2009-2018年汕头市手足口病流行特征与时空聚集性

张驰; 张旭彬; 姚丽君; 许璐; 徐光兴; 张志华; 江素红; 谢润生; 李丽萍

doi:10.16462/j.cnki.zhjbkz.2020.05.015

2009-2018年汕头市手足口病流行特征与时空聚集性

doi: 10.16462/j.cnki.zhjbkz.2020.05.015

1.
515000 汕头, 汕头市疾病预防控制中心
2.
510000 广州, 广东省中医院
3.
515000 汕头, 汕头大学医学院

基金项目: 广东省科技计划项目(2016A020216026)

详细信息

通讯作者:
李丽萍, E-mail:lpli@stu.edu.cn

中图分类号: R725.1;R181.3
计量
- 文章访问数: 454
- HTML全文浏览量: 156
- PDF下载量: 56
- 被引次数: 0
出版历程
- 收稿日期: 2019-10-21
- 修回日期: 2020-01-20
- 刊出日期: 2020-05-10

Epidemiological characteristics and temporal-spatial clustering analysis of hand, foot and mouth disease in Shantou City

1.
Center for Disease Control and Prevention of Shantou, Shantou 515000, China
2.
Guangdong Provincial Hospital of Chinese Medicine 510000, China
3.
Medical College of Shantou University 515000, China

Funds: Science and Technology Planning Project of Guangdong Province(2016A020216026)

More Information

Corresponding author: LI Li-ping, E-mail:lpli@stu.edu.cn

摘要

摘要: 目的分析汕头市2009-2018年手足口病的流行病学特征及时空分布特征, 为制定有效的手足口病防控策略提供科学依据。方法收集汕头市2009-2018年手足口病疫情数据, 采用空间自相关分析和时空扫描统计量相结合的方法对手足口病发病情况进行时空聚集性分析。结果 2009-2018年汕头市累计报告手足口病病例77 814例, 年均发病率为143.52/10万。发病人群以3岁以下散居儿童为主, 主高峰集中在4-7月, 次高峰在9-11月。全局和局部空间自相关分析结果显示, 手足口病在汕头市街道(镇)尺度上呈空间正相关, 全市有25个街道(镇)为“热点”区域, 形成手足口病的高发区域。时空扫描分析结果显示, 2009-2018年汕头市手足口病有2个聚类区, 其中1类聚类区(RR=3.56, LLR=9 444.26, P < 0.001)是以同益街道、新福街道为中心点, 半径为10.05 km的区域, 波及中心城区25个街道(镇)。结论 2009-2018年汕头市手足口病在中心城区呈现明显的时空聚集性, 应在流行季节和高发街道加强重点人群的防控工作, 降低手足口病发病水平。
- 手足口病 /
- 流行病学特征 /
- 时空聚集性
Abstract: Objective To explore the epidemiological characteristics and temporal-spatial clustering of hand, foot and mouth disease(HFMD) from 2009 to 2018 in Shantou City, as a means of providing a scientific basis for conducting effective control strategies. Methods The epidemic data of HFMD from 2009 to 2018 was collected. Spatial autocorrelation analysis and spatiotemporal scan statistics were used to analyse the clustering of HFMD in time and space. Results A total of 77 814 cases of HFMD were reported in Shantou City from 2009 to 2018. The annual average incidence was 143.52/100 000. Children under three years old comprised the HFMD high-risk population.The major HFMD-incidence peak period was from April to July, and the secondary incidence peak period was from September to November. Global and local spatial autocorrelation analysis demonstrated that positive spatial autocorrelation was observed at street(town) level. Twenty-five streets(towns) of Shantou City were hotspot areas, indicating the high incidence of HFMD. Two clustering was found by time-space scanning from 2009-2018, and the Class 1 clustering area(RR=3.56, LLR=9 444.26, P < 0.001) centred on Tongyi and Xinfu street, with a radius of 10.05 km, involving 25 streets(towns) of Shantou City. Conclusions A significant feature of spatiotemporal clustering was shown in the HFMD incidence in Shantou City from 2009 to 2018. Effective prevention and control measures should be undertaken for the high-risk population in high-prevalence area and season to decrease the incidence of HFMD in Shantou City.
- Hand /
- foot and mouth disease /
- Epidemiological characteristics

HTML全文

图 1 2009-2018年汕头市手足口病发病时间分布情况

Figure 1. The distribution of onset time of HFMD in Shantou City from 2009 to 2018

下载: 全尺寸图片幻灯片

图 2 2009-2018年汕头市手足口病发病率热点图

Figure 2. The hotspot map of HFMD incidence in Shantou City from 2009 to 2018

下载: 全尺寸图片幻灯片

图 3 2009-2018年汕头市手足口病时空聚集性分布图

Figure 3. Spatiotemporal clustering distribution of HFMD in Shantou Ccity from 2009 to 2018

下载: 全尺寸图片幻灯片

表 1 2009-2018年汕头市手足口病发病率全局空间自相关分析结果

Table 1. The results of global spatial autocorrelation of incidence of HFMD in Shantou city from 2009 to 2018

年份	Moran's I指数	Z值	P值
2009	0.318	6.056	< 0.001
2010	0.411	7.857	< 0.001
2011	0.354	6.872	< 0.001
2012	0.330	6.428	< 0.001
2013	0.347	6.700	< 0.001
2014	0.307	6.052	< 0.001
2015	0.257	5.075	< 0.001
2016	0.256	5.234	< 0.001
2017	0.179	3.701	< 0.001
2018	0.462	9.184	< 0.001
合计	0.388	7.594	< 0.001

下载: 导出CSV

表 2 2009-2018年汕头市手足口病发病率时空聚集性分析结果

Table 2. The results of spatiotemporal scan analysis of HFMD incidence in Shantou City from 2009 to 2018

年份	聚集类别	聚集时间	聚集街道镇数	实际报告病例数	预期报告病例数	LLR值	RR值	P值
2009	1	2009/6/1-2009/11/30	45	2 046	787.44	1 028.39	4.67	< 0.001
	2	2009/5/1-2009/10/31	1	144	52.09	55.71	2.84	< 0.001
	3	2009/7/1-2009/9/30	1	69	30.26	18.34	2.30	< 0.001
	4	2009/4/1-2009/6/30	1	37	14.65	12.00	2.54	0.009
2010	1	2010/4/1-2010/7/31	37	1 605	562.93	787.62	3.85	< 0.001
	2	2010/5/1-2010/6/30	11	453	234.12	85.72	2.04	< 0.001
2011	1	2011/5/1-2011/9/30	24	3 064	871.33	1 937.47	4.58	< 0.001
	2	2011/7/1-2011/11/30	8	1 988	1 068.82	361.87	2.07	< 0.001
2012	1	2012/4/1-2012/9/30	37	4 486	1 787.54	1 931.79	3.74	< 0.001
	2	2012/4/1-2012/6/30	1	172	72.06	50.20	2.41	< 0.001
	3	2012/9/1-2012/11/30	6	640	452.35	36.30	1.44	< 0.001
	4	2012/11/1-2012/12/31	1	37	12.65	15.39	2.93	< 0.001
2013	1	2013/5/1-2013/9/30	27	3 154	809.76	2 350.73	5.64	< 0.001
	2	2013/5/1-2013/7/31	12	996	654.16	84.53	1.59	< 0.001
2014	1	2014/4/1-2014/7/31	46	6 063	1 640.53	4 720.52	6.82	< 0.001
	2	2014/5/1-2014/6/30	8	719	440.44	77.42	1.68	< 0.001
2015	1	2015/5/1-2015/10/31	46	3 096	1 212.59	1 501.52	4.50	< 0.001
2016	1	2016/5/1-2016/7/31	29	2 126	439.22	1 894.09	6.43	< 0.001
	2	2016/5/1-2016/6/30	13	818	469.78	114.52	1.84	< 0.001
2017	1	2017/5/1-2017/10/31	31	3522	1 130.95	2 190.14	5.30	< 0.001
	2	2017/5/1-2017/6/30	4	323	149.82	77.19	2.21	< 0.001
2018	1	2018/5/1-2018/10/31	23	2 479	530.81	2 340.10	7.90	< 0.001
2009-2018	1	2011/5/1-2015/11/30	25	20 128	7 040.31	9 444.26	3.56	< 0.001
	2	2011/6/1-2011/11/30	12	2 632	1 099.60	781.19	2.45	< 0.001

下载: 导出CSV

参考文献(17)

[1]	国家卫生健康委员会.手足口病诊疗指南(2018年版)[J].中国病毒病杂志, 2018, 8(5): 347-352.DOI: 10.16505/j.2095-0136.2018.0063. National Health Commission of the People's Republic of China. Guidelines for the diagnosis and treatment of hand foot and mouth disease(2018 version)[J]. Chin J Viral Dis, 2018, 8(5): 347-352. DOI: 10.16505/j.2095-0136.2018.0063.
[2]	Jones E, Pillay TD, Liu FF, et al. Outcomes following severe hand foot and mouth disease: a systematic review and meta-analysis[J]. Eur J Paediatr Neurol, 2018, 22(5): 763-773.DOI: 10.1016/j.ejpn.2018.04.007.
[3]	Zhang DG, Chen JL, Ba-Thein W. Hand-foot-mouth disease and use of steroid, intravenous immunoglobulin, and traditional Chinese herbs in a tertiary hospital in Shantou, China[J]. BMC Complement Altern Med, 2018, 18(1): 190.DOI: 10.1186/s12906-018-2259-9.
[4]	陈敏玫.手足口疾病原谱和基因多态性研究进展[J].应用预防医学, 2017, 23(1): 91-94.DOI: 10.3969/j.issn.1673-758X.2017.01.027. Chen MM. The research progress of the pathogenic spectrum and gene polymorphism of hand-foot-mouth disease[J]. J Applied Prev Med, 2017, 23(1): 91-94. DOI: 10.3969/j.issn.1673-758X.2017.01.027.
[5]	赵静, 傅超.经济特区发展战略研究-以汕头经济特区为例[J].中国物价, 2016, 6: 73-75. http://www.cnki.com.cn/Article/CJFDTotal-ZGWJ201606023.htm Zhao J, Fu C. The development strategy of special economic zones-the example of Shantou special economic zone[J]. China Price, 2016, 6: 73-75. http://www.cnki.com.cn/Article/CJFDTotal-ZGWJ201606023.htm
[6]	吴令杰, 张海生, 林沛鸿, 等. 2008-2012年汕头市1689例手足口病患儿流行病学特征分析[J].热带医学杂志, 2013, 13(10): 1274-1275. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=rdyxzz201310030 Wu LJ, Zhang HS, Lin PH, et al. Epidemiology and clinical characteristics of hand-foot-mouth disease in Shantou city from 2008 to 2012[J]. J Trop Med, 2013, 13(10): 1274-1275. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=rdyxzz201310030
[7]	蒋丽娜, 谭毅, 王晶, 等. 2008-2015年广西手足口病流行病学特征及时空聚集性分析[J].中华疾病控制杂志, 2017, 21(4): 340-344.DOI: 10.16462/j.cnki.zhjbkz.2017.04.005. Jiang LN, Tan Y, Wang J, et al. Epidemiological characteristics and temporal-spatial clustering of hand, foot and mouth disease in Guangxi from 2008 to 2015[J]. Chin J Dis Control Prev, 2017, 21(4): 340-344. DOI: 10.16462/j.cnki.zhjbkz.2017.04.005.
[8]	Xing WJ, Liao QH, Viboud C, et al. Epidemiological characteristics of hand-foot-and-mouth disease in China, 2008-2012[J]. Lancet Infect Dis, 2014, 14(4): 308-318.DOI: 10.1016/S1473-3099(13)70342-6.
[9]	Brein A, Sherrard-Smith E, Sile B, et al. Spatical clusters of gonorrhea in England with particular reference to the outcome of partner notification: 2012 and 2013[J]. PLoS One, 2018, 13(4): e0195178.DOI: 10.1371/journal.pone.0195178.eCollection 2018.
[10]	Zhu B, Liu J, Fu Y, et al. Spatio-temporal epidemiology of viral hepatitis in China(2003-2015): implications for prevention and control policies[J]. Int J Environ Res Public Health, 2018, 15(4): 661.DOI: 10.3390/ijerph15040661.
[11]	高阔, 甘筱青.我国患者双向转诊行为决策及影响因素研究[J].中国全科医学, 2015, 18(28): 3393-3395.DOI: 10.3969/j.issn.1007-9572.2015.28.003. Gao K, Gan XQ. Behavioral decision in two-way referral and its influencing factors in China[J]. Chin Gen Pract, 2015, 18(28): 3393-3395. DOI: 10.3969/j.issn.1007-9572.2015.28.003.
[12]	鲍婷, 王佑娟, 马原林, 等.居民就医行为研究进展[J].中国社会医学杂志, 2019, 36(2): 135-138.DOI: 10.3969/j.issn.1673-5625.2019.02.007. Bao T, Wang YJ, Ma YL, et al. Research progress of health care seeking behavior among residents[J]. Chin J Soc Medi, 2019, 36(2): 135-138. DOI: 10.3969/j.issn.1673-5625.2019.02.007.
[13]	Kulldorff M, Heffeman R, Hartman J, et al. A space-time permutation scan statistic for disease outbreak detection[J]. PLoS Med, 2005, 2(3): e59.DOI: 10.1371/journal.pmed.0020059.
[14]	蒋丽娜, 谭毅, 王晶, 等. 2008-2015年广西手足口病流行病学特征及时空聚集性分析[J].中华疾病控制杂志, 2017, 21(4): 340-344.DOI: 10.16462/j.Cnki.Zhjbkz.2017.04.005. Jiang LN, Tan Y, Wang J, et al. Epidemiological characteristics and temporal-spatial clustering of hand, foot and mouth disease in Guangxi from2008 to 2015[J]. Chin J Dis Control Prev, 2017, 21(4): 340-344. DOI: 10.16462/j.Cnki.Zhjbkz.2017.04.005.
[15]	陈灿, 王虹玲, 张辉, 等. 2009-2016年浙江省舟山海岛地区手足口病时空聚集性及病原谱变化分析[J].疾病监测, 2018, 33(1): 45-49.DOI: 10.3784/j.issn.1003-9961.2018.01.011. Chen C, Wang HL, Zhang H, et al. Spatial-temporal clustering and pathogen spectrum change of hand, foot and mouth disease in Zhoushan islands, Zhejiang, 2009-2016[J]. Dis Surveillance, 2018, 33(1): 45-49. DOI: 10.3784/j.issn.1003-9961.2018.01.011.
[16]	胡跃华, 肖革新, 郭莹, 等. 2008-2011年中国大陆手足口病流行特征分析[J].中华疾病控制杂志, 2014, 18(8): 693-697. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=jbkzzz201408001 Hu YH, Xiao GX, Guo Y, et al. The epidemic features of the hand, foot, and mouth disease during 2008-2011 in China[J]. Chin J Dis Control Prev, 2014, 18(8): 693-697. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=jbkzzz201408001
[17]	李欣欣, 候文平, 米卓, 等. 2012-2015年北京市大兴区手足口病时空聚集性分析[J].国际病毒学杂志, 2016, 23(5): 311-317.DOI: 10.3760/cma.j.issn.1673-4092.2016.05.007. Li XX, Hou WP, Mi Z, et al. Temporal and spatial clustering characteristic of hand-foot-mouth disease in Daxing, 2012-2015[J]. Int J Virol, 2016, 23(5): 311-317. DOI: 10.3760/cma.j.issn.1673-4092.2016.05.007.