基于移动流行区间法和综合指数法构建广州市手足口病流行分级预警阈值  

Establishment of early warning threshold of hand,foot and mouth disease based on moving epidemic method and synthetic index method in Guangzhou

作　　者：张婷瑜 张晓[2] 李俊熹 汪慧[2] 罗雷[2] 秦鹏哲[4] 袁俊[1,3,4] ZHANG Tingyu;ZHANG Xiao;LI Junxi;WANG Hui;LUO Lei;QIN Pengzhe;YUAN Jun(School of Public Health,Southern Medical University,Guangzhou 510515,China;Department of Infectious Disease Control and Prevention,Guangzhou Center for Disease Control and Prevention,Guangzhou 510440,China;School of Public Health,Sun Yat-Sen University,Guangzhou 510080,China;Office of Center Director,Guangzhou Center for Disease Control and Prevention,Guangzhou 510440,China)

机构地区：[1]南方医科大学公共卫生学院,广州510515 [2]广州市疾病预防控制中心传染病预防控制部,广州510440 [3]中山大学公共卫生学院,广州510080 [4]广州市疾病预防控制中心主任室,广州510440

出　　处：《中华疾病控制杂志》2024年第4期473-478,共6页Chinese Journal of Disease Control & Prevention

基　　金：广州市科技计划项目重点研发计划(202206080003);广州市卫生健康科技项目(20221A011071)。

摘　　要：目的结合移动流行区间法(moving epidemic method,MEM)和综合指数法构建广州市手足口病流行分级预警阈值,为手足口病防控政策的制定与实施提供科学依据。方法收集2015―2021年广州市手足口病发病率及聚集性疫情监测数据,通过绘制周平均发病率流行曲线对手足口病双流行高峰进行拆分。选择2015―2019年及2021年春夏流行季的周发病率及聚集性疫情数监测资料,运用MEM和综合指数法建立流行分级预警模型,估计2022年春夏流行季手足口病的流行阈值及分级强度阈值,并运用交叉验证法对模型的预警效果进行验证。结果2022年广州市手足口病第10~37周春夏流行季的流行开始阈值为0.78,流行结束阈值为0.60,中等、高等及极高强度阈值分别为1.85、2.72及3.22。模型最优参数值为2.50,合计灵敏度、特异度及约登指数分别为94.15%、92.67%及0.87,拟合效果较好。结论MEM和综合指数法的结合可以实现更客观、全面的手足口病流行分级预警。Objective Using moving epidemic method(MEM)and synthetic index method to establish grading early warning threshold of hand,foot and mouth disease,so as to provide scientific evidence for hand,foot and mouth disease prevention and control in Guangzhou.Methods The weekly incidence and clustered epidemic data of hand,foot and mouth disease from 2015 to 2021 were collected.Two peaks of hand,foot and mouth disease were split by plotting the epidemic curve of the average weekly incidence.Then data on weekly incidence and clusters of hand,foot and mouth disease in spring and summer from 2015 to 2021(except 2020)were extracted to establish grading early warning model by MEM and synthetic index method.The epidemic threshold and grading intensity thresholds in 2022 were estimated and the early warning effect of established model was verified by cross-validation method.Results Based on the established model,the epidemic start threshold of hand,foot and mouth disease in Guangzhou was 0.78 between the 10th and 37th weeks in 2022.And the medium,high and extremely high intensity thresholds of hand,foot and mouth disease were 1.85,2.72 and 3.22,respectively.The optimal parameterδwas 2.5,and the overall sensitivity,specificity and Youden′s index were 94.15%,92.67%and 0.87,respectively,which indicated good fitting effect.Conclusions The combination of MEM and the synthetic index method can achieve more objective and comprehensive early warning of hand,foot and mouth disease.

关 键 词：手足口病 移动流行区间法 综合指数法 预警 

分 类 号：R181.3[医药卫生—流行病学]