非药物性干预措施对湖北省荆州市法定传染病发病的影响

刘天; 吴杨; 陈琦; 黄继贵; 罗曼

doi:10.3784/jbjc.202202170045

非药物性干预措施对湖北省荆州市法定传染病发病的影响

doi: 10.3784/jbjc.202202170045

刘天^{1, 2,},
吴杨^3, ,,
陈琦³,
黄继贵¹,
罗曼²

1.
荆州市疾病预防控制中心传染病防治所, 湖北荆州 434000
2.
长江大学公共卫生研究中心, 湖北荆州 434000
3.
湖北省疾病预防控制中心传染病防治所, 湖北武汉 430079

基金项目: 荆州市2021年度医疗卫生科技计划（No. 2021HC20）

详细信息

作者简介:
刘天，男，湖北省荆州市人，主管医师，主要从事急性传染病防制工作，Email：jzcdclt@163.com

通讯作者:
吴杨，Tel：　　　，Email：hubeiallen@163.com

中图分类号: R211;R-05
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出版历程
- 收稿日期: 2022-02-17
- 网络出版日期: 2022-06-26

Impact of non-pharmaceutical interventions on incidence of notifiable infectious disease in Jingzhou, Hubei

Liu Tian^{1, 2
,},
Wu Yang^{3
, ,},
Chen Qi³,
Huang Jigui¹,
Luo Man²

1.
Department for Infectious Disease Control and Prevention, Jingzhou Center for Disease Control and Prevention, Jingzhou 434000, Hubei, China
2.
Public Health Research Center, Yangtze University, Jingzhou 434000, Hubei, China
3.
Department for Infectious Disease Control and Prevention, Hubei Center for Disease Control and Prevention, Wuhan 430079, Hubei, China

Funds: This study was supported by fund for Jingzhou 2021 Medical and Health Science and Technology Plan Project (No. 2021HC20)

More Information

Corresponding author: Wu Yang, Email: hubeiallen@163.com

摘要

摘要: 目的评价非药物性干预措施（NPIs）对湖北省荆州市法定传染病（NIDs）发病的影响。方法收集2014年12月29日（2015年1周）至2021年1月3日（2020年53周）荆州市NIDs周发病数。 2015年1周至2020年5周作为历史数据拟合贝叶斯结构时间序列（BSTS）模型并预测2020年6—53周NIDs发病数。 2020年6—53周实际值分别与2015—2019年同期NIDs发病数、模型预测值比较，采用相对下降（RR）评价NPIs对NIDs的影响。分病种、分性别、分年龄、分类（甲乙类、丙类；呼吸道、肠道、血源及性传播、自然疫源性）、分时期（6—18周、19—24周、25—53周）进行亚组分析。结果 2020年6—53周累计报告NIDs 20种18 952例，较2015—2019年同期下降45.26%。基于BSTS模型，2020年6—53周较预期下降60.42%（95% CI: 50.98%～69.66%），其中甲乙类NIDs、丙类NIDs分别下降36.63% （95% CI: 30.60%～43.19%）、60.72% （95% CI: 33.97%～85.32%）。 6—18周、19—24周、25—53周分别下降70.29% （95% CI: 56.88%～83.29%）、61.71% （95% CI: 45.34%～79.13%）、55.68% （95% CI: 45.60%～67.29%）。从传播途径来看，呼吸道传染病下降幅度最大（RR=61.53%，95% CI: 22.60%～100.87%）；其次为肠道传染病（RR=19.72%，95% CI: 2.98%～35.29%）。分年龄来看，15～64岁年龄组下降幅度最大（RR=72.74%, 95% CI: 65.68%～80.10%），其次为0～14岁年龄组（RR=54.51%，95% CI: 19.78%～87.15%）。分地区来看，2020年不同地区新型冠状病毒肺炎（新冠肺炎）发病率与降幅存在正相关性（$ {r_s} $= 0.714，P=0.058）。 RR最大的前5位病种分别为风疹（999.77%，95% CI: −2326.82%～4510.97%）、流行性感冒（68.93%, 95% CI: 91.76～117.10%）、猩红热（88.59%, 95% CI: 64.78%～112.12%）、手足口病（86.09%, 95% CI: 77.46%～94.55%）、急性出血性结膜炎（78.54%, 95% CI: 28.11%～127.26%）。结论 NPIs在控制新冠肺炎疫情同时，大幅降低湖北省荆州市NIDs发病数，其效果在人群、疾病、时间和空间方面具有异质性。
- 非药物性干预措施 /
- 传染性疾病 /
- 公共卫生措施 /
- 新型冠状病毒肺炎 /
- 荆州市
Abstract: Objective To evaluate the impact of non-pharmaceutical interventions (NPIs) on the incidence of notifiable infectious disease in Jingzhou of Hubei province. Methods The weekly incidence of notifiable infectious disease in Jingzhou from December 29, 2014 (1^st week in 2015) to January 3, 2021 (53^rd week in 2020) was collected. The 1st week of 2015 to the 5th week of 2020 was used to fit a Bayesian structural time series (BSTS) model and predict the incidence of notifiable infectious disease from 6^th to 53^rd weeks in 2020. The incidence of notifiable infectious disease from 6^th week to 53^rd week in 2020 was compared with those during the same periods of 2015−2019 and the predicted value of the BSTS model in 2020, and the relative reduction (RR) was used to evaluate the impact of NPIs on the incidence of notifiable infectious disease. Disease types, gender, age groups, disease classification (class A, B and C; respiratory infectious diseases, intestinal infectious diseases, blood-borne and sexually transmitted infections, natural focal diseases), and periods (6^th−18^th week, 19^th−24^th week, 25^th−53^rd week) were used for subgroup analysis. Results A total of 18 952 cases of 20 types of notifiable infectious diseases were reported in Jingzhou from 6^th week to 53^rd week in 2020, a decrease of 45.26% compared with the same periods during 2015− 2019. Based on the BSTS model, a decrease of 60.42% was than expected during 6^th week−53^rd week of 2020 (95% CI: 50.98%–69.66%). The notifiable infectious diseases in class A and B and in class C decreased by 36.63% (95% CI: 30.60%–43.19%) and 60.72% (95% CI: 33.97%–85.32%), respectively. The incidence of notifiable infectious disease during 6^th week−18^th week, 19^th week−24^th week, and 25^th week−53^rd week in 2020 decreased by 70.29% (95% CI: 56.88%–83.29%), 61.71% (95% CI: 45.34%–79.13%), 55.68% (95% CI: 45.60%–67.29%) respectively. In terms of transmission routes, the incidence of respiratory infectious disease had the greatest decrease (RR=61.53%, 95% CI: 22.60%–100.87%), followed by intestinal infectious disease (RR=19.72%, 95% CI: 2.98%–35.29%). In terms of age, the largest decrease was found for people aged 15–64 years (RR=72.74%, 95% CI: 65.68%–80.10%), followed by children aged 0–14 years (RR=54.51%, 95% CI: 19.78%–87.15%). There was a positive correlation between the incidence of COVID-19 and the incidence decrease in different areas in 2020 ($ {r_s} $=0.714, P=0.058). The top 5 diseases with the largest incidence decrease were rubella (999.77%, 95% CI: −2326.82%–4510.97%), influenza (68.93%, 95% CI: 91.76%–117.10%), scarlet fever (88.59%, 95% CI: 64.78%–112.12%), hand foot and mouth disease (86.09%, 95% CI: 77.46%–94.55%) and acute hemorrhagic conjunctivitis (78.54%, 95% CI: 28.11%–127.26%). Conclusion The NPIs against COVID-19 could significantly reduce the incidence of notifiable infectious disease in Jingzhou, and its effect had heterogeneity in terms of population, disease, time and space.
- Non-pharmaceutical interventions /
- Infectious disease /
- Public health measure /
- COVID-19 /
- Jingzhou

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图 1 2015—2019年荆州市NIDs分类拟合贝叶斯结构时间序列模型结果

Figure 1. Fitting of BSTS model for notifiable infectious diseases in Jingzhou, 2015–2019

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图 2 基于贝叶斯结构时间序列模型的2020年6—53周荆州市法定传染病预测数与实际数比较

Figure 2. Comparison of predicted and actual cases of notifiable infectious diseases in Jingzhou based on BSTS model, week 6–53 in 2020

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图 3 基于实际值与模型拟合相对下降的空间分布

Figure 3. Spatial distribution of RRs calculated based on actual values and model fitting

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图 4 基于实际值与模型拟合相对下降的分病种比较

Figure 4. Comparison of RRs by disease type based on actual value and model fitting

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表 1 荆州市2020年6—53周病例数与2015—2019年同期法定传染病年均病例数比较

Table 1. Comparison case number of notifiable infectious disease between week 6–53 in 2020 and week 6–53 during 2015–2019 in Jingzhou

分类	6—53周			6—18周			19—24周			25—53周
分类	2015— 2019年	2020年	RR（%）	2015— 2019年	2020年	RR（%）	2015— 2019年	2020年	RR（%）	2015— 2019年	2020年	RR（%）
甲乙类传染病	17 099	11 900	30.41	4 866	2 790	42.66	2 209	1 734	21.50	10 024	7 376	26.42
丙类传染病	17 526	7 052	59.76	5 147	1 032	79.95	2 794	728	73.94	9 585	5 292	44.79
呼吸道传染病	8 970	4 945	44.87	3 015	1 673	44.51	979	542	44.64	4 976	2 730	45.14
肠道传染病	13 496	5 648	58.15	3 560	606	82.98	2 482	609	75.46	7 454	4 433	40.53
血源及性传播疾病	11 615	8 052	30.68	3 314	1 492	54.98	1 477	1 186	19.70	6 824	5 374	21.25
自然疫源性传染病	544	307	43.57	124	51	58.87	65	125	−92.31	355	131	63.10
性别
女性	14 579	8 062	44.70	4 244	1 652	61.07	2 064	1 024	50.39	8 271	5 386	34.88
男性	20 046	10 890	45.67	5 769	2 170	62.39	2 939	1 438	51.07	11 338	7 282	35.77
年龄组（岁）
0～14	14 729	5 219	64.57	4 280	712	83.36	2 537	432	82.97	7 912	4 075	48.50
15～64	15 735	10 236	34.95	4 567	2 370	48.11	1 951	1 510	22.60	9 217	6 356	31.04
≥65	4 161	3 497	15.96	1 166	740	36.54	515	520	−0.97	2 480	2 237	9.80
地区
沙市区	4 888	1 884	61.46	1 294	400	69.09	713	223	68.72	2 881	1 261	56.23
荆州区	3 978	1 552	60.99	1 151	322	72.02	633	216	65.88	2 194	1 014	53.78
公安县	5 619	3 154	43.87	1 559	565	63.76	831	378	54.51	3 229	2 211	31.53
监利市	4 352	3 098	28.81	1 204	656	45.51	619	444	28.27	2 529	1 998	21.00
江陵县	3 009	1 595	46.99	856	305	64.37	426	265	37.79	1 727	1 025	40.65
石首市	3 809	2 377	37.60	1 138	472	58.52	561	275	50.98	2 110	1 630	22.75
洪湖市	4 077	2 409	40.91	1 197	477	60.15	545	285	47.71	2 335	1 647	29.46
松滋市	4 893	2 883	41.08	1 614	625	61.28	675	376	44.30	2 604	1 882	27.73
合计	34 625	18 952	45.26	10 013	3 822	61.83	5 003	2 462	50.79	19 609	12 668	35.40

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表 2 基于BSTS模型的2020年6—53周荆州市法定传染病预计相对下降情况［%（95% CI）］

Table 2. RR of notifiable infectious diseases in Jingzhou based onBSTS model, week 6–53 in 2020 （%）

分类	6—53周	6—18周	19—24周	25—53周
甲乙类传染病	36.63（30.6～43.19）	43.80（35.18～53.12）	26.05（13.74～38.13）	35.68（28.42～43.49）
丙类传染病	60.72（33.97～85.32）	81.57（51.46～112.17）	72.71（33.04～110.1）	45.35（9.61～77.17）
呼吸道传染病	61.53（22.6～100.87）	71.78（34.51～109.67）	66.82（1.01～131.53）	52.37（2.14～105.48）
肠道传染病	19.72（2.98～35.29）	69.97（50.23～89.51）	42.05（14.71～67.64）	−11.75（−33.3～8.87）
血源及性传播疾病	18.07（6.53～29.48）	46.41（34.15～58.35）	5.68（−11.02～22.37）	7.12（−6.63～20.41）
自然疫源性传染病	−140.51（−313.92～43.95）	−44.37（−348.3～210.84）	−597.74（−935.69～−233.42）	−76.06（−300.72～151.78）
性别
女性	62.04（51.18～72.15）	70.90（56.73～85.25）	63.99（46.6～83.18）	57.65（45.64～69.28）
男性	54.59（44.01～65.18）	66.37（50.65～80.65）	54.98（35.71～74.06）	49.20（37.63～61.48）
年龄组（岁）
0～14	54.51（19.78～87.15）	80.67（43.39～118.72）	75.26（24.49～123.41）	32.59（−15.42～76.32）
15～64	72.74（65.68～80.1）	71.19（63.06～79.52）	63.27（53.32～73.21）	74.79（67.23～82.41）
≥65	26.14（20.13～31.95）	41.42（31.97～50.12）	13.55（1.15～26.07）	22.05（15.1～28.99）
地区
沙市区	72.64（54.45～90.43）	77.18（51.71～103.24）	75.92（45.17～109.87）	70.02（49.75～91）
荆州区	68.26（53.31～83.57）	75.20（52.3～96.87）	68.16（41.81～98.97）	65.16（45.1～82.39）
公安县	42.06（34.26～50）	60.78（48.51～73.73）	47.25（30.43～63.85）	32.71（23.3～42.86）
监利市	46.89（39.48～54.21）	55.43（44.13～66.53）	39.16（24.32～53.88）	44.99（35.81～53.61）
江陵县	52.57（30.62～74.23）	65.71（33.02～94.55）	41.99（0.1～84.35）	49.04（23.94～76.48）
石首市	67.21（51.89～82.72）	73.15（48.91～99.21）	71.12（43.3～103.34）	64.06（46.41～82.31）
洪湖市	79.00（70.99～86.5）	81.38（71.81～91.07）	79.19（67.84～91.1）	78.16（70.16～86.29）
松滋市	68.14（56.19～80.47）	73.28（54.04～90.59）	65.47（38.87～91.66）	66.49（52.55～81.31）
合计	60.42（50.98～69.66）	70.29（56.88～83.29）	61.71（45.34～79.13）	55.68（45.6～67.29）

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