2015—2022年四川省猩红热流行特征和时空聚集性分析  

Epidemiological characteristics and temporal-spatial clustering of scarlet fever in Sichuan Province from 2015 to 2022

作　　者：李羚[1] 杜飞[1] 吕强[1] 吴朝学[1] 唐雪峰[1] LI Ling;DU Fei;LYU Qiang;WU Chaoxue;TANG Xuefeng(Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川省疾病预防控制中心,成都610041

出　　处：《预防医学情报杂志》2024年第9期1080-1087,共8页Journal of Preventive Medicine Information

摘　　要：目的了解四川省猩红热流行特征、动态变化趋势及时空聚集性,为疾病的科学防控提供参考。方法通过中国疾病预防控制中心传染病监测和监测报告管理系统导出数据,采用描述性流行病学方法,对2015—2022年四川省间猩红热流行趋势和特征进行分析。采用R 4.3.0软件进行月分布热图绘制,SaTScan 10.0软件进行回顾性时空扫描。结果2015—2022年四川省猩红热年均发病率为1.95/10万,发病率呈波动下降趋势(Z=-25.43,P<0.001)。确诊病例占比3.84%。与偶数年比,奇数年发病强度高、范围广。除2020年外,发病呈现双峰分布,发病高峰为4至7月和10月至次年1月,春季高峰高于冬季高峰。病例集中在3~6岁,幼托儿童、学生发病数占总病例数的83.72%。男性发病率高于女性(χ^(2)=322.34,P<0.001)。报告医院级别以三级居多,占报告病例的74.61%。发病率前5位地区为乐山市、凉山州、绵阳市、成都市和自贡市。2020—2022年猩红热年均发病率1.45/10万,较2015—2019年的2.25/10万下降35.60%,其中全省15个地区发病率均有所下降;上升幅度较大的地区为甘孜州、宜宾市、泸州市和自贡市。时空扫描共探测出4个时空聚集区(1个一类和3个二类聚集区),其中一类聚集区在眉山市、乐山市和成都市,聚集时间为2015年1月9日至2019年1月8日(扫描半径=86.34 km,LLR=1220.49,RR=2.81,P<0.001)。结论四川省猩红热发病率呈下降趋势,尤其是新冠疫情期间。3~6岁幼托儿童高发,建议高发地区在发病高峰到来之前,即开学后的3月和9月,对幼托机构和学校开展针对性的健康宣教并做好监测工作。加强医疗机构诊断能力,不断提高实验室诊断比例,谨防漏诊、漏报和误报。Objective To understand epidemiological characteristics,dynamic change trend and temporalspatial clustering of scarlet fever in Sichuan Province,and to provide reference for scientific prevention and control.Methods Data were exported through the Infectious Disease Surveillance and Surveillance Report Management systems of Chinese Center for Disease Control and Prevention.Description epidemiology analysis was conducted to analyze epidemiological characteristics and trends of scarlet fever in Sichuan Province from 2015 to 2022.R 4.3.0 software was used to draw the monthly distribution heat map,and SaTScan 10.0 software was used for retrospective temporal-spatial scanning statistics.Results The average annual incidence of scarlet fever from 2015 to 2022 was 1.95/10~5,the incidence showed a fluctuating downward trend(Z=-25.43,P<0.001).Confirmed cases accounted for 3.84%.Compared with even years,odd years had higher incidence intensity and wider range.In addition to 2020,the incidence of scarlet fever showed two peaks,the peaks were from April to July and from October to January of the next year,and the peak in spring was higher than that in winter.The cases were concentrated in 3-6 years old,and children and students accounted for 83.72%of the total cases.The incidence was higher in men than in women(χ^(2)=322.34,P<0.001).Most of the reported hospitals were grade 3,with 74.61%of the reported cases.The top 5 incidence areas were Leshan,Liangshan,Mianyang,Chengdu and Zigong.The average annual incidence of scarlet fever was 1.45/10~5 from 2020 to 2022,down 35.60%from 2.25/10~5dein 2015 to 2019,among them,the incidence of scarlet fever in 15 regions had decreased,and the incidence of scarlet fever in Ganzi,Yibin,Luzhou and Zigong have a large increase.A total of 4 temporal-spatial clusters(1 CategoryⅠcluster and 3 CategoryⅡcluster)were detected by temporal-spatial scanning,of which categoryⅠcluster was located in Meishan,Leshan and Chengdu from 9 January 2015 to 8 January 2019(scanning radius=86.34 km,LLR=1220.49

关 键 词：猩红热 流行特征 时空聚集 

分 类 号：R181.3[医药卫生—流行病学] R515.1[医药卫生—公共卫生与预防医学]