2014―2023年云南省猩红热流行趋势及时空分布特征

李晓娟; 王仕莲; 苏建娟; 崔凤灵; 陈静文; 张竞文; 许国; 洪汝丹; 邓淑珍

doi:10.16462/j.cnki.zhjbkz.2025.05.005

2014―2023年云南省猩红热流行趋势及时空分布特征

doi: 10.16462/j.cnki.zhjbkz.2025.05.005

李晓娟¹,
王仕莲²,
苏建娟²,
崔凤灵²,
陈静文³,
张竞文^{4, 5},
许国⁶,
洪汝丹²,
邓淑珍^{4, 5, ,}

1.
河南中医药大学医学院，郑州 450046
2.
大理大学公共卫生学院流行病与卫生统计学教研室，大理 671000
3.
玉溪市疾病预防控制中心监测科，玉溪 653100
4.
云南省疾病预防控制中心健康促进与公共卫生信息中心，昆明 650022
5.
云南省疾病预防控制中心学校卫生所，昆明 650022
6.
云南民族大学医院内科，昆明 650031

李晓娟和王仕莲为共同第一作者

基金项目:

河南省自然科学基金 232300421164

河南省高等学校重点研究计划项目基础研究专项 23ZX005

河南省科技研发计划联合基金(优势学科培育类) 232301420070

详细信息

通讯作者:
邓淑珍，E-mail: 461447164@qq.com

中图分类号: R181.3
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- 被引次数: 0
出版历程
- 收稿日期: 2024-10-22
- 修回日期: 2025-02-23
- 刊出日期: 2025-05-10

Spatiotemporal patterns and epidemiological trends of scarlet fever epidemic in Yunnan Province from 2014 to 2023

1.
Medical College of Henan University of Traditional Chinese Medicine, Zhengzhou 450046, China
2.
Department of Epidemiology and Health Statistics, School of Public Health, Dali University, Dali 671000, China
3.
Monitoring Department of Yuxi Center for Disease Control and Prevention, Yuxi 653100, China
4.
Yunnan Provincial Center for Disease Control and Prevention Health Promotion and Public Health Information Center, Kunming 650022, China
5.
Yunnan Provincial Center for Disease Control and Prevention, School Health Office, Kunming 650022, China
6.
Yunnan Minzu University Hospital of Internal Medicine, Kunming 650031, China

LI Xiaojuan and WANG Shilian contributed equally to this article

Funds:

Natural Science Foundation of Henan Province 232300421164

Basic Research Special Project of Key Research Program of Higher Education Institutions in Henan Province 23ZX005

Joint Fund for Technology Research and Development Plan of Henan Province (Advantageous Discipline Cultivation Category) 232301420070

More Information

Corresponding author: DENG Shuzhen, E-mail: 461447164@qq.com

摘要

摘要: 目的分析2014―2023年云南省猩红热的流行趋势及时空分布特征，为猩红热防控策略提供科学依据。方法采用Joinpoint回归分析计算平均年度变化百分比，使用空间自相关与时空聚集性分析探讨云南省猩红热发病的时空分布特征。结果 2014―2023年云南省猩红热发病率呈波浪上升趋势，累计报告猩红热患者18 210例，年均报告发病率为3.88/10万; 男性年均发病率均高于女性; 发病率最高的年龄组为5~＜10岁年龄组(52.3%)，其次为0~＜5岁年龄组(37.3%); 97.7%的病例集中在托幼儿童(43.4%)、学生(31.9%)和散居儿童(22.5%); 猩红热发病率存在季节性(M=0.526~1.308)，每年均呈双峰分布，即5―6月和11―12月; 年均发病率前3的州(市)为丽江市(11.07/10万)、玉溪市(7.61/10万)和大理白族自治州(6.43/10万)。2014―2023年云南省猩红热发病存在5个聚集区，主要集中在云南省西北部丽江市和大理市，云南省南部和西南部红河哈尼族彝族自治州、玉溪市和普洱市，云南省东部文山壮族苗族自治州、曲靖市及东北部昭通市; 2014―2023年云南省猩红热发病率不存在全局空间自相关(均P>0.05);局部自相关分析显示，“高-高”聚集区主要集中在云南省西北部丽江市宁蒗县和兰坪县、大理白族自治州永平县、玉溪市易门县和峨山县、曲靖市师宗县、昆明市禄劝县; “低-低”聚集区主要集中在云南省西部临沧市、大理白族自治州、楚雄彝族自治州、普洱市、西北迪庆藏族自治州部分地区、东部曲靖市部分地区、中部昆明市部分地区。结论 2014―2023年云南省猩红热发病率呈上升趋势，托幼儿童和学生是发病的高危人群，发病存在空间聚集特征，应加强高发地区和重点人群的病例监测。
- 猩红热 /
- 流行趋势 /
- 时空分布特征
Abstract: Objective To analyze the epidemiological trend and distribution characteristics of scarlet fever in Yunnan Province from 2014 to 2023, and to provide scientific basis for scarlet fever prevention and control strategies. Methods Joinpoint regression analysis was used to calculate the annual percentage of change. And spatial autocorrelation and spatio-temporal aggregation analysis were used to explore the spatial and temporal distribution characteristics of scarlet fever in Yunnan Province. Results A total of 18 210 cases of scarlet fever were reported in Yunnan Province from 2014 to 2023, with an average annual incidence of 3.88/100 000. The incidence of scarlet fever in Yunnan Province showed a wave upward trend in the past 10 years. The incidence of male was higher than that of female. The age group with the highest incidence was 5- < 10 years old (52.3%), followed by 0- < 5 years old (37.3%). 97.7 % of the cases were concentrated in preschool children (43.4%), students (31.9%) and scattered children (22.5%). The incidence of scarlet fever had obvious seasonality (M=0.526-1.308), with a bimodal distribution every year, concentrated in May-June and November-December. The top three areas with the highest average annual incidence were Lijiang City (11.07/100 000), Yuxi City (7.61/100 000) and Dali Bai Autonomous Prefecture (6.43/100 000). The results of spatio-temporal scanning analysis showed that there were five clustering areas of scarlet fever in Yunnan Province from 2014 to 2023. The clustering areas were mainly concentrated in Lijiang City and Dali Prefecture in northwest Yunnan, Honghe Prefecture, Yuxi City and Pu ′er City in south and southwest Yunnan, Wenshan Prefecture, Qujing City in east Yunnan and some areas of Zhaotong City in northeast Yunnan. There was no global spatial autocorrelation in the incidence of scarlet fever in Yunnan Province from 2014 to 2023 (all P>0.05). The local autocorrelation analysis showed that the high-high clustering areas were mainly concentrated in Ninglang County and Lanping County of Lijiang City, Yongping County of Dali Prefecture, Yimen County and Eshan County of Yuxi City, Shizong County of Qujing City and Luquan County of Kunming City in the northwest of Yunnan Province. The low-low aggregation areas are mainly concentrated in Lincang City, Dali Prefecture, Chuxiong Prefecture, part of Pu′er City, part of Diqing Prefecture in Northwest Yunnan, part of Qujing City in East Yunnan, and part of Kunming City in Central Yunnan. Conclusions Scarlet fever in Yunnan Province showed an upward trend. Kindergarten children and students are the high-risk groups of the disease. The incidence of scarlet fever in Yunnan Province has spatial clustering characteristics. We should pay close attention to the changes of epidemic trends and strengthen the monitoring of cases in high-risk areas and High-risk groups.
- Scarlet fever /
- Popular trend /
- Spatial and temporal distribution characteristics

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图 1 2014―2023年云南省报告猩红热发病例数和发病率

Figure 1. The number of cases and incidence rate of scarlet fever reported in Yunnan Province from 2014 to 2023

下载: 全尺寸图片幻灯片

图 2 2014―2023年云南省各县(市、区)猩红热发病率分布情况

Figure 2. Distribution of scarlet fever incidence rate in counties of Yunnan Province from 2014 to 2023

下载: 全尺寸图片幻灯片

图 3 2014―2023年云南省猩红热发病时空扫描聚集图

Figure 3. Spatio-temporal scan aggregation map of scarlet fever in Yunnan Province from 2014 to 2023

下载: 全尺寸图片幻灯片

图 4 2014―2023年云南省猩红热发病率局部空间自相关指标聚集分布

Figure 4. Aggregation distribution of local spatial autocorrelation index of scarlet fever incidence rate in Yunnan Province from 2014 to 2023

下载: 全尺寸图片幻灯片

表 1 2014―2023年云南省各州(市)猩红热发病率及均匀分布检验

Table 1. The incidence rate of scarlet fever and uniform distribution test in Yunnan Province from 2014 to 2023

地区 Region	猩红热发病率The incidence rate of scarlet fever/100 000^-1										P值 value
地区 Region	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023	P值 value
昆明市Kunming City	3.52	4.38	5.89	2.81	3.26	2.13	0.56	2.39	1.63	1.94	0.001
曲靖市Qujing City	1.64	2.38	1.87	1.82	1.83	4.00	1.46	5.78	3.92	2.36	0.085
玉溪市Yuxi City	5.80	9.64	9.15	9.26	11.26	10.77	1.72	8.06	5.51	4.92	0.332
保山市Baoshan City	5.37	5.69	5.66	8.36	8.15	5.86	2.89	3.08	4.34	6.80	0.569
昭通市Zhaotong City	1.63	2.18	1.92	1.64	1.59	1.56	1.01	2.00	2.02	1.17	0.482
丽江市Lijiang City	6.29	15.39	5.86	5.91	17.52	18.60	8.45	11.80	5.72	15.19	0.739
普洱市Pu′er City	2.69	4.82	4.18	8.44	9.36	4.82	2.26	10.77	5.00	6.84	0.406
临沧市Lincang City	0.24	0.52	0.48	1.31	0.75	0.28	0.20	0.22	0.18	0.58	0.300
楚雄彝族自治州Chuxiong Prefecture	1.02	0.97	1.43	0.69	1.49	1.38	0.80	1.45	0.67	0.59	0.591
红河哈尼族彝族自治州Honghe Prefecture	2.11	5.13	4.41	4.63	5.11	7.99	2.35	7.59	3.15	3.56	0.759
文山壮族苗族自治州Wenshan Prefecture	1.25	1.80	1.66	2.71	1.98	2.11	1.25	6.11	4.07	3.91	0.002
西双版纳州Xishuangbanna Prefecture	0.17	0.26	0.26	1.71	1.44	1.77	0.17	1.08	0.93	0.69	0.805
大理白族自治州Dali Prefecture	2.28	5.64	3.72	8.75	13.81	6.46	4.01	5.51	6.32	7.84	0.426
德宏傣族景颇族自治州Dehong Prefecture	1.70	2.66	4.22	3.04	7.79	3.04	1.96	2.58	2.21	3.71	0.984
怒江傈僳族自治州Nujiang Prefecture	0.37	1.64	6.80	4.13	4.94	3.07	9.16	4.89	2.73	3.30	0.834
迪庆藏族自治州Diqing Prefecture	1.96	0.97	0.74	5.99	0	1.93	5.50	15.23	2.86	3.84	0.114

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表 2 2014―2023年云南省猩红热发病率集中度值

Table 2. Concentration value of scarlet fever incidence rate in Yunnan Province from 2014 to 2023

年份Year	R_x	R_y	M
2014	0.650	-0.151	0.667
2015	0.984	-0.861	1.294
2016	0.369	-0.683	0.776
2017	0.443	-0.616	0.812
2018	0.820	-0.771	1.013
2019	0.375	-0.529	0.664
2020	-0.474	0.228	0.526
2021	0.539	-0.626	0.826
2022	0.367	-0.442	0.574
2023	-0.391	-0.361	0.607
注：M, 集中度; R, 离散度。 Note: M, concentration, R, dispersion.

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表 3 2014―2023年云南省猩红热时空扫描分析

Table 3. Spatio-temporal scan analysis of scarlet fever in Yunnan Province from 2014 to 2023

聚集区 Clusters detected	中心点 Coordinates	半径 Radius/km	聚集时间/年 Time frame/year	聚集地区数 Number of agglomerations	实际病例数 Actual number of cases	理论病例数 Expected cases	RR值 value	LLR值 value	P值 value
1	26.687 766N, 100.749 742E	96.71 km	2016―2019	8	1 512	310.86	5.21	1 231.86	< 0.001
2	23.434 743N, 101.690 555E	117.81 km	2018―2021	13	1 779	526.77	3.63	958.30	< 0.001
3	24.535 070N, 103.763 981E	67.34 km	2014―2017	7	968	485.14	2.05	192.47	< 0.001
4	23.708 484N, 102.494 623E	77.82 km	2014―2015	13	490	307.04	1.61	47.02	< 0.001
5	34.254 093N, 117.246 281E	1 366.08 km	2014―2015	3	86	48.46	1.78	11.83	0.012

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表 4 2014―2023年云南省猩红热发病率全局空间自相关分析

Table 4. Global spatial autocorrelation analysis of scarlet fever incidence rate in Yunnan Province from 2014 to 2023

年份 Year	莫兰指数 Moran′s I	Z值 value	P值 value	聚集 Aggregation
2014	0.02	0.51	0.61	否No
2015	0.02	0.47	0.64	否No
2016	-0.02	-0.22	0.83	否No
2017	-0.01	0.03	0.97	否No
2018	-0.01	-0.03	0.98	否No
2019	0.01	0.45	0.66	否No
2020	0.04	0.98	0.33	否No
2021	0.00	0.16	0.87	否No
2022	-0.02	-0.37	0.71	否No
2023	0.03	0.66	0.51	否No

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