2018-2024年北京市大兴区水痘流行病学特征分析

Epidemiological characteristics of varicella in Daxing district of Beijing, 2018−2024

  • 摘要:
    目的 分析2018-2024年北京市大兴区水痘的流行病学特征,为更有效地控制水痘疫情提供科学依据。
    方法 2018-2024年大兴区水痘发病数据来源于全民健康信息化疾病预防控制信息系统,采用Excel 2019和R 4.1.1软件对水痘发病数据等进行描述性流行病学分析,运用Geoda软件开展空间自相关分析,使用SaTScan10.1.3软件进行时空扫描分析。
    结果 2018-2024年北京市大兴区共报告水痘病例5 290例,年均报告发病率为42.16/10万;地区间发病率差异有统计学意义(P<0.01);水痘发病总体呈季节性双峰分布,主高峰在10-12月,次高峰在5月;年均报告发病率居前两位的年龄组依次为0~4岁(195.50/10万)和15~19岁(154.41/10万);病例主要为学生(26.86%)及散居儿童(17.64%)。学生及幼托儿童水痘病例中,有免疫史者的发热、中重度出疹比例低于无免疫史者(P<0.01)。全局自相关分析显示,2018、2020年大兴区水痘呈空间聚集性(P均<0.05);局部空间自相关分析显示,2018、2019、2024年存在高−高聚集区,且相对集中分布于西北部区域。时空扫描分析共发现10个聚集区,其中Ⅰ类聚集区位于观音寺街道,聚集时间为2018年3月-2019年6月。
    结论 2018-2024年北京市大兴区水痘总体发病呈下降趋势;发病具有地区差异,且全年呈季节性双峰分布;高发人群为学生及散居儿童,发病年龄集中在0~4岁和15~19岁;有水痘疫苗免疫史者较无免疫史者临床症状轻微。发病呈局部聚集性特征,主要集中于大兴区西北部区域。建议提升高发地区、重点人群水痘监测敏感性和及时处置能力;持续加强水痘疫苗接种宣传,提高适龄儿童疫苗接种率。

     

    Abstract:
    Objective To analyze epidemiological characteristics and spatiotemporal clustering of varicella in Daxing district of Beijing, 2018−2024, and provide scientific evidence for more effective control of varicella.
    Methods The incidence data of varicella in Daxing from 2018 to 2024 were collected from National Health Information System for Disease Prevention and Control. Software Excel 2019 and R 4.1.1 were used to analyze the varicella incidence data, and software Geoda was used for spatial autocorrelation analysis. SaTScan 10.1.3 was used for spatiotemporal scanning analysis.
    Results A total of 5 290 varicella cases were reported during 2018−2024 in Daxing, the average annual incidence was 42.16/100 000. There was statistically significant difference in the incidence among different sub-districts (P<0.01). The overall incidence of varicella showed two seasonal peaks, with the main peak occurring during October-December and -subpeak in May. The top two age groups with high average annual reported incidence rate were age group 0~4 years (195.50/100 000) and age group 15~19 years (154.41/100 000). The cases were mainly students (26.86%), followed by home-cared children (17.64%). Among the varicella cases in students and preschool children, the proportion of the children with fever and moderate-to-severe rash were lower in those with vaccination history than in those without vaccination history (P<0.05). The global autocorrelation analysis indicated that the incidence of varicella showed spatial clustering in 2018 and 2020 (P<0.05). Local spatial autocorrelation analysis indicated the presence of "high-high" clustering areas in 2018, 2019, and 2024 in the northwestern area. Spatiotemporal scanning analysis detected ten clustering areas, of which claas I clustering area was in Guanyinsi from March 2018 to June 2019.
    Conclusion From 2018 to 2024, the overall incidence of varicella in Daxing showed a declining trend. The incidence of the disease had area specific disparities and two seasonal peaks. The main populations at high-risk were students and home-cared children, and the cases were mainly distributed in age groups 0~4 years and 15~19 years. Furthermore, the children with vaccination history had milder clinical symptoms compared with those unvaccinated. The incidence of the disease had local spatial clustering in the district, which was mainly in the northwestern area. It is suggested to improve surveillance sensitivity and response timeliness for varicella in areas with high-incidence and key populations, and continuously strengthen vaccination promotion to increase the vaccination rate of age-eligible children.

     

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