摘要
目的分析杭州市人间布鲁氏菌病(简称布病)疫情流行特征变化趋势,为进一步制定防治措施提供依据。方法2004-2021年杭州市布病疫情资料收集自"中国疾病预防控制信息系统"及杭州市历年布病年报表、汇编和防治工作总结,对比分析2004-2009、2010-2015、2016-2021年3个阶段杭州市布病病例的流行病学特征及其变化趋势。结果2004-2021年杭州市共确诊布病病例186例,年均发病率为0.151/10万,范围为0.016/10万~0.289/10万,2004-2009、2010-2015、2016-2021年发病率呈阶段性上升趋势(Z=3.15,P=0.002)。布病病例发病年龄以18~60岁为主,占78.49%(146/186);男女性别比为2.10∶1.00(126∶60);职业人群、非职业人群分别占62.90%(117/186)和37.10%(69/186),其中非职业人群病例3个阶段占比分别为28.57%、23.29%、51.76%,呈上升趋势(χ^(2)_(趋势)=9.85,P=0.002)。地区分布以余杭区为主,占55.91%(104/186),其次为江干区(9.14%,17/186)和富阳区(7.53%,14/186),布病流行县(市、区)数由6个增加至9个;季节性分析显示,1-6月发病数占比由2004-2009年的84.93%(23/28)下降至2016-2021年的54.12%(46/85)。省外感染例数3个阶段占比分别为0、10.96%和27.38%,呈上升趋势(χ^(2)_(趋势)=18.16,P<0.001),感染地主要为河南省、黑龙江省和内蒙古自治区。临床症状及体征中,出现肌肉关节疼痛者和腰痛者分别由2004-2009年的60.71%(17/28)和10.71%(3/28)上升至2016-2021年的83.53%(71/85)和25.88%(22/85),均呈上升趋势(χ^(2)_(趋势)=9.92、4.67,P=0.002、0.031)。结论杭州市人间布病发病率呈上升趋势,非职业人群发病数近年有所增加,羊养殖场所聚集地逐渐成为杭州市布病高发区。建议加强普通民众布病防护知识宣传教育,重点开展高发区人间布病主动监测工作。
Objective To analyze the changing trends of the epidemic characteristics of human brucellosis in Hangzhou City,and to provide a basis for further formulating prevention and control measures.Methods The epidemic data of brucellosis in Hangzhou City from 2004 to 2021 were collected from the"China Disease Control and Prevention Information System"and the annual reports,compilations and summaries of prevention and control work of brucellosis in Hangzhou City,and the epidemiological characteristics and trends of brucellosis cases in Hangzhou City from 2004 to 2009,2010 to 2015,and 2016 to 2021 were compared and analyzed.Results A total of 186 cases of brucellosis were diagnosed in Hangzhou City from 2004 to 2021,with an average annual incidence rate of 0.151/100000,ranging from 0.016/100000 to 0.286/100000.The incidence rate showed a stage-by-stage upward trend from 2004 to 2009,2010 to 2015,and 2016 to 2021(Z=3.15,P=0.002).The age of onset of brucellosis cases was predominantly 18-60 years old,accounting for 78.49%(146/186).The male-to-female ratio was 2.10∶1.00(126∶60).The occupational and non-occupational populations accounted for 62.90%(117/186)and 37.10%(69/186),respectively,with the proportion of non-occupational cases in the three stages being 28.57%,23.29%and 51.76%,showing an increasing trend(χ^(2)_(trend)=9.85,P=0.002).The regional distribution was dominated by Yuhang District,accounting for 55.91%(104/186),followed by Jianggan District(9.14%,17/186)and Fuyang District(7.53%,14/186).The number of brucellosis epidemic counties(cities,districts)increased from 6 to 9.The seasonal analysis showed that the proportion of cases from January to June decreased from 84.93%(23/28)from 2004 to 2009 to 54.12%(46/85)from 2016 to 2021.The proportion of infection from outside the province in the three stages was 0,10.96%and 27.38%,respectively,showing an upward trend(χ^(2)_(trend)=18.16,P<0.001),the main infected areas were Henan Province,Heilongjiang Province,and Inner Mongolia Autonomous Region.In clinical symptoms and signs,the incidence of muscle and joint pain and low back pain increased from 60.71%(17/28)and 10.71%(3/28)from 2004 to 2009,respectively,to 83.53%(71/85)and 25.88%(22/85)from 2016 to 2021,both showing an upward trend(χ^(2)_(trend)=9.92,4.67,P=0.002,0.031).Conclusions The incidence of human brucellosis in Hangzhou City is on the rise,and the number of cases of non-occupational population has increased significantly in recent years.The sheep breeding places have gradually become the high incidence areas of brucellosis in Hangzhou City.It is recommended to strengthen the promotion and education of knowledge on brucellosis prevention among the general public,and focus on actively monitoring human brucellosis in high-risk areas.
作者
朱素娟
金行一
霍亮亮
孙昼
赵婷婷
徐卫民
Zhu Sujuan;Jin Xingyi;Huo Liangliang;Sun Zhou;Zhao Tingting;Xu Weimin(Institute of Infectious Disease,Hangzhou Center for Disease Control and Prevention,Hangzhou 310021,China;Health Monitoring Institute,Hangzhou Center for Disease Control and Prevention,Hangzhou 310021,China)
出处
《中华地方病学杂志》
CAS
北大核心
2024年第5期370-375,共6页
Chinese Journal of Endemiology
关键词
布鲁氏菌病
流行特征
趋势分析
Brucellosis
Epidemic characteristics
Trend analysis
作者简介
通信作者:徐卫民,Email:41469739@qq.com
