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中国登革热发病趋势与时空分布特征

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目的 根据中国疾病预防控制信息系统和国家卫生健康委员会公布的《全国法定传染病疫情概况》资料,分析中国登革热发病趋势与时空分布特征,为登革热疫情防控提供科学依据.方法 收集2015-2023年中国登革热发病率和月发病数信息,按疫情严重程度及媒介伊蚊分布状况对各省份进行分类,对中国登革热发病趋势、季节性分布、空间聚集性进行统计分析.结果 2015-2023年平均每年发病率排前5位的省份分别为云南(6.16/10万)、广东(1.70/10万)、海南(1.13/10万)、福建(1.13/10万)和重庆(0.74/10万).2015-2019年中国登革热发病率平均每年升高70.79%[平均年度变化百分比(average annual percentage change,AAPC)=70.79,P=0.045].Ⅰ类地区中,广西、海南发病率具有线性回归趋势,平均每年升高844.73%(AAPC=844.73,P=0.021)、516.51%(AAPC=516.51,P=0.013).Ⅱ类地区中,除上海外,其他省份发病率均具备线性回归趋势,其中江西平均每年上升幅度最高(610.16%)(AAPC=610.16,P=0.021),其次为重庆(345.12%)(AAPC=345.12,P=0.038).Ⅲ类地区中,河北、山西、辽宁发病率具有线性回归趋势,平均每年升高80.67%(AAPC=80.67,P=0.028)、202.31%(AAPC=202.31,P=0.001)、70.19%(AAPC=70.19,P=0.031).登革热的流行在2021年无明显季节性,2022年表现为严格的季节性,其余年份均表现为很强的季节性.流行高峰日多集中于每年的9月中下旬至10月初,流行高峰期主要集中于8-11月.2015-2018年发病率在全国范围无空间聚集性,2019年发病率在全国具有空间聚集性.2015-2019年、2023年全国无高—低聚集区,2018年(福建、海南)、2019年(广西)出现高—高聚集区.结论 我国登革热防控形势严峻,登革热高风险流行区将不再局限于Ⅰ类省份,高流行地区将有向Ⅱ类省份扩张的风险.
Incidence trends and spatiotemporal distribution characteristics of dengue fever in China
Objective To analyze the incidence trends and spatiotemporal distribution characteristics of dengue fever in China based on the data from the China Disease Control Information System and the"National Statutory Infectious Disease Epidemic Overview"published by the National Health Commission of the People's Republic of China,and to provide a scientific basis for the prevention and control of dengue fever epidemics.Methods The incidence rates and monthly case numbers of dengue fever in China from 2015 to 2023 were collected.Provinces were classified according to the severity of the epidemic and the distribution status of the Aedes vector.The incidence trends,seasonal distribution,and spatial aggregation of dengue fever in China were statistically analyzed.Results The top five provinces with the highest average annual incidence rates from 2015 to 2023 were Yunnan(6.16/100 000),Guangdong(1.70/100 000),Hainan(1.13/100 000),Fujian(1.13/100 000),and Chongqing(0.74/100 000).The average annual incidence rate of dengue fever in China increased by 70.79%from 2015 to 2019(AAPC=70.79,P=0.045).In Class Ⅰ regions,the incidence of Guangxi and Hainan showed a linear regression trend,with average annual increases of 844.73%(AAPC=844.73,P=0.021)and 516.51%(AAPC=516.51,P=0.013),respectively.In ClassⅡ regions,except for Shanghai,the incidence of other provinces showed a linear regression trend,with Jiangxi having the highest average annual increase of 610.16%(AAPC=610.16,P=0.021),followed by Chongqing at 345.12%(AAPC=345.12,P=0.038).In ClassⅢregions,the incidence of Hebei,Shanxi,and Liaoning had a linear regression trend,with average annual increases of 80.67%(AAPC=80.67,P=0.028),202.31%(AAPC=202.31,P=0.001),and 70.19%(AAPC=70.19,P=0.031),respectively.The epidemic of dengue fever showed no obvious seasonality in 2021,strict seasonality in 2022,and strong seasonality in the rest of the years.The epidemic peak days were mostly concentrated in the middle and late September to early October of each year,and the epidemic peak periods were mainly concentrated in August-early November.From 2015 to 2018,the incidence rate had no spatial aggregation nationwide,and the incidence rate in 2019 had spatial aggregation nationwide.In 2015-2019 and 2023,there were no high-low gathering areas in the country,and high-high gathering areas appeared in 2018(Fujian,Hainan)and 2019(Guangxi).Conclusions The situation of dengue fever prevention and control in China is grim.High-risk epidemic areas of dengue fever will no longer be limited to Class Ⅰ provinces,and the risk of expansion to ClassⅡprovinces is increasing.

Dengue feverincidence trendseasonal distributionspatial aggregation

赵锦、周银柱、陈水连、邱劲松、杨学文

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长沙市疾病预防控制中心,湖南长沙 410000

湖南师范大学医学院分子流行病学湖南省重点实验室,湖南长沙 410000

登革热 发病趋势 季节分布 空间聚集性

湖南省自然科学基金项目

2024JJ9547

2024

中国热带医学
中华预防医学会,海南疾病预防控制中心

中国热带医学

CSTPCD北大核心
影响因子:0.722
ISSN:1009-9727
年,卷(期):2024.24(8)