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目的分析江苏省无锡市手足口病(Hand-Foot-Mouth Disease,HFMD)流行的时空分布特征,探讨气象因素对HFMD发病的影响,为HFMD的防控提供科学依据。方法应用时空聚类分析确定HFMD及重症HFMD患者的聚集区域和高发时段,用负二项分布模型分析HFMD发病与气象因素的关联。结果无锡市2009-2014年共报告HFMD患者79 571例,年均发病率为196.99/10万,2012年及2014年为2个发病高峰年,无锡市HFMD存在两个季节性发病高峰(4-7月和11-12月)。时空聚集分析显示无锡市HFMD1号聚集区相对危险度(Relative Risk,RR)为1.96,共覆盖25个乡镇,主要位于城区及城乡结合部,高发时段为2011年5月10日-2014年12月22日;2号聚集区RR为3.47,共覆盖22个乡镇,主要位于远郊及农村地区,高发时段为2014年3月25日-2014年7月21日。重症HFMD 1号聚集区RR为4.04,共覆盖17个乡镇,主要位于远郊及农村地区;2号聚集区RR为2.53,共覆盖17个乡镇,主要位于城区及城乡结合部。控制了“年”因素后,月平均气温每升高1℃,HFMD月发病数上升4.27%(95%CI:0.59%-8.10%)。结论无锡市HFMD发病呈周期性及季节性分布特征;HFMD及重症HFMD发病不是随机分布,存在明显时空聚集的特点;气温为HFMD发病的危险因素。
Objective To analyze the spatiotemporal distribution characteristics of Hand-Foot-Mouth Disease (HFMD) in Wuxi City, Jiangsu Province, and to explore the influence of meteorological factors on the incidence of HFMD so as to provide a scientific basis for the prevention and control of HFMD. Methods Spatiotemporal clustering analysis was used to identify the areas of aggregation and high incidence of HFMD and HFMD. The negative binomial distribution model was used to analyze the association between HFMD incidence and meteorological factors. Results A total of 79 571 HFMD patients were reported in Wuxi in 2009-2014, with an average annual incidence of 196.99 / 100 000. There were two peak incidence years in 2012 and 2014. There were two seasonal peak occurrences in Wuxi HFMD (4- July and November-December). Spatial and temporal cluster analysis showed that the relative risk (RR) of HFMD1 gathering area in Wuxi was 1.96, covering 25 towns and townships, mainly located in the urban area and the junction of urban and rural areas. The high incidence period was from May 10, 2011 to December 2014 On the 22nd, the RR of No.2 gathering area was 3.47, covering a total of 22 townships, mainly in the outer suburbs and rural areas. The high incidence period was from March 25, 2014 to July 21, 2014. Severe HFMD agglomeration RR 1 was 4.04, covering a total of 17 towns and villages, mainly in the outer suburbs and rural areas; RRR of 2.52, covering a total of 17 townships, mainly in the urban area and urban-rural integration. After controlling for “year”, monthly incidence of HFMD increased by 4.27% (95% CI: 0.59% -8.10%) for every 1 ℃ increase in monthly average temperature. Conclusions The incidence of HFMD in Wuxi is cyclical and seasonal. The incidence of HFMD and severe HFMD is not randomly distributed, and has the obvious feature of spatial and temporal aggregation. The temperature is the risk factor of HFMD.