云南省2013-2022年恙虫病的流行病学特征分析  

Epidemiological characteristics of scrub typhus in Yunnan Province,China,2013-2022

作　　者：邓淑珍[1] 董雪梅 沈秀莲[1] 周燕梅 韩兆梅 税铁军[1] DENG Shu-zhen;DONG Xue-mei;SHEN Xiu-lian;ZHOU Yan-mei;HAN Zhao-mei;SHUI Tie-jun(Department of School Health/Epidemic Surveillance/Public Health Emergency Response Center/Department of Leprosy Prevention and Control,Yunnan Center for Disease Control and Prevention,Kunming,Yunnan 650000,China;Department of Health Education and Promotion,Nujiang Lisu Autonomous Prefecture Center for Disease Control and Prevention,Nujiang,Yunnan 673100,China;Yuxi Vocational and Technical College,Yuxi,Yunnan 653100,China;Malong Center for Disease Control and Prevention of Qujing City,Qujing,Yunnan 655100,China)

机构地区：[1]云南省疾病预防控制中心学校卫生所/疫情管理/突发公共卫生事件应急处理中心/麻风病防制所,云南昆明650000 [2]云南省怒江傈僳族自治州疾病预防控制中心健康教育与促进科,云南怒江673100 [3]云南玉溪职业技术学院,云南玉溪653100 [4]曲靖市马龙区疾病预防控制中心,云南曲靖655100

出　　处：《中国媒介生物学及控制杂志》2024年第2期194-199,共6页Chinese Journal of Vector Biology and Control

摘　　要：目的分析云南省2013-2022年恙虫病的三间分布特征,为制定恙虫病的防治策略提供科学依据。方法收集云南省2013-2022年的恙虫病疫情资料,采用描述流行病学方法和ArcGIS 10.3软件的可视化技术等,系统研究云南省恙虫病流行及时空分布特征,确定高风险地区。结果10年间云南省累计报告恙虫病病例69246例,死亡19例,年均发病率为14.58/10万,年发病率由2013年的5.95/10万上升至2022年的25.53/10万,呈线性递增趋势(χ_(趋势)^(2)=30.573,P<0.001),病死率为0.036%;发病县(区)从2013年的70个扩增至2022年的97个,发病率排前3位的为德宏傣族景颇族自治州(10906例,85.14/10万)、临沧市(13677例,55.67/10万)和保山市(13406例,52.44/10万),年均增长率为17.82%,年均增长率最快的3个州(市)为怒江傈僳族自治州(84.15%)、曲靖市(48.91%)和文山壮族苗族自治州(45.12%);2013年发病率较高的地区主要集中在云南省西、中部,自2019年开始,高发病率地区由西、中部地区逐渐向东南扩散。总体来说,男性发病率高于女性(χ^(2)=332.635,P<0.001);0~<5和50~<55岁组人群发病数较多,分别占11.05%和11.19%;职业以农民居多,流行季节仍以夏、秋季为主。报告病例以县(区)级医院报告为主(56.44%),从发病至确诊的时间中位数为4 d,医院等级越高发病到确诊的时间越短(H=15.924,P<0.001)。病例以临床诊断病例为主,占96.07%。结论云南省恙虫病发病呈逐年上升趋势,病例由滇西、中部向东南扩散,5、6月病例快速上升,中老年女性农民高发,近几年乡镇卫生院报告病例数明显增多,应加强基层医生的培训及居民和旅游者的健康教育工作。Objective To analyze the disease distribution characteristics of scrub typhus in Yunnan Province,China from 2013 to 2022,so as to provide scientific evidence for formulating prevention and control strategies for scrub typhus.Methods By using descriptive epidemiological methods and visual analysis in ArcGIS 10.3 software,the data about scrub typhus in Yunnan Province from 2013 to 2022 were systematically analyzed to determine the epidemiological characteristics,spatiotemporal distribution,and high-risk areas of scrub typhus in Yunnan Province.Results A total of 69246 cases of scrub typhus were reported in Yunnan Province from 2013 to 2022,including 19 deaths.The average annual incidence rate was 14.58/100000.The annual incidence rate showed a rapid increase over the years,from 5.95/100000 in 2013 to 25.53/100000 in 2022(χ_(trend)^(2)=30.573,P<0.001).The fatality rate was 0.036%.The number of affected counties or districts increased from 70 in 2013 to 97 in 2022.The top three regions by incidence rate were the Dehong Dai and Jingpo Autonomous Prefecture(10906,85.14/100000),Lincang(13677,55.67/100000),and Baoshan(13406,52.44/100000).The average annual growth rate of new cases was 17.82%.The top three regions by average annual growth rate were the Nujiang Lisu Autonomous Prefecture(84.15%),Qujing City(48.91%),and the Wenshan Zhuang and Miao Autonomous Prefecture(45.12%).In 2013,the areas with high incidence were mainly concentrated in the western and central part of Yunnan Province,but since 2019,the hotspots gradually spread to the southeastern part.In general,the incidence of scrub typhus was higher in males(χ^(2)=332.635,P<0.001).The cases were more in the age group of 0-<5 and 50-<55 years accounting for 11.05% and 11.19%,respectively,more among farmers,and more in summer and autumn.The cases were mainly reported by county/district-level hospitals(56.44%).The median time from disease onset to diagnosis was 4 days.Hospitals at higher levels were associated with a shorter time from onset to diagnosis(H=15.924,P<0

关 键 词：云南省 恙虫病 流行病学 监测 

分 类 号：R513.2[医药卫生—内科学]