2013-2024年中国6岁以下岁儿童肠道传染病流行特征分析

Epidemiological characteristics of intestinal infectious disease in children aged <6 years in China, 2013−2024

  • 摘要:
    目的  6岁以下岁儿童属于肠道传染病高发人群,分析我国6岁以下儿童肠道传染病的流行特征及变化趋势,可为完善优化肠道传染病防控策略和措施提供科学依据。
    方法 通过法定传染病报告系统收集整理2013-2024年我国肠道传染病发病数据,采用描述性流行病学方法,分析发病时间趋势、季节性流行和地区分布特征。构建Joinpoint回归模型计算年平均变化百分比(AAPC)评估发病率变化。以31个省级行政区为单位进行空间自相关分析和时空聚集分析。
    结果 2013-2024年我国6岁以下岁儿童肠道传染病年均报告发病率为2436.13/10万,整体呈下降趋势(AAPC=−4.70%,P=0.017)。其中,男童肠道传染病报告发病率2696.86/10万明显高于女童2134.10/10万(χ2=362 572.900, P<0.001)。6岁以下岁各个年龄组均有肠道传染病病例报告,其中1~岁组报告发病率最高。甲型肝炎、戊型肝炎、痢疾和手足口病报告发病率均呈下降趋势(均P<0.05);伤寒/副伤寒、急性出血性结膜炎和其他感染性腹泻病发病随年份无显著变化趋势(均P>0.05)。5-7月为6岁以下岁儿童肠道传染病高发时间,6月达峰。全局空间自相关分析均具有空间聚集性(全局Moran’s I值为0.17~0.41,均P<0.05)。时空扫描分析显示,2013-2024年全国31个省级行政区共发现8个有统计学意义的时空聚集区(均P<0.001),主要分布于中国东部。
    结论 2013-2024年我国6岁以下岁儿童肠道传染病的报告发病率总体呈下降趋势,主要高发季节为夏季,存在明显的时空聚集。应根据不同地区、不同季节肠道传染病的流行趋势和时空聚集特征对对6岁以下岁儿童采取针对性防控措施。

     

    Abstract:
    Objective Children aged <6 years are highly susceptible to intestinal infectious disease. Understanding its epidemiological characteristics and trend is critical for the development of targeted prevention and control strategies in China.
    Methods The incidence data of intestinal infectious diseases in China from 2013 to 2024 were collected from National Disease Prevention and Control Information System for a descriptive epidemiological analysis on the temporal trend, seasonality, and spatial distribution of the disease. Joinpoint regression model was used to estimate the average annual percent change (AAPC). Global and local spatial autocorrelation and spatiotemporal scanning in 31 provinces (municipalities, autonomous regions) were conducted.
    Results From 2013 to 2024, the mean annual reported incidence of intestinal infectious disease in children aged <6 years was 2436.13/100 000 in China, showing a downward trend (AAPC=−4.70%, P=0.017). The incidence was significantly higher in boys (2696.86/100 000) than in girls (2134.10/100 000) (χ2=362 572.900, P<0.001). The cases were reported in all age groups, with the highest incidence being reported in age goup 1 year. The reported incidences of hepatitis A, hepatitis E, dysentery, and hand, foot and mouth disease exhibited significant declining trends, whereas no significant temporal trends were observed for typhoid/paratyphoid fever, acute hemorrhagic conjunctivitis, or other infectious diarrheal diseases (all P>0.05). The disease mainly occurred from May to July, with the peak in June. Global Moran’s I values ranged from 0.17 to 0.41 (P<0.05), indicating significant spatial clustering. Spatiotemporal scanning analysis identified eight significant clustering areas in China from 2013 to 2024 (all P<0.001), mainly distributed in eastern China.
    Conclusions From 2013 to 2024, the overall incidence of intestinal infectious disease declined in children aged <6 years in China. The diseases exhibited obvious seasonality and regional heterogeneity. Continuous surveillance and region-specific interventions are essential to further reduce the burden level of intestinal infectious disease in young children aged <6 years.

     

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