Epidemiological characteristics of hemorrhagic fever with renal syndrome in Yunnan, 2004−2021
-
摘要:
目的 对2004—2021年云南省肾综合征出血热（HFRS）报告病例进行流行病学分析，了解HFRS流行特征。 方法 从国家法定传染病监测系统获得了2004—2021年云南省HFRS报告病例数据，采用描述性流行病学方法对全省2004—2021年HFRS时间、地区和人群分布和诊断类别资料进行统计分析，并以县级为单位进行空间聚集分析。 结果 2004—2021年全省共报告HFRS病例2556例，年均发病率为0.30 /10万，死亡病例17例，病死率为0.67%；每年主要以3 — 8月（春夏季）为发病高峰，70.81%患者为男性，16～60岁患者占76.72%，77.11%病例为农民；全局空间自相关分析Moran's I系数0.010～0.319，仅2011—2021年有相关性（P＜0.05），高−高聚集区主要集中在大理白族自治州、楚雄彝族自治州和丽江市，实验室确诊病例和病死率存在较强的负相关（r＝−0.720，P=0.019），疑似病例和病死率存在较强的正相关（r=0.649，P=0.042），报告病例数少的地区病死率高。 结论 云南省HFRS在2012—2021年间处于相对高发期，波及地理范围有扩大趋势，但仍呈现明显的时空聚集特征，累及人群逐渐向高龄人群偏移，应推动高发地区落实综合防控措施，提高病例诊断与实验室检测能力。 Abstract:Objective To understand the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Yunnan province from 2004 to 2021. Methods The incidence data of HFRS reported in Yunnan from 2004 to 2021 were obtained from National Notifiable Infectious Diseases Surveillance System for a descriptive epidemiological analysis on the time, area and population distributions of HFRS, and classification of the cases. The spatiotemporal clustering analysis was carried out at county level in the province. Results From 2004 to 2021, a total of 2556 HFRS cases, including 17 deaths, were reported in Yunnan, with an average annual incidence rate of 0.30/100 000 and a case fatality rate of 0.67%. The annual incidence peaked during March-August (spring and summer), Up to 70.81% of the cases were men, 76.72% were aged 16–60 years, and 77.11% were farmers. The global spatial autocorrelation analysis showed that the Moran's I coefficient ranged from 0.010 to 0.319, and only the cases reported during 2011–2021 showed a significant correlation (P＜0.05). High-high clustering areas were mainly in Dali, Chuxiong and Lijiang. In addition, there was a strong negative correlation between the laboratory-confirmed cases and the case fatality rate (r=−0.72, P=0.019), and there was a strong positive correlation between the suspected cases and the case fatality rate (r=0.649, P=0.042), and the case fatality rate was high in areas with less cases. Conclusion The incidence of HFRS in Yunnan reached a relative high level during 2012–2021, the affected areas expanded with obvious spatiotemporal clustering. Population affected became older gradually. It is necessary to promote the implementation of comprehensive prevention and control measures in high-risk areas and improve the cases diagnosis and laboratory testing. -
图 1 2004－2021年云南省肾综合征出血热报告病例数与发病率
Figure 1. The reported cases and incidence of hemorrhagic fever with renal syndrome in Yunnan province from 2004 to 2021
图 2 2004－2021年云南省肾综合征出血热各地区发病率
Figure 2. Incidence rate of hemorrhagic fever with renal syndrome in various regions of Yunnan province, 2004−2021
图 3 2004－2021年云南省肾综合征出血热热点区域示意图
Figure 3. Schematic diagram of hotspots of hemorrhagic fever with renal syndrome in Yunnan province from 2004 to 2021
图 4 2004－2021年云南省肾综合征出血热诊断类别和病死率趋势
Figure 4. Diagnosis categories and mortality trends of hemorrhagic fever with renal syndrome in Yunnan province from 2004 to 2021
表 1 2004－2021年云南省不同性别、年龄组肾综合征出血热患者总数分析
Table 1. Analysis of the total number of patients with hemorrhagic fever with renal syndrome in different gender and age groups from 2004 to 2021
年龄组（岁） 男性 女性 P值 ＜16 40（62.50） 24（37.50） ＜0.001 16～ 1431（72.97） 530（27.03） ＜0.001 ≥60 339（63.84） 192（36.16） ＜0.001 合计 1810（70.81） 746（29.19） 注：括号外数据为病例数（例），括号内数据为构成比（%） 
下载: 导出CSV
表 2 2004－2021年云南省肾综合征出血热发病数全局自相关
Table 2. Global autocorrelation of the incidence of hemorrhagic fever with renal syndrome in Yunnan province
年份 Moran's I系数 Z值 P值 2004 0.084 1.733 0.083 2005 0.093 1.845 0.065 2006 0.041 1.134 0.257 2007 0.073 1.495 0.135 2008 0.011 0.852 0.394 2009 0.010 0.567 0.571 2010 0.029 0.737 0.461 2011 0.311 6.050 0.000 2012 0.129 3.851 0.000 2013 0.081 4.126 0.000 2014 0.036 3.462 0.001 2015 0.146 4.667 0.000 2016 0.207 5.950 0.000 2017 0.233 7.052 0.000 2018 0.269 6.264 0.000 2019 0.319 7.113 0.000 2020 0.252 6.017 0.000 2021 0.177 4.571 0.000
下载: 导出CSV
-
[1] Avšič-Županc T, Saksida A, Korva M. Hantavirus infections[J]. Clin Microbiol Infect, 2019, 21 Suppl: e6–16. DOI: 10.1111/1469-0691.12291. [2] Zhang YZ, Zou Y, Fu ZF, et al. Hantavirus infections in humans and animals, China[J]. Emerg Infect Dis, 2010, 16(8): 1195–1203. DOI: 10.3201/eid1608.090470. [3] Mattar S, Guzmán C, Figueiredo LT. Diagnosis of hantavirus infection in humans[J]. Expert Rev Anti Infect Ther, 2015, 13(8): 939–946. DOI: 10.1586/14787210.2015.1047825. [4] Liu QY, Liu XD, Jiang BF, et al. Forecasting incidence of hemorrhagic fever with renal syndrome in China using ARIMA model[J]. BMC Infect Dis, 2011, 11: 218. DOI: 10.1186/1471−2334−11−218. [5] 靳寿华, 张海林, 杨卫红, 等. 云南省1976-2012年肾综合征出血热流行特征分析[J]. 中国媒介生物学及控制杂志,2013,24(6):498–502. DOI: 10.11853/j.issn.1003.4692.2013.06.006.Jin SH, Zhang HL, Yang WH, et al. Epidemiological analysis of hemorrhagic fever with renal syndrome during 1976 to 2012 in Yunnan province, China[J]. Chin J Vector Biol Control, 2013, 24(6): 498–502. DOI: 10.11853/j.issn.1003.4692.2013.06.006. [6] 尚翠, 张全福, 殷强玲, 等. 汉坦病毒病流行影响因素分析[J]. 中华流行病学杂志,2020,41(6):968–974. DOI:10.3760/cma.j.cn112338−20190916−00678.Shang C, Zhang QF, Yin QL, et al. Influence factors related epidemics on hantavirus disease[J]. Chin J Epidemiol, 2020, 41(6): 968–974. DOI: 10.3760/cma.j.cn112338−20190916−00678. [7] 王芹, 周航, 韩仰欢, 等. 中国2005－2008年肾综合征出血热监测及疫情分析[J]. 中华流行病学杂志, 2010, 31(6): 675–680. DOI: 10.3760/cma.j.issn.0254-6450.2010.06.019.Wang Q, Zhou H, Han YH, et al. Epidemiology and surveillance programs on hemorrhagic fever with renal syndrome in Mainland China, 2005-2008[J]. Chin J Epidemiol, 2010, 31(6): 675–680. DOI: 10.3760/cma.j.issn.0254-6450.2010.06.019. [8] 王芹, 李建东, 张全福, 等. 2014年全国肾综合征出血热监测总结和疫情分析[J]. 疾病监测,2016,31(3):192–199. DOI:10.3784/j.issn.1003−9961.2016.03.005.Wang Q, Li JD, Zhang QF, et al. Surveillance for hemorrhagic fever with renal syndrome in China, 2014[J]. Dis Surveill, 2016, 31(3): 192–199. DOI: 10.3784/j.issn.1003−9961.2016.03.005. [9] 周济华, 张云智, 韩茜, 等. 云南省2013-2018年肾综合征出血热宿主动物监测分析[J]. 医学动物防制,2022,38(4):340–344. DOI: 10.7629/yxdwfz202204008.Zhou JH, Zhang YZ, Han Q, et al. Surveillance and analysis on host animals of hemorrhagic fever with renal syndrome in Yunnan from 2013 to 2018[J]. J Med Pest Control, 2022, 38(4): 340–344. DOI: 10.7629/yxdwfz202204008. [10] 周济华, 张云智, 章域震, 等. 云南省2012-2020年肾综合征出血热流行特征分析[J]. 中国媒介生物学及控制杂志,2021,32(6):715–719. DOI: 10.11853/j.issn.1003.8280.2021.06.012.Zhou JH, Zhang YZ, Zhang YZ, et al. Epidemiological characteristics of hemorrhagic fever with renal syndrome in Yunnan province, China, 2012–2020[J]. Chin J Vector Biol Control, 2021, 32(6): 715–719. DOI: 10.11853/j.issn.1003.8280.2021.06.012. [11] 张蓉, 张宁, 凌锋, 等. 浙江省2005-2020年肾综合征出血热流行趋势分析[J]. 中华流行病学杂志,2021,42(11):2030–2036. DOI:10.3760/cma.j.cn112338−20210528−00435.Zhang R, Zhang N, Ling F, et al. Study on epidemic trend of hemorrhagic fever with renal syndrome in Zhejiang province, 2005–2020[J]. Chin J Epidemiol, 2021, 42(11): 2030–2036. DOI: 10.3760/cma.j.cn112338−20210528−00435. [12] 黄立勇, 周航, 殷文武, 等. 2010年中国肾综合征出血热监测及疫情分析[J]. 中华流行病学杂志,2012,33(7):685–691. DOI:10.3760/cma.j.issn.0254−6450.2012.07.010.Huang LY, Zhou H, Yin WW, et al. The current epidemic situation and surveillance regarding hemorrhagic fever with renal syndrome in China, 2010[J]. Chin J Epidemiol, 2012, 33(7): 685–691. DOI: 10.3760/cma.j.issn.0254−6450.2012.07.010. [13] 宋宁娟, 谢昀, 袁辉, 等. 江西省2012-2017年肾综合征出血热疫情分析[J]. 中华疾病控制杂志,2019,23(6):685–689. DOI: 10.16462/j.cnki.zhjbkz.2019.06.013.Song NJ, Xie Y, Yuan H, et al. Analysis on the prevalence of hemorrhagic fever with renal syndrome in Jiangxi province from 2012 to 2017[J]. Chin J Dis Control Prev, 2019, 23(6): 685–689. DOI: 10.16462/j.cnki.zhjbkz.2019.06.013. [14] Zhang S, Wang SW, Yin WW, et al. Epidemic characteristics of hemorrhagic fever with renal syndrome in China, 2006–2012[J]. BMC Infect Dis, 2014, 14: 384. DOI: 10.1186/1471−2334−14−384. [15] Shang C, Sun YW, Yin QL, et al. Hemorrhagic fever with renal syndrome - Liaoning province, China, 1999–2018[J]. China CDC Wkly, 2020, 2(20): 350–354. DOI: 10.46234/ccdcw2020.091. [16] 宋宁娟, 谢昀, 丁晟, 等. 江西省2013-2018年肾综合征出血热空间自相关分析[J]. 中华疾病控制杂志,2020,24(8):876–880. DOI: 10.16462/j.cnki.zhjbkz.2020.08.003.Song NJ, Xie Y, Ding S, et al. Analysis of spatial autocorrelation of hemorrhagic fever with renal syndrome in Jiangxi province from 2013 to 2018[J]. Chin J Dis Control Prev, 2020, 24(8): 876–880. DOI: 10.16462/j.cnki.zhjbkz.2020.08.003. -
点击查看大图
图(4) / 表(2)
计量
- 文章访问数: 118
- HTML全文浏览量: 60
- PDF下载量: 23
- 被引次数: 0
