Analysis of the epidemiological characteristics of notifiable infectious diseases in the population aged 60 years and above in China from 2004 to 2019
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摘要:
目的 分析2004―2019年我国≥60岁老年人群法定报告传染病长期趋势，为我国老年人群法定报告传染病防控提供参考依据。 方法 使用Joinpoint回归模型分析2004―2019年我国≥60岁老年人群法定报告传染病的标化发病率和标化病死率趋势，并通过年度变化百分比和平均年度变化百分比(average annual percent change, AAPC)分析合计、分性别、分传播方式、分病原体类型、纳入国家免疫规划以及分传染病病种的长期趋势。 结果 2004―2019年我国老年人群法定报告传染病标化发病率和病死率的AAPC分别为2.03%和8.22%(均P < 0.05)，标化发病率上升趋势排前5位的病种包括登革热、流行性感冒、艾滋病、手足口病及梅毒。经血液/性传播的传染病标化发病率AAPC为17.33%，病原体为病毒的传染病标化发病率AAPC为7.58%(均P < 0.05)，其中仅艾滋病标化病死率呈上升趋势。 结论 2004―2019年我国老年人群法定报告传染病标化发病率及病死率整体呈上升趋势，尤其是病原体为病毒和经血液/性传播的传染病上升较快，应制定有针对性的法定报告传染病预防与控制措施。 -
关键词:
- 法定报告传染病 /
- Joinpoint回归模型 /
- 流行趋势
Abstract:Objective To analyze the long-term trend of notifiable infectious diseases among the population aged 60 years and above in China from 2004 to 2019, and to provide a reference for the prevention and control of notifiable infectious diseases in this population. Methods The Joinpoint regression model was used to analyze the trends of standardized incidence and fatality rates of notifiable infectious diseases in the elderly population aged 60 years and above in China from 2004 to 2019. Annual percent change and average annual percent change (AAPC) were used to analyze the total, gender, mode of transmission, pathogen type, Long-term trends in inclusion in national immunization programmes and by communicable disease. Results The standardized incidence and fatality rates of notifiable infectious diseases among the elderly population in China from 2004 to 2019 showed an AAPC of 2.03% and 8.22%, respectively (all P < 0.05). Among these, the top five diseases with increasing standardized incidence rates were dengue, influenza, HIV, hand- foot- mouth disease, and syphilis. The AAPC for standardized incidence rates of diseases transmitted through blood/sexual contact was 17.33%, and the AAPC for viral pathogens was 7.58% (all P < 0.05). Among these, only the standardized fatality rate of HIV showed an increasing trend. Conclusions From 2004 to 2019, the standardized incidence and fatality rates of notifiable infectious diseases in the elderly population in China have shown an overall upward trend, especially for viral and blood/sexually transmitted infectious diseases, which have increased rapidly. Targeted prevention and control measures for notifiable infectious diseases should be developed for the elderly population. -
图 1 2004―2019年老年人群法定报告传染病标化发病率和病死率总体趋势
A：总体标化发病率; B：总体标化病死率。
Figure 1. Trend of the standardized incidence and fatality rates of notifiable infectious diseases in the elderly population during 2004-2019
A: overall standardized incidence; B: overall standardized fatality rate.
图 2 不同传播方式法定报告传染病标化发病率及病死率趋势
A1~F1：依次为呼吸道传播、肠道传播、血液/性传播、人畜共患传播、媒介传播、其他方式传播的标化发病率; A2~E2：依次为呼吸道传播、肠道传播、血液/性传播、人畜共患传播、媒介传播的标化病死率。其他方式传播的法定报告传染病标化病死率数据较少，未展示。
Figure 2. Transmission mode specific trends in the standardized incidence and fatality rates of notifiable communicable diseases
A1-F1: the standardized incidence of respiratory transmission, intestinal transmission, blood/sexual transmitted, zoonotic transmission, media communication, and other means of transmission was in order; A2-E2: the standardized fatality rate of respiratory transmission, intestinal transmission, blood/sexual transmitted, zoonotic transmission, media communication of transmission was in order. Data on the fatality rate of notifiable communicable diseases transmitted by other means are scarce and not presented.
图 3 不同病原体法定报告传染病标化发病率和病死率趋势
A：细菌标化发病率; B：细菌标化病死率; C：病毒标化发病率; D：病毒标化病死率; E：寄生虫标化发病率; F: 寄生虫标化病死率。
Figure 3. Pathogen specific trends in the standardized incidence and fatality rates of notifiable infectious diseases
A: standardized incidence of bacteria; B: standardized fatality rate of bacterial; C: standardized incidence of the virus; D: standardized fatality rate of virus; E: standardized incidence of parasites; F: standardized fatality rate of parasites.
图 4 纳入国家免疫规划的法定报告传染病标化发病率和病死率趋势
A：标化发病率; B：标化病死率。
Figure 4. Trends in the standardized incidence and fatality rates of notifiable communicable diseases included in the national immunization program
A: standardized incidence; B: standardized fatality rate.
表 1 2004―2019年我国老年人群不同病种法定报告传染病标化发病率流行趋势
Table 1. Epidemiological trends of standardized incidence of notifiable infectious diseases in different types in the elderly population of China from 2004 to 2019
疾病名称
Disease name发病人数
Number of cases年发病率
Annual incidence/100 000-1区段Section AAPC值value
(95% CI)/%年份
YearAPC值value
(95% CI)/%肺结核Pulmonary tuberculosis 4 667 187 144.31 2004―2006 3.47(-6.56-14.59) -3.19(-4.42~-1.94) 2006―2019 -4.17(-4.68~-3.66) 乙型病毒性肝炎Hepatitis B 2 394 392 74.04 2004―2010 10.61(7.77~13.53) 4.58(3.34~5.83) 2010―2019 0.74(-0.67~2.16) 其他感染性腹泻Other infectious diarrhea 1 464 917 45.30 2005―2009 1.20(-6.57~9.62) 4.27(1.84~6.76) 2009―2019 5.52(3.47~7.62) 梅毒Syphilis 1 268 505 39.22 2004―2010 34.59(28.17~41.33) 16.78(14.19~19.43) 2010―2019 6.24(3.47~9.08) 丙型病毒性肝炎Hepatitis C 720 554 22.28 2004―2012 18.29(15.05~21.62) 10.40(8.29~12.55) 2012―2019 2.03(-1.38~5.55) 细菌性痢疾Bacillary dysentery 516 462 15.97 2004―2013 -8.64(-10.57~6.67) -10.20(-11.81~-8.56) 2013―2019 -12.49(-15.88~-8.97) 流行性感冒Influenza 379 627 11.74 2005―2017 34.12(28.79~39.68) 37.11(25.12~50.25) 2017―2019 56.48(-21.21~210.75) 艾滋病Acquired immunodeficiency syndrome 216 574 6.70 2004―2011 47.75(38.15~58.02) 29.64(24.78~34.69) 2011―2019 15.63(9.45~22.15) 戊型病毒性肝炎Hepatitis E 122 791 3.80 2004―2012 7.96(4.77~11.25) 3.47(1.33~5.65) 2012―2019 -1.44(-4.99~2.25) 甲型病毒性肝炎Hepatitis A 85 920 2.66 2004―2010 -11.70(-14.94~-8.33) -6.18(-7.77~-4.55) 2010―2019 -2.30(-4.26~-0.31) 淋病Gonorrhea 93 082 2.88 2004―2013 -5.00(-6.67~-3.30) -3.76(-5.20~-2.30) 2013―2019 -1.88(-5.05~1.39) 布鲁氏菌病Brucellosis 90 223 2.79 2004―2014 23.98(20.24~27.82) 12.20(8.69~15.82) 2014―2019 -8.11(-15.83~0.32) 急性出血性结膜炎Acute hemorrhagic conjunctivitis 72 906 2.25 2004―2019 13.24(3.49~23.91) 13.24(3.49~23.91) 伤寒和副伤寒Typhoid and paratyphoid fever 37 778 1.17 2004―2019 -3.87(-5.48~-2.23) -3.87(-5.48~-2.23) 疟疾Malaria 34 582 1.07 2004―2019 -36.23(-43.74~-27.71) -36.23(-43.74~-27.71) 出血热Hemorrhagic fever 32 753 1.01 2004―2008 -21.10(-30.30~-10.80) -7.80(-10.00~-5.50) 2008―2019 18.90(-2.20~44.50) 流行性腮腺炎Epidemic parotitis 22 927 0.71 2005―2012 14.41(9.31~19.75) 8.81(5.76~11.94) 2012―2019 3.48(-1.13~8.30) 血吸虫病Schistosomiasis 19 517 0.60 2005―2019 -19.28(-30.11~-6.77) -19.28(-30.11~-6.77) 登革热Dengue fever 15 100 0.47 2004―2019 39.78(17.70~65.99) 39.78(17.70~65.99) 棘球蚴病Hydatidosis 9 348 0.29 2005―2019 9.49(3.86~15.43) 9.49(3.86~15.43) 狂犬病Rabies 7 172 0.22 2004―2007 12.96(-4.78~34.00) -10.26(-13.23~-7.19) 2007―2019 -15.27(-16.97~-13.55) 斑疹伤寒Typhus fever 4 181 0.13 2004―2019 -1.51(-2.80~-0.21) -1.51(-2.80~-0.21) 阿米巴痢疾Amoebic dysentery 3 974 0.12 2004―2014 -10.57(-12.27~-8.83) -9.44(-11.23~-7.61) 2014―2017 -7.13(-12.13~-1.85) 流行性乙型脑炎Japanese encephalitis 2 603 0.08 2004―2019 1.34(-8.22~11.90) 1.34(-8.22~11.90) 手足口病Hand, foot, and mouth disease 1 730 0.05 2008―2011 97.50(52.01~156.62) 23.07(14.92~31.79) 2011―2019 3.07(-2.66~9.13) 风疹Rubella 1 675 0.05 2004―2019 -10.20(-16.72~-3.16) -10.20(-16.72~-3.16) 钩端螺旋体病Leptospirosis 1 503 0.05 2004―2019 -4.23(-7.05~-1.32) -4.23(-7.05~-1.32) 麻风病Leprosy 1 008 0.05 2004―2019 -2.57(-5.34~0.28) -2.57(-5.34~0.28) 麻疹Measles 762 0.02 2004―2019 -5.00(-12.43~3.05) -5.00(-12.43~3.05) 炭疽Anthrax 604 0.02 2004―2019 -5.17(-7.53~-2.76) -5.17(-7.53~-2.76) 注：APC，年度变化百分比; AAPC，平均年度变化百分比。
Note: APC, annual percent change; AAPC, average annual percent change.
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表 2 2004―2019年我国老年人群不同病种法定报告传染病标化病死率流行趋势
Table 2. Epidemiological trends of standardized fatality rate of notifiable infectious diseases in different types in the elderly population of China from 2004 to 2019
疾病名称
Disease name死亡人数
Number of cases年均病死率
Annual fatality rate/1 000-1区段Section AAPC值value
(95% CI)/%年份
YearAPC值value
(95% CI)/%狂犬病Rabies 7 004 976.58 2004―2019 -0.48(-0.69~-0.27) -0.48(-0.69~-0.27) 艾滋病Acquired immunodeficiency syndrome 78 810 363.89 2004―2009 39.37(28.92~50.67) 11.83(8.73~15.03) 2009―2019 0.18(-2.50~2.93) 钩端螺旋体病Leptospirosis 25 16.66 2004―2019 -49.30(-67.08~-21.90) -49.30(-67.08~-21.90) 戊型病毒性肝炎Hepatitis E 253 2.06 2004―2015 -14.29(-20.33~-7.78) -11.42(-19.41~-2.65) 2015―2019 -3.05(-31.22~36.65) 丙型病毒性肝炎Hepatitis C 713 0.99 2004―2019 -11.83(-14.42~-9.17) -11.83(-14.42~-9.17) 甲型病毒性肝炎Hepatitis A 72 0.84 2004―2019 -9.69(-16.54~-2.27) -9.69(-16.54~-2.27) 梅毒Syphilis 384 0.30 2004―2014 -13.06(-17.29~-8.62) -15.01(-19.30~-10.50) 2014―2019 -18.78(-29.60~-6.29) 乙型病毒性肝炎Hepatitis B 3 016 0.30 2004―2015 -11.74(-13.46~-9.98) -8.35(-10.65~-5.99) 2015―2019 1.64(-7.33~11.48) 其他感染性腹泻Other infectious diarrhea 99 0.07 2005―2012 -25.41(-37.44~-11.08) -14.15(-23.05~-4.23) 2012―2019 -1.19(-17.12~17.80) 注：APC，年度变化百分比; AAPC，平均年度变化百分比。
Note: APC, annual percent change; AAPC, average annual percent change.
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