2013—2022年北京市东城区手足口病流行特征和趋势分析  

Epidemiological characteristics and trend of hand-feet-mouth disease in Dongcheng district of Beijing,2013-2022

作　　者：李春艳 张海艳[1] 汪静[1] LI Chunyan;ZHANG Haiyan;WANG Jing(Dongcheng District Center for Disease Prevention and Control,Public Health Emergency Management Innovation Center,Beijing 100009,China)

机构地区：[1]北京市东城区疾病预防控制中心,公共卫生应急管理创新中心,100009

出　　处：《首都公共卫生》2024年第6期364-368,共5页Capital Journal of Public Health

摘　　要：目的探索北京市东城区手足口病的发病情况和流行趋势变化特征,为制定防控策略提供依据。方法收集2013—2022年东城区手足口病发病资料,分别运用Excel 2019和R4.4.1软件对数据进行整理和χ^(2)检验,用Joinpoiat回归软件拟合线性回归并计算年度变化百分比(APC)和平均年度变化百分比(AAPC)。结果2013—2022年北京市东城区共报告手足口病例4387例,年均报告发病率50.46/10万,2020—2022年年均发病率与2013—2019年比较,差异有统计学意义(χ^(2)=331.37,P<0.001)。2013—2022年东城区手足口病的发病率呈下降趋势(AAPC=-22.90%,P<0.001),2018年是手足口病发病趋势变化的转折点。手足口病发病呈现6—8月主高峰分布,季节变化趋势以6月份为转折点,1—6月发病率呈上升趋势(APC=125.12%,P<0.001),6—12月缓慢下降(APC=-22.40%,P<0.001)。5岁以下儿童报告病例3368例,占报告病例的76.77%。年龄组发病率趋势变化有2个转折点,为4~<5和15~<20岁年龄组,0~<1至4~<5岁年龄组发病率呈快速上升趋势(APC=17.16%,P=0.038);4~<5至15~<20岁年龄组发病率呈下降趋势(APC=-37.27%,P<0.001);15~<20岁至≥60岁年龄组发病率平稳(APC=-4.17%,P=0.251)。不同年份病原体构成比较,差异有统计学意义(χ^(2)=440.96,P<0.001),2019年以后柯萨奇病毒A组6型(coxsackie virus A6,Cox A6)累计报告占比超过其他肠道病毒,成为主要的病原体。结论北京市东城区手足口病报告年发病率存在下降趋势,应重点关注夏季高峰和5岁以下的低龄儿童,同时加强对手足口病的病原学监测,开展针对性的防控措施。Objective To explore the incidence and epidemiological trends of hand-feet-mouth disease(HFMD)in Dongcheng district of Beijing,from 2013 to 2022,to support the development of targeted prevention and control strategies.Methods HFMD cases in Dongcheng district from 2013 to 2022 were collected and analyzed using Excel 2019 and R4.4.1 software for data organization and chi-square tests,while Joinpoint regression software was used for regression analysis and calculating the annual percent change(APC)and the average annual percent change(AAPC).Results A total of 4387 HFMD cases were reported in Dongcheng district of Beijing,from 2013 to 2022,with an average annual incidence rate of 50.46 per 100000.There is a significant difference in the average annual incidence rate between the periods of 2020-2022 and 2013-2019(χ^(2)=331.37,P<0.001).HFMD incidence declined over this period(AAPC=-22.90%,P<0.001),with 2018 identified as a trend turning point.The incidence of HFMD mainly peaks from June to August,with June as a seasonal turning point.The incidence rate showed an upward trend from January to June(APC=125.12%,P<0.001),and slowly declines from June to December(APC=-22.40%,P<0.001).Among cases,3368 cases(76.77%)were children under 5 years old.Age-specific incidence trends had two turning points at 4-<5 and 15-<20 years age group.Incidence increased rapidly from the 0-<1 to 4-<5 years age group(APC=17.16%,P=0.038)and decreased from the 4-<5 to<15-<20 years age group(APC=-37.27%,P<0.001),while remaining stable from 15-<20 to≥60 years age group(APC=-4.17%,P=0.251).HFMD incidence predominantly displayed a unimodal distribution.Statistically significant differences were observed in the composition of pathogens across years(χ^(2)=440.96,P<0.001).After the year of 2019,Coxsackie virus A6(Cox A6)accounted for more than other enteroviruses in cumulative reports,becoming the main pathogen.Conclusions The annual incidence rate of HFMD in Dongcheng district of Beijing,has shown a downward trend.Special attention should be paid to

关 键 词：手足口病 Joinpoint回归 趋势分析 流行特征 

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