2014－2018年广西柳州市手足口病流行病学特征及病原学监测分析

周婉婉; 陈蔚恩; 梁忠福; 杨俊; 谢艺红

doi:10.3784/jbjc.202108160445

2014－2018年广西柳州市手足口病流行病学特征及病原学监测分析

doi: 10.3784/jbjc.202108160445

1.
广西医科大学公共卫生学院, 广西南宁 530021
2.
广西壮族自治区柳州市疾病预防控制中心, 广西柳州 545005

详细信息

作者简介:
周婉婉，女，广西壮族自治区柳州市人，在读硕士研究生，主要从事流行病与卫生统计学研究，Email：gxzhouww@163.com

陈蔚恩，男，广西壮族自治区柳州市人，副主任医师，主要从事病媒生物控制工作，Email：1176254131@qq.com

通讯作者:
谢艺红，Tel：0771–5358144；Email：gxxieyihong@163.com

中图分类号: R211; R181.2
计量
- 文章访问数: 173
- HTML全文浏览量: 94
- PDF下载量: 68
- 被引次数: 0
出版历程
- 收稿日期: 2021-08-16
- 网络出版日期: 2022-03-07
- 刊出日期: 2022-05-31

Epidemiological and etiological characteristics of hand foot and mouth disease in Liuzhou, Guangxi, 2014−2018

1.
School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
2.
Liuzhou Center for Disease Control and Prevention, Liuzhou 545005, Guangxi, China

More Information

Corresponding author: Xie Yihong, Email: gxxieyihong@163.com

摘要

摘要: 目的分析2014—2018年广西壮族自治区柳州市手足口病的流行病学特征和病原学检测结果，为柳州市手足口病的防控提供依据。方法采用描述性和空间流行病学方法分析手足口病的流行病学特征，利用全局和局部空间自相关分析手足口病的空间聚集性，利用趋势面分析手足口病的空间分布趋势，并对各年度的病原学检测结果进行分析。结果 2014—2018年柳州市手足口病的平均发病率为821.59/10万，主要为0～5岁儿童（95.90%），以散居儿童居多（64.58%）。 2014—2018年手足口病发病率及重症病例数总体呈下降趋势，其高发季节在4—7月和9—11月。病原学检测结果显示，2014年主要病原为肠道病毒71型（EV71）和其他肠道病毒，2015和2017年以其他肠道病毒为主（>80%），2016和2018年以柯萨奇病毒A组16型（Cox A16）为主，其次为其他肠道病毒，EV71占比较低。手足口病存在高度空间聚集性，热点区域集中在柳州市南部地区，冷点区域集中在融水苗族自治县；高发地区集中在柳南区城区、鱼峰区城区、柳北区城区、城中区、拉堡镇、鹿寨镇、雒容镇、三都镇、进德镇、成团镇、沙塘镇、四排乡和古宜镇。趋势面分析显示，手足口病发病率总体呈由北向南逐渐升高、东西两边向中间逐渐升高趋势。结论柳州市手足口病以<5岁散居儿童多见，有明显夏、秋季的发病高峰和地区聚集性，不同年份主导病原不同，应加强高发地区的危险因素研究，为防控策略的制定和公共卫生资源的优化配置提供科学依据。
- 手足口病 /
- 流行病学特征 /
- 病原学 /
- 空间自相关 /
- 趋势面分析
Abstract: Objective To understand the epidemiological and etiological characteristics of hand foot and mouth disease (HFMD) in Liuzhou, Guangxi, from 2014 to 2018, and provide evidences for the prevention and control of HFMD. Methods Descriptive and spatial analyses were used to analyze the epidemiological characteristics of HFMD in Liuzhou. Global and local spatial autocorrelation analysis was used to analyze the spatial clustering of HFMD. The trend surface analysis was used to evaluate the spatial distribution trend of HFMD, and the annual etiological test results of HFMD were analyzed. Results The annual average incidence rate of HFMD was 821.59/100 000 in Liuzhou from 2014 to 2018. Most cases were aged 0–5 years (95.90%), and 64.58% of them were children outside child care settings. The incidence rate and severe case number of HFMD showed decline trends from 2014 to 2018 (P<0.01), and the epidemic season was from April to July and September to November. EV71 and other enteroviruses were the main pathogens in 2014. Other enteroviruses were the main pathogens in 2015 and 2017 (＞80%). Cox A16 was the main pathogen in 2016 and 2018, followed by other enteroviruses, and EV71 accounted for a relatively low proportion. There was spatial clustering with hot spots in the southern part of Liuzhou and cold spots in Rongshui Miao autonomous county. The high-incidence areas were in Liunan, Yufeng, Liubei, Chengzhong districts, and Labao, Luzhai, Luorong, Sandu, Jinde, Chengtuan, Shatang, Sipai and Guyi townships. The trend surface analysis showed that the incidence of HFMD increased gradually from north to south, and from east and west to central area. Conclusion HFMD mainly occurred in children under 5 years old in Liuzhou with the seasonal incidence peaks in summer and autumn, and had obviously spatial clustering distribution. The predominant pathogens were different in different years. It is necessary to further explore the risk factors in high-risk areas to provide scientific evidences for the development of HFMD prevention and control strategies and the allocation of public health resources.
- Hand foot and mouth disease /
- Epidemiological characteristics /
- Etiology /
- Spatial autocorrelation /
- Trend surface analysis

HTML全文

图 1 2014－2018年柳州市手足口病发病率、重症病例发生率及病死率

Figure 1. Incidence rate, severe cases proportion and case fatality rate of hand foot and mouth disease in Liuzhou, 2014–2018

下载: 全尺寸图片幻灯片

图 2 2014－2018年柳州市手足口病病例月份分布

Figure 2. Monthly distribution of hand foot and mouth disease cases in Liuzhou, 2014–2018

下载: 全尺寸图片幻灯片

图 3 2014－2018年柳州市各乡镇手足口病各年度及5年平均发病率、累计重症病例数及死亡病例数

Figure 3. Annual and 5-year average incidences, cumulative severe case numbers, and deaths of hand foot and mouth disease in each township in Liuzhou, 2014–2018

下载: 全尺寸图片幻灯片

图 4 2014－2018年柳州市手足口病平均发病率局部空间自相关分析

Figure 4. Local spatial autocorrelation analysis on average incidences of hand foot and mouth disease in Liuzhou, 2014–2018

下载: 全尺寸图片幻灯片

图 5 2014－2018年柳州市手足口病发病率趋势面分析

注：X线. 经度；Y线. 纬度；Z线. 发病率；a线/绿线. 东西走向的发病率趋势；b线/蓝线. 南北走向的发病率趋势

Figure 5. Trend surface analysis on incidences of hand foot and mouth disease in Liuzhou, 20142018

下载: 全尺寸图片幻灯片

表 1 2014－2018年柳州市手足口病病例人群分布特征

Table 1. Demographic characteristics of hand foot and mouth disease cases in Liuzhou, 2014–2018

组别	全部病例（n=154 857）		重症病例（n=192）		死亡病例（n=13）
组别	病例数（例）	构成比（%）	病例数（例）	构成比（%）	病例数（例）	构成比（%）
性别
男性	87 821	56.71	115	59.90	10	76.92
女性	67 036	43.29	77	40.10	3	23.08
年龄组（岁）
0～	15 719	10.15	20	10.42	1	7.69
1～	47 623	30.75	89	46.35	4	30.77
2～	36 511	23.58	49	25.52	5	38.46
3～	29 053	18.76	20	10.42	3	23.08
4～	13 655	8.82	8	4.17	0	0.00
5～	5 947	3.84	5	2.60	0	0.00
>5	6 349	4.10	1	0.52	0	0.00
职业
散居儿童	100 012	64.58	160	83.33	12	92.31
幼托儿童	51 145	33.03	31	16.15	1	7.69
学生	3 392	2.19	1	0.52	0	0.00
其他	308	0.20	0	0.00	0	0.00

下载: 导出CSV

表 2 2014－2018年柳州市手足口病病原学检测结果

Table 2. Etiological test results of hand foot and mouth disease in Liuzhou, 2014–2018

年份	病例数（例）	阳性病例数（例）	阳性率（%）	肠道病毒71型		柯萨奇病毒A组16型		其他肠道病毒
年份	病例数（例）	阳性病例数（例）	阳性率（%）	阳性病例数（例）	构成比（%）	阳性病例数（例）	构成比（%）	阳性病例数（例）	构成比（%）
2014	993	755	76.03	279	36.96	189	25.03	287	38.01
2015	934	773	82.76	73	9.44	56	7.25	644	83.31
2016	900	619	68.78	123	19.87	285	46.04	211	34.09
2017	1 142	478	41.86	53	11.09	21	4.39	404	84.52
2018	901	591	65.59	95	16.07	254	42.98	242	40.95
合计	4 870	3 216	66.04	623	19.37	805	25.03	1 788	55.60

下载: 导出CSV

参考文献(13)

[1]	中华人民共和国国家卫生健康委员会. 手足口病诊疗指南(2018年版)[J]. 传染病信息,2018,31(3):193–198. DOI:10.3969/j.issn.1007−8134.2018.03.001. National Health Commission of the People′s Republic of China. Hand, foot and mouth disease diagnosis and treatment guidelines (2018)[J]. Infec Dis Inf, 2018, 31(3): 193–198. DOI: 10.3969/j.issn.1007−8134.2018.03.001.
[2]	周海峰. 基于GIS的手足口病扩散模型与空间分布研究—以宁波市为例［M］. 宁波: 宁波大学, 2010. Zhou HF. A study on the spread model and spatial distribution of HFMD based on GIS－a case study of Ningbo［M］. Ningbo: Ningbo University, 2010.
[3]	黄翠, 陈晓晖, 谢峰, 等. GIS在传染病防控方面的应用[J]. 公共卫生与预防医学,2017,28(1):77–80. Huang C, Chen XH, Xie F, et al. Application of GIS (geographic information system) in infectious diseases control and prevention[J]. J Public Health Prev Med, 2017, 28(1): 77–80.
[4]	姚梦雷, 黄继贵. 地理信息系统在荆州市手足口病监测中的应用[J]. 公共卫生与预防医学,2015,26(4):32–34. Yao ML, Huang JG. Application of geographic information system (GIS) for hand-foot-mouth disease (HFMD) surveillance in Jingzhou city[J]. J Public Health Prev Med, 2015, 26(4): 32–34.
[5]	蒋丽娜, 谭毅, 王晶, 等. 2008-2015年广西手足口病流行病学特征及时空聚集性分析[J]. 中华疾病控制杂志,2017,21(4):340–344. DOI: 10.16462/j.cnki.zhjbkz.2017.04.005. Jiang LN, Tan Y, Wang J, et al. Epidemiological characteristics and temporal- spatial clustering of hand, foot and mouth disease in Guangxi from 2008 to 2015[J]. Chin J Dis Control Prev, 2017, 21(4): 340–344. DOI: 10.16462/j.cnki.zhjbkz.2017.04.005.
[6]	刘蕾, 张凌云, 李家文. 近52年柳州地区降水时空分布变化[J]. 气象研究与应用,2013,34(2):22–25. DOI:10.3969/j.issn.1673−8411.2013.02.005. Liu L, Zhang LY, Li JW. Spatial and temporal distribution variation of precipitation in Liuzhou during Recent 52 years[J]. J Meteorol Res Appl, 2013, 34(2): 22–25. DOI: 10.3969/j.issn.1673−8411.2013.02.005.
[7]	张驰, 张旭彬, 姚丽君, 等. 2009-2018年汕头市手足口病流行特征与时空聚集性[J]. 中华疾病控制杂志,2020,24(5):573–578,596. DOI: 10.16462/j.cnki.zhjbkz.2020.05.015. Zhang C, Zhang XB, Yao LJ, et al. Epidemiological characteristics and temporal-spatial clustering analysis of hand, foot and mouthdisease in Shantou city[J]. Chin J Dis Control Prev, 2020, 24(5): 573–578,596. DOI: 10.16462/j.cnki.zhjbkz.2020.05.015.
[8]	陈琦, 吴杨, 童叶青, 等. 2013-2017年湖北省手足口病时空聚集性分析[J]. 公共卫生与预防医学,2019,30(2):42–45. DOI:10.3969/j.issn.1006−2483.2019.02.011. Chen Q, Wu Y, Tong YQ, et al. Temporal-spatial clustering analysis of hand, foot and mouth disease in Hubei province (2013–2017)[J]. J Public Health Prev Med, 2019, 30(2): 42–45. DOI: 10.3969/j.issn.1006−2483.2019.02.011.
[9]	郭凤云, 路紫. 基于空间分析方法的疾病地理研究进展[J]. 地理信息世界,2009,7(6):22–26,46. DOI:10.3969/j.issn.1672−1586.2009.06.004. Guo FY, Lu Z. Disease geography research development based on spatial analysis method[J]. Geomat World, 2009, 7(6): 22–26,46. DOI: 10.3969/j.issn.1672−1586.2009.06.004.
[10]	韩桃利, 郭悦, 许文波, 等. 2008-2017年中国大陆手足口病空间聚集性分析[J]. 病毒学报,2018,34(5):698–706. DOI: 10.13242/j.cnki.bingduxuebao.003449. Han TL, Guo Y, Xu WB, et al. Spatial clustering of hand, foot and mouth disease in Mainland China from 2008 to 2017[J]. Chin J Virol, 2018, 34(5): 698–706. DOI: 10.13242/j.cnki.bingduxuebao.003449.
[11]	吕榜军, 程红, 杨晓波, 等. 2010-2015年柳州市手足口病流行病学及病原学特征分析[J]. 中国病毒病杂志,2018,8(2):124–129. DOI:10.16505/j.2095−0136.2018.0027. Lv BJ, Cheng H, Yang XB, et al. Epidemiological features of hand, foot and mouth disease from 2010 to 2015 in Liuzhou city of China[J]. Chin J Viral Dis, 2018, 8(2): 124–129. DOI: 10.16505/j.2095−0136.2018.0027.
[12]	姚梦雷, 刘天, 王黎, 等. 2008-2017年湖北省荆州市手足口病时空特征分析[J]. 疾病监测,2019,34(7):634–639. DOI:10.3784/j.issn.1003−9961.2019.07.013. Yao ML, Liu T, Wang L, et al. Spatial-temporal distribution characteristics of hand, foot and mouth disease in Jingzhou, Hubei, 2008–2017[J]. Dis Surveill, 2019, 34(7): 634–639. DOI: 10.3784/j.issn.1003−9961.2019.07.013.
[13]	张小康, 朱春晖, 陈强. 南昌地区儿童手足口病发病影响因素分析[J]. 华中科技大学学报:医学版,2013,42(3):359–364. DOI:10.3870/j.issn.1672−0741.2013.03.028. Zhang XK, Zhu CH, Chen Q. Influence factors for Hand-foot-mouth disease among children in Nanchang district[J]. Acta Med Univ Sci Technol Huazhong, 2013, 42(3): 359–364. DOI: 10.3870/j.issn.1672−0741.2013.03.028.