网络首发:2014-07-20,
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广东省2009-2012年手足口病流行趋势分析[J]. 中山大学学报(医学科学版), 2014,35(4).
Epidemiological Features and Trends of Hand, Foot and Mouth Disease in GuangdongProvince, 2009-2012[J]. Journal of Sun Yat-sen University (Medical Sciences), 2014, 35(4).
【目的】 分析广东省2009-2012年手足口病在三间分布和病原构成上的流行病学特征及其变化趋势。【方法】利用广东省2009-2012年手足口病监测数据、广东省人口数据和地理资料,对全省的手足口病时间趋势、人群分布特征以及病原构成等进行分析,继而运用Moran’s I确证相邻区县发病率的空间自相关性和异质性,并纳入贝叶斯空间模型,估算各年各区县发病的相对危险度(RR),探索全省手足口病发病风险变化的空间模式。【结果】广东省手足口病病例数(9.3万 ~ 33.1万)和发病率(9.75/万~32.08/万)逐年上升,年内呈双峰分布。男性高发,男女发病率之比(1.75 ~ 1.90)逐年下降;不同类型病例均主要集中于5岁以下儿童,以1~ < 2岁组儿童所占比例和发病率最高;EV71感染者的重症率(22.62% ~ 34.11%)和病死率(0.93%~3.83%)均比COX A16感染者(重症率:1.32%~ 3.48%;病死率:0.00%)要高。各年Moran’s I在0.39 ~ 0.51之间。珠三角地区的发病率和相对危险度最高,且逐年上升。【结论】 在2009-2012年之间,广东省手足口病流行强度逐年增强。不同时间、不同性别、不同年龄组发病率均存在较大差异。手足口病的发病率存在中等强度的空间自相关性和异质性,珠三角区域是该病高发病高风险区域,且每年的空间风险分布格局有所变化。
【Objective】 To identify the epidemiological features and trends of hand, footand mouth disease (HFMD) during 2009-2012 in Guangdong Provinceso as to facilitate better intervention allocations. 【Methods】 Surveillance dataof HFMD, population data and geographical data of Guangdong Province during thestudy period were analyzed for the characterizing purpose. Then Moran’s I was calculated to discern the existence of spatial autocorrelationand heterogeneity between neighboring districts, which was later incorporated intoBayesian spatial models to calculate the RR of HFMD for every districts and determinethe spatial pattern of RR changing. 【Results】 The analysis showed that both thenumber of cases[(9.3 ~ 33.1)×105] and the incidence[(9.75 ~ 32.08)×10-5] of HFMDin Guangdong were increasing, with two peaks occurred every year during 2009-2012.The HFMD incidence of males was higher than that of females, and the ratio of thesetwo figures (1.75 ~ 1.90) was decreasing annually. All kinds of cases were clusteringmainly in children under 5, while children of 1 ~ year age-grouptended to have the most cases and the highest morbidity every year. Both the incidenceof severe cases and the case-fatality rate of EV71 infection(incidence of severe cases: 22.62% ~ 34.11%; case-fatalityrate: 0.93%~3.83%) were higher than those of COX A16 infection (incidence of severecases: 1.32%~3.48%; case-fatality rate: 0.00%). The Moran’s I ranged from 0.39 ~ 0.51. The morbidity and relative risk(RR) of the Pearl River Delta region were the highest, and kept increasing annually.【Conclusions】 The study suggests that the HFMD epidemics in Guangdong Province wereincreasing from 2009 to 2012. Incidence deviations were seen existed between groupsof different time periods, genders or ages. The spatial analysis showed a mediumspatial autocorrelation and heterogeneity of incidence between neighboring districts,and the Pearl River Delta region was the major region of high risk. The spatialpatterns of these specific regions were changing annually.
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