2010-2022年江苏省手足口病暴发疫情流行病学特征及其影响因素分析  

Epidemiological characteristics and influencing factors of hand,foot,and mouth disease outbreaks in Jiangsu province,2010-2022:a register data analysis

作　　者：李明阳 程晓庆 魏叶[1] 樊欢[3] 张雪峰[3] 鲍倡俊[3] 尚庆香 嵇红[3] LI Mingyang;CHENG Xiaoqing;WEI Ye;FAN Huan;ZHANG Xuefeng;BAO Changjun;SHANG Qingxiang;JI Hong(Acute Infectious Disease Prevention and Control Department,Nantong Municipal Center for Disease Control and Prevention,Nantong 226000,China;Epidemiology Training Program,Jiangsu Provincial Centre for Disease Control and Prevention,Nanjing 210000,China;Institute of Acute Infectious Disease Prevention and Control,Center for Disease Control and Prevention,Jiangsu Province,Nanjing 210000,China;School of Public Health,Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南通市疾病预防控制中心急性传染病防制科,南通226000 [2]江苏省现场流行病学培训项目,南京210000 [3]江苏省疾病预防控制中心急性传染病防制所,南京210000 [4]南京医科大学公共卫生学院,南京210000

出　　处：《中国公共卫生》2024年第3期336-341,共6页Chinese Journal of Public Health

基　　金：国家自然科学基金(81672020,81402732);江苏省卫生计生委青年人才项目(QNRC2016552)。

摘　　要：目的 了解江苏省2010-2022年手足口病(HFMD)暴发疫情流行病学特征及其影响因素,为当地HFMD的预防控制提供参考依据。方法 收集中国疾病预防控制中心突发公共卫生事件信息管理系统中江苏省2010年1月1日-2022年12月31日上报的238起HFMD暴发疫情的相关数据,对江苏省HFMD暴发疫情的流行病学特征进行统计学描述,应用ArcGIS 10.7和GeoDa1.18软件分析其空间分布特征,并采用多因素非条件logistic回归模型分析HFMD暴发疫情罹患率和持续时间的主要影响因素。结果 江苏省2010-2022年上报的238起HFMD暴发疫情累计暴露人数167 934人,累计发病数5 296例,暴发疫情罹患率中位数为3.43%;HFMD暴发疫情在春季(3-5月)和秋季(9-11月)高发,分别占36.97%和29.83%;有68.07%的HFMD暴发疫情由苏南地区报告,暴发疫情发生的主要场所为托幼机构或学校,占99.16%;HFMD暴发疫情发现时间和持续时间分别为0~44 d和3~78 d,发现时间和持续时间中位数分别为8 d和15.5 d;HFMD暴发疫情流行优势毒株在2010、2012、2014、2015、2018、2019和2021年均以柯萨奇病毒A16型(Cox A16)为主,2011、2013和2017年均以肠道病毒71型(EV71)为主,2020年以柯萨奇病毒A6型(Cox A6)为主,2016年以Cox A16和EV71为主,2022年以Cox A16和Cox A6为主;HFMD暴发疫情在空间上呈现聚集性分布,暴发疫情罹患率的高-高聚集区主要位于无锡市惠山区、滨湖区、梁溪区、江阴市,常州市武进区、溧阳市和连云港市赣榆区、海州区、连云区;多因素非条件logistic回归分析结果显示,Cox A16感染和混合感染、疫情持续时间≥21 d、报告来源为其他机构的江苏省HFMD暴发疫情罹患率较高,暴发场所为其他机构的江苏省HFMD暴发疫情罹患率较低,事件级别为一般、场所地为县镇、疫情发现时间≥15 d的江苏省HFMD暴发疫情持续时间较长。结论 江苏省2010-2022年HFMD暴发疫情主要发生在春、秋两季,Cox A16为主�Objective To analyze epidemiological characteristics and determinants of hand,foot,and mouth disease(HFMD)outbreaks in Jiangsu province over the period of 2010 to 2022 for developing local HFMD prevention and control measures.Methods The data on 238 HFMD outbreaks reported in Jiangsu province from 2010 through 2022 were collected from the Public Health Emergency Information Management System of the Chinese Center for Disease Control and Prevention.The epidemiological characteristics of the HFMD outbreaks were described using statistical analysis.The spatial distribution characteristics of the outbreaks were analyzed using ArcGIS10.7 and GeoDal.18 software.The main influencing factors of the incidence and duration of the HFMD outbreaks were analyzed using a unconditional multivariate logistic regression model.Results A total of 238 outbreaks of HFMD were reported in the province during the study period,involving a total of 167934 individuals exposed to the epidemic and resulting in 5296 confirmed cases.The median attack rate for these outbreaks was 3.43%.The HFMD outbreaks were more frequently observed during the spring season(March to May)and autumn season(September to November),accounting for 36.97%and 29.83%of all outbreaks respectively.Furthermore,68.07%of the outbreaks occurred in the southern region of the province.Almost all(99.16%)of these outbreaks took place in childcare institutions and schools.The time interval between incidence and identification ranged from 0 to 44 days(median=8 days),while the outbreak duration varied from 3 to 78 days,with a median duration of 15.5 days.The predominant strains responsible for the HFMD outbreaks differed by year:Coxsackievirus A16(Cox A16)was prevalent in 2010,2012,2014,2015,2018,2019,and 2021;enterovirus 71(EV71)dominated in 2011,2013,and 2017;Coxsackievirus(Cox A6)was prominent in 2020;and both Cox A16 and EV71 were significant contributors in 2016;finally,Cox A16 and Cox A6 were identified as major strains in 2022.Geographically speaking,the HFMD outbreaks exhibi

关 键 词：手足口病(HFMD) 暴发疫情 流行病学特征 空间分布特征 影响因素 

分 类 号：R725.1[医药卫生—儿科] R181.3[医药卫生—临床医学]