曾四清, 孙立梅, 钟豪杰, 谭小华, 杨芬, 龙遗芳. 2008-2017年广东省手足口病流行趋势变化特征的Joinpoint回归模型分析[J]. 疾病监测, 2019, 34(2): 141-146. DOI: 10.3784/j.issn.1003-9961.2019.02.012
引用本文: 曾四清, 孙立梅, 钟豪杰, 谭小华, 杨芬, 龙遗芳. 2008-2017年广东省手足口病流行趋势变化特征的Joinpoint回归模型分析[J]. 疾病监测, 2019, 34(2): 141-146. DOI: 10.3784/j.issn.1003-9961.2019.02.012
Siqing Zeng, Limei Sun, Haojie Zhong, Xiaohua Tan, Fen Yang, Yifang Long. Joinpoint regression model analysis on epidemiological trends of hand, foot and mouth disease in Guangdong, 2008–2017[J]. Disease Surveillance, 2019, 34(2): 141-146. DOI: 10.3784/j.issn.1003-9961.2019.02.012
Citation: Siqing Zeng, Limei Sun, Haojie Zhong, Xiaohua Tan, Fen Yang, Yifang Long. Joinpoint regression model analysis on epidemiological trends of hand, foot and mouth disease in Guangdong, 2008–2017[J]. Disease Surveillance, 2019, 34(2): 141-146. DOI: 10.3784/j.issn.1003-9961.2019.02.012

2008-2017年广东省手足口病流行趋势变化特征的Joinpoint回归模型分析

Joinpoint regression model analysis on epidemiological trends of hand, foot and mouth disease in Guangdong, 2008–2017

  • 摘要:
    目的了解广东省手足口病流行趋势变化特征。
    方法通过国家“传染病报告信息管理系统”收集2008 — 2017年手足口病发病资料,通过《广东统计年鉴》收集人口资料;采用Joinpoint回归模型进行分析。
    结果2012年为广东省手足口病年发病率趋势变化转折点,2008 — 2012年间呈快速上升趋势(β1=72.552,P=0.001),2012 — 2017年间呈小幅波动上升趋势,但差异无统计学意义(β2=6.647,P=0.588);男、女性年发病率趋势变化不平衡,男性变化速度高于女性。 年平均月发病率呈现“快升缓降”的“单峰”趋势变化特点,5月为峰值和转折点;1 — 5月间发病率呈快速上升趋势,月发病率变化百分比(APC)为138.33%(P=0.002),5 — 12月间呈较缓下降趋势,APC为–19.19%(P=0.002);2008、2013和2017年的月发病率趋势变化有2个转折点,其余年度均只有1个转折点。 年龄组发病率呈现“高升快降低拖尾”的趋势变化特点,2 ~ 岁组和15 ~ 19岁组为转折点;从0 ~ 岁组至2 ~ 岁组,发病率呈上升趋势,年龄组APC为17.32%(P=0.001);从2 ~ 岁组至15 ~ 19岁组,发病率呈下降趋势,APC为−44.81%(P=0.000);从15 ~ 19岁组至≥85岁组,APC为–2.66%(P=0.148),呈现极低位拖尾现象。
    结论广东省手足口病经历了几年快速上升后,进入了小幅波动上升时期,目前仍处在高发态势;年度发病率趋势变化存在性别差异;月发病率趋势变化存在两种模式,存在显著的季节性变化;幼儿为高发人群,是重点防控对象,防控措施要更有针对性。

     

    Abstract:
    ObjectiveTo analyze the change in the epidemiological trends of hand, foot and mouth disease (HFMD)in Guangdong province.
    MethodsThe incidence data of HFMD in Guangdong during 2008–2017 were collected from National Notifiable Infectious Disease Reporting Information System, and population data in Guangdong during this period were collected from Guangdong Statistical Yearbook. The epidemiological trends of HFMD were analyzed by using Joinpoint regression model.
    ResultsThe incidence trend of HFMD began to change in 2012. From 2008 to 2012, the incidence rate of HFMD increased sharply (β1=72.552, P=0.001), and from 2012 to 2017, the incidence increased with slight fluctuation, the difference had no significance (β2=6.647, P=0.588). The incidence change trend was not parallel between males and females, the change extent in males exceeded that in females. The incidence increase sharply from January to May and peaked in May, then it began to decline, the monthly annual percent change (APC) was 138.33%(P=0.002). From May to December, the incidence of HFMD declined slightly, the monthly APC was –19.19% (P=0.002). Two joinpoints were detected among the trend change of the monthly incidence rate of HFMD in 2008、2013 and 2017 years respectively and only one joinpoint was found in the other years. The age specific incidence was characterized by high level in age group from 0– to 2– years (Age group APC=17.32%, P=0.001), decrease rapidly from age group 2– years to 15–19 years (APC=−44.81%, P=0.000), and keeping at very low level from age group 15–19 years to ≥85 years (APC=−2.66%, P=0.148).
    ConclusionThe annual incidence of HFMD in Guangdong first showed a rapid increase and then slight increase with fluctuation during 2008–2017. The trend change of annual incidence rate was significantly different between male and female. Two models were found in the trend change of monthly incidence rate and there were significant seasonal variations. Very most of the HFMD case were among young children, so they were the key object for prevention and control. Prevention and control measures should be more targeted.

     

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