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2006－2025年山东省肾综合征出血热发病趋势及年龄−时期−队列效应分析

nalysis on incidence trend of hemorrhagic fever with renal syndrome and its age-period-cohort effects in Shandong, 2006–2025

    摘要
  • 摘要:
    目的 分析2006－2025年山东省肾综合征出血热（HFRS）发病态势及年龄−时期−出生队列效应，为明确不同年龄阶段及出生队列人群的疾病风险，识别重点防控人群提供理论依据。
    方法 通过中国疾病预防控制信息系统传染病监测系统收集山东省HFRS报告发病资料，应用Joinpoint回归模型分析HFRS发病率的变化情况及历史转折点，应用年龄−时期−队列模型分析HFRS发病率随年龄、时期和出生队列效应的变化。
    结果 2006－2025年山东省HFRS年均报告发病率为1.02/10万。Joinpoint回归模型结果显示，2006－2025年HFRS发病率整体呈下降态势（平均年度变化百分比=−5.31%，P=0.010）。 2014年为转折点，2006－2014年无显著变化年度变化百分比（APC）=4.03%，P=0.231，2014－2025年呈显著下降态势（APC=−11.57%，P<0.001）。 年龄−时期−队列模型结果显示，随着年龄的增加，2006－2025年山东省HFRS报告发病率总体呈先上升后下降的态势（χ2=139.835，P<0.001），发病率高峰集中在50岁及以上中老年年龄组。 随着时期的推移，HFRS报告发病率呈现出先缓慢上升后快速下降的态势（χ2=362.391，P<0.001），发病风险在2011－2015年时期达到最高值。 随着出生年份的推移，HFRS报告发病率呈现逐步下降的态势（χ2=617.145，P<0.001），发病风险在1931－1935年出生组时为最高值。 局部漂移结果显示，HFRS报告发病率在各年龄组内部均呈现下降的态势（χ2=62.769，P<0.001）。
    结论 山东省HFRS发病率整体呈下降趋势，2014年后下降尤为显著。 发病风险存在明显的年龄、时期和出生队列差异，中老年群体及早期出生队列为防控重点。 应强化以重点时期、重点人群为核心的精准防控措施，持续巩固防控成果。

     

    Abstract:
    Objective To analyze the incidence trend of hemorrhagic fever with renal syndrome (HFRS) in Shandong province from 2006 to 2025 and the effects of age, period, and birth cohort, clarify the disease risk in different age groups and birth cohorts and provide theoretical evidence to identify key populations in HFRS prevention and control.
    Methods The reported incidence data of HFRS in Shandong were collected from the Infectious Disease Surveillance System of Chinese Information System for Disease Control and Prevention. Joinpoint regression model was applied to analyze the changes of HFRS incidence during this period, and the age-period-cohort model was used to analyze the variations in HFRS incidence associated with age, period, and birth cohort.
    Results The average annual reported incidence of HFRS was 1.02/100000 in Shandong from 2006 to 2025. The Joinpoint regression model results showed that the overall HFRS incidence exhibited a downward trend from 2006 to 2025 (average annual percent change=−5.31%, P=0.010). There was no significant change from 2006 to 2014 annual percent change (APC)=4.03%, P=0.231, while a significant downward trend was observed from 2014 to 2025 (APC=−11.57%, P<0.001). The age-period-cohort model results indicated that the reported HFRS incidence showed an increase trend then a decrease trend with age in Shandong from 2006 to 2025 (χ2=139.835, P<0.001), with the peak in age groups aged ≥50 years. Over time, the reported HFRS incidence exhibited a slow increase trend then a rapid decrease trend (χ2=362.391, P<0.001), and the incidence risk reached its peak during 2011-2015. In terms of birth cohort effect, the reported HFRS incidence showed a gradual downward trend (χ2=617.145, P<0.001), with the highest incidence risk being observed in the 1931−1935 birth cohort. The local drift analysis results demonstrated that the reported HFRS incidence exhibited a decreasing trend in all age groups (χ2=62.769, P<0.001).
    Conclusion The overall HFRS incidence in Shandong showed a downward trend, especially after 2014. The incidence risk exhibited distinct age, period, and birth cohort differences, with the 10−34 age group and early birth cohorts being the key groups in HFRS prevention and control. Precise prevention and control measures should be taken in key periods and for key populations to continuously consolidate the achievements of disease control.

     

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