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.