热带病与寄生虫学

热带病与寄生虫学 ›› 2025, Vol. 23 ›› Issue (4): 239-244.doi: 10.20199/j.issn.1672-2302.2025.04.009

• 防治研究 • 上一篇    下一篇

2012—2023年楚雄彝族自治州肾综合征出血热流行特征及时空聚集性分析

李琴1,2(), 钱发宝3(), 江素宏3, 王安伟4, 吴学林3, 胡海梅3, 周思蕾3, 高丽芬3()   

  1. 1.楚雄彝族自治州人民医院， 云南楚雄 675000
    2.云南省疾病预防控制中心现场流行病学培训项目
    3.楚雄彝族自治州疾病预防控制中心
    4.云南省地方病防治所
  • 收稿日期:2024-11-27 出版日期:2025-08-20 发布日期:2025-09-19
  • 通信作者: 高丽芬，E-mail: 68134968@qq.com
  • 作者简介:李琴，女，本科，主治医师，研究方向：传染病控制。E-mail: 1162007924@qq.com；|钱发宝，男，本科，主治医师，研究方向：急性传染病控制。E-mail: qianfabao@hotmail.com

Epidemiological characteristics and spatiotemporal clustering analysis of hemorrhagic fever with renal syndrome in Chuxiong Yi Autonomous Prefecture, 2012-2023

LI Qin1,2(), QIAN Fabao3(), JIANG Suhong3, WANG Anwei4, WU Xuelin3, HU Haimei3, ZHOU Silei3, GAO Lifen3()   

  1. 1. The People’s Hospital of Chuxiong Yi Autonomous Prefecture, Chuxiong 675000, Yunnan Province, China
    2. Yunnan Field Epidemiology Training Program, Yunnan Provincial Center for Disease Control and Prevention
    3. Chuxiong Yi Autonomous Prefecture Center for Disease Control and Prevention
    4. Yunnan Institute of Endemic Diseases Control and Prevention
  • Received:2024-11-27 Online:2025-08-20 Published:2025-09-19
  • Contact: GAO Lifen, E-mail: 68134968@qq.com

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摘要： 目的 分析云南省楚雄彝族自治州（简称楚雄州）肾综合征出血热（hemorrhagic fever with renal syndrome, HFRS）流行特征及时空聚集性，为科学防控提供依据。方法 通过中国疾病预防控制信息系统获取2012—2023年楚雄州HFRS病例资料，从楚雄州疾病预防控制中心获取2021年宿主动物监测资料。对HFRS的三间分布特征及宿主动物监测结果进行描述性分析，对发病趋势进行Joinpoint回归分析，对病例的时空聚集特征使用空间信息可视化技术和核密度估计法进行评估。结果 2012—2023年楚雄州累计报告HFRS病例1 131例，死亡2例；年报告发病率为0.41/10万~8.18/10万，总体呈上升趋势（AAPC=34.37%，t=3.74，P<0.01）。3—7月报告病例数较多（583例，占51.55%）。病例主要分布在姚安县、楚雄市和禄丰市，共占总病例数的77.54%（877/1 131）。2012—2023年姚安县发病率持续上升（APC=AAPC=62.45%，t=13.26，P<0.01），楚雄市自2018年后呈下降趋势（APC=-25.30%，t=-2.42，P<0.05）；时空热点区域分布呈现由楚雄市鹿城镇和东瓜镇向姚安县栋川镇及周边乡镇扩散的特征。男性年均发病率（4.88/10万）高于女性（2.16/10万），职业以农民为主（837例，占74.00%）。病例年龄中位数为50.0（38.0，61.0）岁，发病年龄由2012年的40.0（32.0，56.0）岁上升至2023年的57.0（48.0，68.0）岁。2021年平均鼠密度为3.01%，优势鼠种为褐家鼠（占64.00%）和黄胸鼠（占21.09%），鼠类汉坦病毒感染率为14.74%（158/1 072）。结论 楚雄州的HFRS发病存在明显的时空聚集性；男性、农民和50岁以上年龄段是主要发病人群，发病年龄有逐年上升趋势。应在高发季节做好宿主动物防制和重点人群防控工作。

关键词: 肾综合征出血热, 时空分布, 汉坦病毒, 宿主动物监测, 楚雄彝族自治州

Abstract:

Objective To analyze the spatiotemporal distribution characteristics of hemorrhagic fever with renal syndrome (HFRS) in Chuxiong Yi Autonomous Prefecture, Yunnan Province, so as to provide a basis for scientific prevention and control of infection. Methods HFRS case data reported from 2012 to 2023 in Chuxiong Prefecture were retrieved from the Infectious Disease Surveillance System of Chinese Disease Prevention and Control Information System. Host animal surveillance data for 2021 were obtained from Chuxiong Prefecture Center for Disease Control and Prevention. Descriptive analysis was conducted on the characteristics of time, region and population for HFRS, as well as on the surveillance results of its host animals. Joinpoint regression model was used to analyze the incidence trend. Spatial information visualization techniques and kernel density estimation were used to evaluate the spatiotemporal clustering characteristics of cases. Results A total of 1 131 HFRS cases and 2 deaths were reported in Chuxiong Prefecture during 2012-2023. The annual incidence rate fluctuated between 0.41/100 000 and 8.18/100 000, showing an overall upward trend (AAPC=34.37%, t=3.74, P<0.01). More cases were reported from March to July (n=583; 51.55%). The cases were mainly distributed in Yao’an County, Chuxiong City, and Lufeng City, accounting for 77.54% (877/1 131) of total cases. The incidence rate in Yao’an County showed a continuous increase from 2012 to 2023 (APC=AAPC=62.45%, t=13.26, P<0.01), while Chuxiong City demonstrated a declining trend after 2018 (APC=-25.30%, t=-2.42, P<0.05). Spatiotemporal hotspots evolved from Lucheng Town and Donggua Town in Chuxiong City to Dongchuan Town and surrounding townships in Yao’an County. The average annual incidence rate was higher in males (4.88/100 000) than in females (2.16/100 000). The majority of cases were farmers (n=837; 74.00%). The median age of cases was 50.0 (38.0, 61.0) years, with the age at onset increasing from 40.0 (32.0, 56.0) years in 2012 to 57.0 (48.0, 68.0) years in 2023. In 2021, the average rodent density was 3.01%, with Rattus norvegicus (64.00%) and Rattus flavipectus (21.09%) being the dominant species. The hantavirus infection rate in rodents was 14.74% (158/1 072). Conclusion The incidence of HFRS in Chuxiong Prefecture showed obvious spatiotemporal clustering. Males, farmers, and population over 50 years old were most affected, and the age at disease onset showed a yearly increasing trend. The findings suggest that host animal control and prevention measures for key populations should be strengthened during high-incidence seasons.

Key words: Hemorrhagic fever with renal syndrome, Spatiotemporal distribution, Hantavirus, Host animal surveillance, Chuxiong Yi Autonomous Prefecture

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