目的 分析2014-2023年南宁市小学水痘突发公共卫生事件(public health emer-gency events,PHEEs)的流行病学特征和影响因素,为开展小学水痘疫情防控工作提供科学参考.方法 通过中国疾病预防控制信息系统收集2014-2023年南宁市水痘发病资料和小学水痘突发公共卫生事件信息,采用移动平均预警方法识别水痘流行期,运用描述性流行病学方法分析小学水痘PHEEs疫情特征,采用逐步法建立多重线性回归模型,分别分析水痘突发疫情持续时间和各流行期内PHEEs起数和疫情总病例数的相关因素.结果 2014-2023年南宁市共报告116起小学水痘突发公共卫生事件,疫情主要发生在冬春季流行期(66.38％),不同流行期水痘突发公共卫生事件的中位持续时间(H=1.62,P=0.204)和疫情中位病例数(H=1.69,P=0.194)差异无统计学意义.农村小学总发病率(5.82％)高于其他类型学校(x2=646.04,P＜0.001);县镇小学的疫情持续时间(F=4.02,P=0.021)、疫情平均病例数(F=4.54,P=0.013)、涉及班级数(F=9.36,P＜0.001)最高;城市小学疫情涉及人数(F=28.06,P＜0.001)最高.疫情首次报告病例数(β=0.84,P=0.006)、单起疫情病例数(β=0.16,P=0.048)和涉及班级数(β=1.21,P=0.004)是小学水痘突发公共卫生事件持续时间的影响因素;流行期内疫情总起数及疫情病例总数与首起疫情持续时间呈正相关(疫情总起数:β=0.08,P=0.029;疫情病例总数:β=6.16,P=0.001),与流行期内疫情平均时间间隔呈负相关(疫情总起数:β=-0.21,P＜0.001;疫情病例总数:β=-8.14,P=0.001).结论 在水痘流行期应重视小学水痘疫情的防控,提高对校园水痘聚集疫情监测的敏感度,减少班级间传播可缩短突发公共卫生事件持续时间,同时应加强流行期异常信号识别(首起疫情持续时间、疫情间隔时间),以及时评估整体暴发水平.
Epidemiological characteristics and related factors of varicella public health emergency events in primary schools of Nanning City from 2014 to 2023
Objective This study aimed to analyze the epidemiological characteristics and related factors of varicella public health emergency events(PHEEs)in primary schools in Nanning City from 2014 to 2023,offering scientific insights for the prevention and control of varicella outbreaks in schools.Methods Utilizing the China information system for disease control and prevention,we collected data on varicella cases and PHEEs in primary schools.The moving average warning method identified varicella epidemic periods.Descriptive epidemiology was applied to characterize these PHEEs.We employed stepwise approaches to construct multiple linear regression models,focusing on the factors associated with the duration of varicella outbreaks,the frequency of PHEEs,and the total number of cases during each epidemic period.Results Between 2014 and 2023,Nanning City reported 116 varicella PHEEs in primary schools,predominantly occurring during the winter and spring epidemic periods(66.38％).No significant differences were observed in the median duration(H=1.62,P=0.204)and case numbers across various epidemic periods(H=1.69,P=0.194).The overall incidence rate in rural primary schools was significantly higher at 5.82％,compared to other school types(x2=646.04,P＜0.001).County-town primary schools experienced the longest epidemic duration(F=4.02,P=0.021),highest average number of cases per outbreak(F=4.54,P=0.013),and the greatest involvement of classes(F=9.36,P＜0.001).Urban primary schools had the highest number of people affected(F=28.06,P＜0.001).The duration of varicella PHEEs was significantly influenced by the initial case numbers reported(β=0.84,P=0.006),the number of cases per outbreak(β=0.16,P=0.048),and the number of classes involved(β=1.21,P=0.004).Furthermore,the total number of PHEEs and total case numbers during an epidemic period were positively associated with the duration of the first outbreak(β=0.08,P=0.029;β=6.16,P=0.001)and negatively with the average interval time between outbreaks(β=-0.21,P＜0.001;β=-8.14,P=0.001).Conclusions Heightened focus on varicella prevention and control in primary schools is essential,especially during epidemic periods.Enhancing the sensitivity of school-based varicella outbreak monitoring and reducing transmission between classes can shorten the duration of PHEEs.Strengthening the recognition of abnormal signals during the epidemic,such as the duration of the first outbreak and the interval between outbreaks,is crucial for the timely assessment of the overall outbreak level.
VaricellaPrimary schoolPublic health emergency eventEpidemic period
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