Sheng;FANG Qiwen;LIU Rui;ZHANG Hao;CHEN Xin(Shanghai Institute of Preventive Medicine,Shanghai 200336,China;School of Public Health,Fudan University,Shanghai 200032,China;Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Shanghai Municipal Disease Control and Prevention Administration,Shanghai 200115,China)

机构地区：[1]上海市预防医学研究院,上海200336 [2]复旦大学公共卫生学院,上海200032 [3]上海市疾病预防控制中心,上海200336 [4]上海市疾病预防控制局,上海200115

出　　处：《上海预防医学》2024年第1期5-10,共6页Shanghai Journal of Preventive Medicine

基　　金：上海市加强公共卫生体系建设三年行动计划(2023—2025年)面上项目(GWVI-1);上海市公共卫生体系建设三年行动计划(2023—2025年)重点学科建设(GWVI-11.1-01);上海市“医苑新星”青年医学人才培养资助计划公共卫生领导者项目[(2022)_65];上海市疾病预防控制青年骨干人才培养项目(22QNGG09)。

摘　　要：【目的】以新型冠状病毒感染为例,介绍基于社区自然人群的急性传染病前瞻性随访研究方法在传染病监测中的探索与应用,为完善传染病监测预警体系提供参考。【方法】采用多阶段按概率比例抽样方法,在上海市16个行政区所有街镇进行抽样,建立基于社区自然人群的急性传染病监测队列,对所有监测对象开展基线调查,并发放新型冠状病毒(简称“新冠病毒”)抗原检测试剂。收集2022年12月21日—2023年9月30日前瞻性随访监测对象每周新冠病毒抗原、核酸检测情况,描述监测对象的基线特征以及随访情况。【结果】急性传染病监测队列共纳入12881名监测对象,男性6098人(47.3%),女性6783人(52.7%),基线调查显示35.2%(4540/12881)的监测对象既往有新冠病毒感染史。2022年12月21日—2023年9月30日随访期间,该队列人群发病密度为0.61/人·年,女性(0.63/人·年)发病密度高于男性(0.59/人·年)。60岁及以上老年人(0.64/人·年)和有基础性疾病者(0.67/人·年)发病密度较高。医务人员的发病密度(0.84/人·年)明显高于其他职业人群。截至2023年9月30日,该队列人群中共有340人发生二次感染,首次感染和再次感染的时间间隔中位数为170 d。【结论】本研究将队列研究方法应用于急性传染病监测中,为社区急性传染病感染率估计和传染病预测预警提供重要的数据支撑,可作为一种新的急性传染病监测方法应用推广。[Objective]To present the exploration and application of a prospective follow-up research method for acute infectious disease surveillance based on natural community populations,using COVID-19 infection as an example,and to provide a reference for improving the infectious disease surveillance and early warning system.[Methods]A multi-stage probability proportional sampling method was employed to sample residents from all communities of 16 administrative districts in Shanghai,with households as the units.A cohort for acute infectious diseases based on natural community populations was established.The baseline survey was conducted for all cohort subjects,and COVID-19 antigen test kits were distributed.From December 21,2022 to September 30,2023,prospective follow-up monitoring of COVID-19 antigen and nucleic acid was carried out on the study subjects on a weekly basis.The baseline characteristics and follow-up information of the cohort subjects were described.[Results]The cohort for acute infectious diseases included a total of 12881 subjects,comprising 6098 males(47.3%)and 6783 females(52.7%).The baseline survey revealed that 35.2%(4540/12881)of the subjects had a history of COVID-19 infection.During the follow-up period from December 21,2022 to September 30,2023,the average incidence density in the cohort was 0.61/person-year,with a higher incidence density in females(0.63/person-year)compared to males(0.59/person-year).Individuals aged 60 and above(0.64/person-year)and those with underlying health conditions(0.67/person-year)had a higher incidence density.Healthcare workers showed a notably higher incidence density(0.84/person-year)than that in other occupational groups.As of September 30,2023,a total of 340 subjects in the cohort experienced secondary infections,with a median interval of 170 days between the first and second infections.[Conclusion]This study applies cohort study method to acute infectious disease surveillance,providing crucial data support for estimating infection rates and forecasting alerts fo

关 键 词：急性传染病 新型冠状病毒感染 前瞻性随访研究 社区自然人群 发病密度 

分 类 号：R183.3[医药卫生—流行病学]