2018-2024年云南省大理白族自治州百日咳流行特征分析

Analysis of epidemiological characteristics of pertussis in Dali Bai Autonomous Prefecture, Yunnan province, 2018−2024

  • 摘要:
    目的  分析云南省大理白族自治州(大理州)2018-2024年间百日咳流行特征,为今后该病有效防控措施的制定提供科学依据。
    方法 采用描述性流行病学方法,对从中国疾病预防控制信息系统和云南省免疫规划信息系统收集到的2018-2024年大理州百日咳报告病例相关数据进行整理和描述性统计分析。
    结果 2018-2024 年大理州共报告百日咳病例387例,年均发病率 1.65/10 万;2021年起呈持续上升趋势,2024年迅速升至 10.41/10 万(线性趋势χ2=602.375,P<0.001)。 病例分布于全州12 县(市),宾川县(44.96%)、祥云县(25.06%)位居前2位。 夏秋季为高发季节,主要呈“夏主秋次”双峰。 年龄构成占比主要为6~<9岁(35.14%,)、1~<6岁(21.19%)、9~<15岁(21.19%);职业以学生(47.03%)、散居儿童(23.77%)为主。 18岁以下病例未完成免疫程序比例随年龄增长下降,4~<18岁组94.51%接种≥4剂无细胞百白破联合疫苗(DTaP),0~<4岁组DTaP免疫史0剂占比最高为51.72%,且3~<6月龄占比为66.67%。 大理州医疗机构开展百日咳核酸检测项目检测覆盖率为29.27%。
    结论 大理州近年来百日咳发病率呈大幅上升趋势,呈现地区集中、季节性双峰及学龄儿童为主的特点,适龄儿童疫苗接种及时性、医疗机构诊断能力不足以及疫苗产生抗体水平自然衰减可能是大理州百日咳发病率上升的重要危险因素,需加强3岁以内儿童DTaP全程及时免疫、学龄儿童加强针接种工作和百日咳检测技术提升,加强常规监测的同时补充开展百日咳血清流行病学调查工作。

     

    Abstract:
    Objective  To analyze the epidemiological characteristics in Dali Bai Autonomous Prefecture, Yunnan province from 2018 to 2024, so as to provide a scientific basis for formulating effective prevention and control measures in the future.
    Methods Descriptive epidemiological methods were used to collate, describe, and statistically analyze the reported pertussis case data from 2018 to 2024 in Dali Prefecture, collected from the China Disease Prevention and Control Information System and the Yunnan Provincial Immunization Program Information System.
    Results From 2018 to 2024, a total of 387 pertussis cases were reported in Dali Prefecture, with an average annual incidence rate of 1.65/100000. The incidence showed a continuous upward trend starting from 2021, rising rapidly to 10.41/100000 in 2024 (Linear trend χ2=602.375, P<0.001). Cases were distributed across all 12 counties (cities) in the prefecture, with Binchuan county (44.96%) and Xiangyun county (25.06%) ranking the top two. Summer and autumn were the high-incidence seasons, primarily showing a bimodal distribution with “summer peak followed by autumn peak”. The age distribution was mainly 6−<9 years old (35.14%), −<6years old (21.19%), and 9−<15years old (21.19%). The majority of cases were students (47.03%) and scattered children (23.77%). The proportion of cases under 18 years old who did not complete the immunization schedule decreased with age; 94.51% of the 4~18 year old group received ≥ 4 doses of diphtheria,tetanus and acellular pertussis combined vaccine (DTaP) vaccination. In the 0−<4years age group, the proportion with 0 doses of DTaP vaccination history was the highest at 51.72%, and within this group, 66.67% were 3−<6 months old. The coverage of pertussis nucleic acid testing projects implemented by medical institutions in Dali Prefecture was 29.27%.
    Conclusion In recent years, pertussis incidence in Dali Prefecture has risen substantially, featuring regional clustering, seasonal bimodality, and predominance in school-age children. Key contributors to this upward trend include delayed vaccination in eligible children, inadequate diagnostic capacity of medical institutions, and natural attenuation of vaccine-induced antibody levels. To address this issue, priority should be given to ensuring timely completion of full-dose DTaP immunization in children under 3 years, expanding booster vaccination coverage in school-age populations, and upgrading pertussis detection techniques. Additionally, routine surveillance needs to be strengthened and complemented with pertussis seroepidemiological investigations.

     

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