Epidemiological characteristics and trends of infectious diseases in Gansu province from 2015 to 2022
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摘要:
目的 分析2015―2022年甘肃省传染病发病死亡数据,了解甘肃省传染病流行特点及趋势,确定甘肃省防控重点。 方法 利用Excel 2021软件、JPR 4.9.10软件计算传染病发病顺位、死亡顺位、病死率、发病率和死亡率的年度变化百分比(annual percent change, APC)、年平均变化百分比(average annual percent change, AAPC)。通过Joinpoint回归模型分析传染病发病及死亡变化趋势。 结果 2015―2022年甘肃省传染病发病670 992例,死亡1 127例,发病率为324.12/10万,死亡率为0.54/10万。发病顺位前5的疾病分别为其他感染性腹泻、肺结核、乙型病毒性肝炎(乙肝)、流行性感冒、手足口病;死亡顺位前2的疾病分别为艾滋病和肺结核。2019―2022年传染病发病和2017―2022年传染病死亡呈下降趋势,APC(95% CI)分别为-16.0%(-25.4%~-5.3%)和-9.1%(-13.7%~-1.2%),其余时间段发病、死亡趋势变化不明显。肺结核、甲型病毒性肝炎(甲肝)等10种疾病发病率呈下降趋势,急性出血性结膜炎发病率呈上升趋势;肺结核死亡率呈下降趋势,艾滋病死亡率呈上升趋势。这些传染病中病死率最高的为鼠疫和狂犬病。 结论 甘肃省传染病防控重点为其他感染性腹泻、肺结核、乙肝、流行性感冒、手足口病;同时还应重点关注死亡风险高的艾滋病与鼠疫和发病率上升的急性出血性结膜炎、布鲁氏菌病。 Abstract:Objective This study analyzes infectious disease morbidity and mortality data in Gansu province from 2015 to 2022, aiming to comprehend the epidemiological characteristics and trends, as well as to determine prevention and control priorities. Methods We need Excel 2021 and JPR4.9 1.0 software to calculate morbidity ranks, mortality ranks, fatality rates, annual percentage change (APC) and annual average percentage change (AAPC) in morbidity and morality rates of the infectious diseases. We also analyzed the trend in infectious diseases morbidity and mortality using the Toinpoint regression model. Results From 2015 to 2022, Gansu province reported 670 992 cases of infectious diseases and 1 127 deaths, with an incidence rate of 324.12 per 100 000 and a mortality rate of 0.54 per 100 000 cases. The top five diseases in morbidity were infectious diarrhea, tuberculosis, hepatitis B, influenza, and hand-foot-mouth disease; the top two in mortality were AIDS and tuberculosis. Morbidity (2019-2022) and mortality (2017-2022) showed a decreasing trend, with APC values of -16 (-25.4, -5.3) and -9.1 (-13.7, -1.2). No significant changes in the incidence or mortality trends were observed during the remaining periods. Ten diseases, including tuberculosis and hepatitis A, exhibited decreasing incidence, while acute hemorrhagic conjunctivitis showed an upward trend. Tuberculosis deaths declined, but AIDS-related deaths increased. Plague and rabies had the highest mortality rates. Conclusions In Gansu province, prevention and control efforts should focus on infectious diarrhea, tuberculosis, hepatitis B, influenza, and hand-foot-mouth disease. Special attention is needed for the high mortality risk of AIDS and plague, as well as the incidence of acute hemorrhagic conjunctivitis and brucellosis. -
Key words:
- Infectious disease /
- Morbidity /
- Death /
- Trends
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表 1 2015―2022甘肃省法定传染病发病及死亡情况
Table 1. Incidence and death of notifiable infectious diseases in Gansu province from 2015 to 2022
年份
Year年人口数
Annual population发病数
Number of cases发病率/10万-1
Morbidity/100 000-1死亡数
Deaths死亡率/10万-1
Mortality/100 000-12015 25 907 800 78 960 304.77 120 0.46 2016 25 995 600 88 049 338.71 127 0.49 2017 26 100 500 88 763 340.08 179 0.69 2018 26 257 500 93 833 357.36 169 0.64 2019 26 372 600 115 383 437.51 159 0.60 2020 26 474 300 72 603 274.23 149 0.56 2021 25 019 900 71 635 304.30 113 0.45 2022 24 900 500 61 766 248.09 102 0.41 总计Total 207 028 700 670 992 324.12 1 118 0.54 表 2 2015―2022年甘肃省法定传染病发病及死亡变化趋势
Table 2. Changing trends of incidence and death of statutory infectious diseases in Gansu province, 2015-2022
分类Classify 发病率Morbidity 死亡率Mortality 年度Year APC(95% CI)/% AAPC(95% CI)/% 年度Year APC(95% CI)/% AAPC(95% CI)/% 传染病总体
Overall infectious diseases2015―2019 6.6(-0.3~13.9) -3.7(-7.5~0.1) 2015―2017 26.5(-0.8~61.2) -0.1(-4.8~4.9) 2019―2022 -16.0(-25.4~-5.3) 2017―2022 -9.1(-13.7~-1.2) 甲、乙传染病合并
Class A and Class B infectious diseases2015―2022 -4.6(-6.5~-2.6) -4.6(-6.5~-2.6) 2015―2017 28.1(-3.8~70.6) -0.8(-4.8~6.7) 2017―2022 -8.4(-13.8~-2.7) 丙类传染病
Class C infectious diseases2015―2019 19.6(0.2~42.7) -1.3(-11.0~9.5) ― 2019―2022 -23.6(-44.2~4.8) ― 注:1. APC, 年度变化百分比;AAPC, 年平均变化百分比。
2. “—”表示该位次无传染病死亡病例发生。
Note: 1. APC, annual percent change; AAPC, average annual percent change.
2. "—" indicates that no deaths from infectious diseases have occurred at that level.表 3 2015―2022年法定传染病的发病顺位及变化情况
Table 3. Incidence sequence and change of notifiable infectious diseases from 2015 to 2022
顺位
Order病种(占比/%)Disease(proportion/%) 2015年year 2016年year 2017年year 2018年year 2019年year 2020年year 2021年year 2022年year 1 肺结核Pulmonary tuberculosis(18.02) 肺结核Pulmonary tuberculosis(17.16) 其他感染性腹泻Other infectious diarrhea(20.14) 其他感染性腹泻Other infectious diarrhea(19.41) 其他感染性腹泻Other infectious diarrhea(16.06) 其他感染性腹泻Other infectious diarrhea(23.63) 其他感染性腹泻Other infectious diarrhea(22.26) 其他感染性腹泻Other infectious diarrhea(23.37) 2 其他感染性腹泻Other infectious diarrhea(15.26) 其他感染性腹泻Other infectious diarrhea(16.76) 肺结核Pulmonary tuberculosis(16.63) 手足口病Hand, foot and mouth disease(14.43) 手足口病Hand, foot and mouth disease(15.91) 乙型病毒性肝炎Hepatitis B(14.80) 手足口病Hand, foot and mouth disease(13.81) 乙型病毒性肝炎Hepatitis B(12.58) 3 乙型病毒性肝炎Hepatitis B(12.72) 乙型病毒性肝炎Hepatitis B(11.24) 乙型病毒性肝炎Hepatitis B(12.44) 乙型病毒性肝炎Hepatitis B(12.71) 流行性感冒Influenza(12.64) 肺结核Pulmonary tuberculosis(11.18) 乙型病毒性肝炎Hepatitis B(12.43) 流行性感冒Influenza(11.08) 4 手足口病Hand, foot and mouth disease(11.61) 手足口病Hand, foot and mouth disease(10.65) 手足口病Hand, foot and mouth disease(9.68) 肺结核Pulmonary tuberculosis(10.84) 流行性腮腺炎Mumps(11.48) 流行性感冒Influenza(10.44) 肺结核Pulmonary tuberculosis(10.04) 肺结核Pulmonary tuberculosis(10.39) 5 丙型病毒性肝炎Hepatitis C(8.60) 流行性感冒Influenza(9.63) 丙型病毒性肝炎Hepatitis C(8.74) 流行性感冒Influenza(8.66) 乙型病毒性肝炎Hepatitis B(10.32) 梅毒Syphilis(9.01) 梅毒Syphilis(8.92) 布鲁氏菌病Brucellosis(8.07) 6 细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(7.07) 丙型病毒性肝炎Hepatitis C(8.05) 流行性感冒Influenza(8.20) 丙型病毒性肝炎Hepatitis C(8.25) 肺结核Pulmonary tuberculosis(8.27) 丙型病毒性肝炎Hepatitis C(8.53) 流行性感冒Influenza(8.66) 梅毒Syphilis(8.04) 7 流行性感冒Influenza(6.40) 细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(7.19) 梅毒Syphilis(6.62) 梅毒Syphilis(6.93) 丙型病毒性肝炎Hepatitis C(6.41) 流行性腮腺炎Mumps(5.84) 丙型病毒性肝炎Hepatitis C(7.39) 丙型病毒性肝炎Hepatitis C(7.37) 8 梅毒Syphilis(5.51) 梅毒Syphilis(5.49) 细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(5.48) 流行性腮腺炎Mumps(5.86) 梅毒Syphilis(6.22) 布鲁氏菌病Brucellosis(4.07) 布鲁氏菌病Brucellosis(5.99) 新型冠状病毒感染Novel coronavirus infection(5.59) 9 流行性腮腺炎Mumps(3.48) 流行性腮腺炎Mumps(3.48) 流行性腮腺炎Mumps(3.46) 细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(4.31) 细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(3.03) 手足口病Hand, foot and mouth disease(3.79) 流行性腮腺炎Mumps(2.82) 手足口病Hand, foot and mouth disease(3.14) 10 布鲁氏菌病Brucellosis(2.92) 麻疹Measles(3.29) 布鲁氏菌病Brucellosis(1.85) 猩红热Scarlet fever(1.73) 布鲁氏菌病Brucellosis(1.48) 细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(3.48) 细菌性和阿米巴性痢疾Bacillary and amoebic dysentery(2.46) 流行性腮腺炎Mumps(3.04) 合计
Total91.59 92.94 93.24 93.13 91.82 94.76 94.78 92.62 表 4 2015―2022年法定传染病的死亡顺位及变化情况
Table 4. Death sequence and change of notifiable infectious diseases from 2015 to 2022
顺位
Order病种(占比/%)Disease(proportion/%) 2015年year 2016年year 2017年year 2018年year 2019年year 2020年year 2021年year 2022年year 1 艾滋病Acquired immunodeficiency syndrome(47.51) 艾滋病Acquired immunodeficiency syndrome(49.22) 艾滋病Acquired immunodeficiency syndrome(45.81) 艾滋病Acquired immunodeficiency syndrome(60.95) 艾滋病Acquired immunodeficiency syndrome(82.38) 艾滋病Acquired immunodeficiency syndrome(89.26) 艾滋病Acquired immunodeficiency syndrome(89.38) 艾滋病Acquired immunodeficiency syndrome(81.37) 2 肺结核Pulmonary tuberculosis(35.83) 肺结核Pulmonary tuberculosis(32.03) 流行性乙型脑炎Japanese encephalitis(24.85) 流行性乙型脑炎Japanese encephalitis(24.85) 肺结核Pulmonary tuberculosis(12.58) 肺结核Pulmonary tuberculosis(8.73) 肺结核Pulmonary tuberculosis(9.72) 肺结核Pulmonary tuberculosis(18.63) 3 狂犬病Hydrophobia(9.17) 狂犬病、流行性感冒Hydrophobia, Influenza(6.25) 肺结核Pulmonary tuberculosis(18.99) 肺结核Pulmonary tuberculosis(8.28) 乙型病毒性肝炎、丙型病毒性肝炎Hepatitis B, Hepatitis C(1.26) 新型冠状病毒感染Novel coronavirus infection(1.34) 梅毒Syphilis(0.88) - 4 手足口病Hand, foot and mouth disease(3.33) 流行性乙型脑炎Epidemic hemorrhagic fever(2.35) 狂犬病Hydrophobia(5.02) 手足口病Hand, foot and mouth disease(2.96) 其他感染性腹泻、鼠疫、流行性出血热、流行性脑脊髓炎Other infectious diarrhea, Plague, Epidemic hemorrhagic fever, Epidemic cerebrospinal meningitis(0.63) 狂犬病Hydrophobia(0.67) - - 5 乙型病毒性肝炎Hepatitis B(1.67) 手足口病、麻疹、皮肤炭疽、其他感染性腹泻、黑热病(0.78)Hand, foot and mouth disease, Measles, Cutaneous anthrax, Other infectious diarrhea, Leishmaniasis(0.78) 乙型病毒性肝炎Hepatitis B(1.68) 乙型病毒性肝炎Hepatitis B(1.78) - - - - 6 甲型病毒性肝炎、麻疹、细菌性和阿米巴性痢疾Hepatitis A, Measles, Bacillary and amoebic dysentery(0.83) 流行性感冒、手足口病、其他感染性腹泻疾病、细菌性和阿米巴性痢疾、鼠疫、新生儿破伤风、人感染H7N9禽流感Influenza, Hand, foot and mouth disease, Other infectious diarrhea, Bacillary and amoebic dysentery, Plague, Neonatal tetanus, Human infection with H7N9 avian influenza(0.56) 狂犬病、梅毒Hydrophobia, Syphilis(0.59) - - - - 注:“-”表示该位次无传染病死亡病例发生。
Note:"—" Indicates that no deaths from infectious diseases have occurred at that level.表 5 2015―2022年甘肃省传染病各病种发病及死亡变化趋势
Table 5. Changing of morbidity and mortality trends of infectious diseases in Gansu Province by disease types, 2015-2022
趋势分类Trends classification 病种Disease 年度Year APC(95% CI)/% AAPC(95% CI)/% 发病趋势Incidence trends 艾滋病Acquired immunodeficiency syndrome 2015―2018 26.8(5.6~52.4) 4.9(-1.3~11.4) 2018―2022 -9.1(-18.1~0.9) 病毒性肝炎Viral hepatitis 2015―2019 3.2(-2.0~8.7) -4.1(-7.0~-1.2) 2019―2022 -13.1(-20.9~-4.6) 甲型病毒性肝炎Hepatitis A 2015―2019 -1.7(-8.0~4.9) -18.9(-23.1~-14.5) 2019―2022 -37.2(-47.5~-24.9) 乙型病毒性肝炎Hepatitis B 2015―2019 5.0(-1.0~11.5) -2.4(-5.7~1.0) 2019―2022 -11.5(-20.1~-1.9) 丙型病毒性肝炎Hepatitis C 2015―2018 5.1(-3.4~14.4) -4.5(-7.4~-1.5) 2018―2022 -11.1(-16.3~-5.6) 丁型肝炎Hepatitis D 2015―2022 -52.4(-67.4~-29.4) -52.4(-67.4~-29.4) 未分型肝炎Unclassified hepatitis 2015―2022 -24.4(-30.9~-17.3) -24.4(-30.9~-17.3) 麻疹Measles 2015―2022 -47.4(-76.6~18.3) -47.4(-76.6~18.3) 流行性出血热Epidemic hemorrhagic fever 2015―2019 102.6(-10.9~360.7) 14.1(-25.5~74.8) 2019―2022 -46.9(-83.8~74.1) 流行性脑脊髓膜炎Epidemic cerebrospinal meningitis 2015―2022 -13.1(-65.3~117.5) -13.1(-65.3~117.5) 皮肤炭疽Cutaneous anthrax 2015―2022 -1.8(-14.6~12.8) -1.8(-14.6~12.8) 细菌性和阿米巴性痢疾Bacillary and amoebic dysentery 2015―2022 -18.3(-22.2~-14.3) -18.3(-22.2~-14.3) 肺结核Pulmonary tuberculosis 2015―2022 -11.7(-15.5~-7.7) -11.7(-15.5~-7.7) 伤寒、副伤寒Typhoid fever, Paratyphoid fever 2015―2022 -5.0(-13.5~4.4) -5.0(-13.5~4.4) 新生儿破伤风Neonatal tetanus 2015―2022 -31.5(-42.7~-17.5) -31.5(-42.7~-17.5) 百日咳Pertussis 2015―2022 15.6(-10.4~49.1) 15.6(-10.4~49.1) 猩红热Scarlet fever 2015―2022 -11.7(-26.6~6.2) -11.7(-26.6~6.2) 布鲁氏菌病Brucellosis 2015―2018 -13.6(-44.8~35.1) 14.6(-0.7~32.3) 2018―2022 41.8(12.7~78.4) 淋病Gonorrhea 2015―2022 -1.8(-8.5~5.5) -1.8(-8.5~5.5) 梅毒Syphilis 2015―2019 13.5(-2.5~32.2) 3.9(-4.2~12.7) 2019―2022 -7.7(-26.8~16.4) 发病趋势Incidence trends 疟疾Malaria 2015―2022 -16.21(-29.1~-1.0) -16.21(-29.1~-1.0) 流行性感冒Influenza 2015―2022 2.1(-12.0~18.4) 2.1(-12.0~18.4) 流行性腮腺炎Mumps 2015―2019 56.4(15.8~111.3) -3.8(-19.7~15.3) 2019―2022 -49.7(-7.1~-12.4) 风疹Rubella 2015―2019 131.6(58.2~23.9) -47.6(-61.6~-28.5) 2019―2022 -92.8(-95.5~-79.1) 急性出血性结膜炎Acute hemorrhagic conjunctivitis 2015―2022 7.1(0.2~4.4) 7.1(0.2~4.4) 黑热病Leishmaniasis 2015―2017 23.6(1.4~50.6) -15.11(-18.8~-11.2) 2017―2022 -27.0(31.3~-22.3) 包虫病Echinococcosis 2015―2017 7.6(21.5~47.4) -7.21(-13.1~-0.9) 2017―2022 -12.6(-19.3~-5.3) 其他感染性腹泻Other infectious diarrhea 2015―2017 23.8(-5.3~61.6) 4.3(-1.0~10.0) 2017―2022 -2.6(-7.6~2.8) 手足口病Hand, foot and mouth disease 2015―2022 -0.6(-22.3~27.0) -0.6(-22.3~27.0) 死亡趋势Trends in deaths 艾滋病Acquired immunodeficiency syndrome 2015―2019 26.2(18.9~33.8) 8.3(5.1~11.5) 2019―2022 -11.7(-18.4~-4.4) 肺结核Pulmonary tuberculosis 2015―2022 -16.0(-24.9~-6.2) -16.0(-24.9~-6.2) 表 6 2015―2022年部分传染病病死率
Table 6. Case fatality rate for selected infectious diseases, 2015-2022
病种Disease 发病数
Number of cases死亡数
Number of deaths病死率/%
Case fatality rate/%鼠疫Plague 2 2 100.000 艾滋病Acquired immunodeficiency syndrome 3 827 753 19.676 肺结核Pulmonary tuberculosis 85 981 195 0.227 甲型病毒性肝炎Hepatitis A 4 321 1 0.023 乙型病毒性肝炎Hepatitis B 82 771 10 0.012 丙型病毒性肝炎Hepatitis C 53 143 2 0.004 麻疹Measles 4 682 2 0.042 狂犬病Rabies 31 31 100.000 流行性出血热Epidemic hemorrhagic fever 796 1 0.130 细菌性和阿米巴性痢疾Bacillary and amoebic dysentery 30 528 1 0.003 皮肤炭疽Cutaneous anthrax 567 1 0.176 流行性乙型脑炎Japanese encephalitis 1 050 89 8.476 人感染H7N9禽流感Human infection with H7N9 avian influenza 5 1 20.000 梅毒Syphilis 47 031 1 0.000 新生儿破伤风Neonatal tetanus 28 1 3.571 疟疾Malaria 131 1 0.763 流行性脑脊髓膜炎Epidemic cerebrospinal meningitis 7 1 14.286 新型冠状病毒感染Novel coronavirus infection 3 810 1 0.026 其他感染性腹泻Other infectious diarrhea 129 963 3 0.002 手足口病Hand, foot and mouth disease 74 270 11 0.015 流行性感冒Influenza 64 530 9 0.013 黑热病Leishmaniasis 369 1 0.271 合计Total 587 843 1 118 0.190 -
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