2014—2022年合肥市恙虫病流行特征分析

doi:10.3969/j.issn.1672-2302.2023.06.002

摘要/Abstract

摘要：

目的了解合肥市恙虫病历年发病情况及流行特征，为合肥市恙虫病防治工作提供科学依据。方法通过中国疾病预防控制信息系统监测报告管理系统收集合肥市2014—2022年报告的恙虫病病例信息，采用描述流行病学方法对发病情况及其三间分布特征等进行分析，并用SatScan软件对其空间聚集性进行分析。结果 2014—2022年，合肥市共报告恙虫病病例301例，其中临床诊断病例167例，确诊病例134例。病例由合肥市21家三级医疗机构报告，其中省级医疗机构报告病例193例（占64.12%），市级医疗机构报告病例65例（占21.59%），县级医疗机构报告病例43例（占14.29%）。年均报告发病率为0.41/10万，年报告发病率为0.20/10万~0.63/10万，总体呈下降趋势（χ²_趋势=10.608，P<0.001）。病例发病至诊断时间间隔中位数为9（1，67）d。病例报告时间主要集中在10—11月（242例，占80.40%）。男性报告病例数154例，女性报告病例数147例，性别比1.05∶1；病例年龄中位数为59（48，68）岁，60岁及以上病例数最多（149例，占49.50%），不同年龄段发病呈随年龄增长而上升的趋势（χ²_趋势=271.445，P<0.001）；职业主要集中在农民（198例，占65.78%）和家政、家务及待业人员（61例，占20.27%）；报告病例数前三的县（区）分别为肥西县（110例，占36.54%）、肥东县（64例，占21.26%）和蜀山区（48例，占15.95%）。空间扫描发现2014—2022年肥东县、巢湖市共10个乡镇为一类聚集区。结论合肥市恙虫病主要发生在秋季，农民和中老年人是重点人群。建议在流行季节加强恙虫病监测，提高医务人员诊疗水平和报告意识，加强重点人群健康知识宣教及宿主和媒介消杀力度，控制恙虫病的发生与流行。

关键词: 恙虫病, 流行特征, 合肥市

Abstract:

Objective To understand the historical incidence and epidemic characteristics of scrub typhus in Hefei for scientific evidences in prevention and treatment of scrub typhus in Hefei area. Methods The data of scrub typhus cases reported in Hefei from 2014 to 2022 were collected through the Monitoring and Reporting Management System of China Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the incidence and characteristics of spatial, regional and time distribution, and SatScan software was used to analyze the spatial clustering. Results A total of 301 cases of scrub typhus were reported in Hefei from 2014 to 2022, including 167 clinically diagnosed cases and 134 confirmed cases. All the cases were reported by 21 tertiary medical institutions in Hefei City. One hundred and ninty-three cases (64.12%) were reported by provincial medical institutions, 65 cases (21.59%) by municipal medical institutions, and 43 cases (14.29%) by county-level medical institutions. The average annual incidence was 0.41/100 000 and annual reported incidence ranged from 0.20/100 000 to 0.63/100 000, showing a decreasing trend (χ²_trend=10.608, P<0.001). The median time interval from onset to diagnosis was 9 (1, 67) days. The cases mainly occurred in October-November each year (242 cases, 80.40%). One hundred and fifty-four cases were males, and 147 females. The gender ratio was 1.05∶1. The median age of the cases was 59 (48, 68) years old, and the number of cases aged 60 and above was the largest (149 cases, 49.50%). The incidence of different age groups showed an increasing trend (χ²_trend=271.445, P<0.001). The occupations were mainly involved in farmers (198 cases, 65.78%), domestic workers and unemployed workers (61 cases, 20.27%). The top 3 counties (districts) with reported cases were Feixi County (110 cases, 36.54%), Feidong County (64 cases, 21.26%) and Shushan District (48 cases, 15.95%). The spatial scanning results showed that 10 towns in Feidong County and Chaohu City were type A clustering areas from 2014 to 2022. Conclusion Scrub typhus primarily occurs in autumn in Hefei area. Farmers and middle-aged and elderly people should be the key groups. It is recommended to strengthen the monitoring of scrub typhus in epidemic season, improve the diagnosis and treatment level of medical staff and the awareness of reporting. At the same time, it is necessary to strengthen health knowledge education, intensify the elimination of host and vector, and control the occurrence and epidemic of scrub typhus.

Key words: Scrub typhus, Epidemic characteristics, Hefei City

中图分类号:

R513.2

刘溦, 刘思洋, 尤恩情, 陈丽丽, 陈伟, 李娟, 张磊, 张家祥. 2014—2022年合肥市恙虫病流行特征分析[J]. 热带病与寄生虫学, 2023, 21(6): 311-314.

LIU Wei, LIU Siyang, YOU Enqing, CHEN Lili, CHEN Wei, LI Juan, ZHANG Lei, ZHANG Jiaxiang. Analysis on the epidemiological characteristics of scrub typhus in Hefei City from 2014 to 2022[J]. Journal of Tropical Diseases and Parasitology, 2023, 21(6): 311-314.

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行政区划	病例数（例）	年均发病率（/10万）
瑶海区	15	0.16
庐阳区	5	0.08
蜀山区	48	0.39
包河区	13	0.15
长丰县	13	0.21
肥东县	64	0.80
肥西县	110	1.52
庐江县	20	0.23
巢湖市	13	0.18

聚集类型	聚集地区	病例数（例）	RR	LLR	P值
一类	肥东（古城、包公、石塘、陈集、张集、八斗、马湖、杨店），巢湖（苏湾、栏杆集）	33	11.86	49.77	<0.001
二类	肥西（严店、三河、丰乐），庐江（同大、郭河、金牛）	45	4.02	26.77	<0.001
三类	长丰（陶楼、双墩、下塘、吴山、杜集），肥东（元疃、白龙），蜀山（三十头）	14	12.01	21.68	<0.001
四类	肥西（高店），蜀山（高刘）	6	17.88	11.58	<0.001