中越边境云南省红河州2013－2022年恙虫病流行特征分析

doi:10.11853/j.issn.1003.8280.2023.06.014

摘要/Abstract

摘要： 目的分析中越边境云南省红河哈尼族彝族自治州（红河州）恙虫病流行病学分布特征,为制定恙虫病防制策略提供科学依据。方法从中国疾病预防控制信息系统中收集红河州2013－2022年恙虫病相关资料,采用描述性流行病学方法,利用χ²检验、秩和检验、集中度分布对数据进行统计分析。结果红河州10年间共报告恙虫病8 035例,年均报告发病率为17.37/10万,死亡1例。报告发病率呈现逐年上升趋势（χ趋势2=3 044.855,P<0.001）,元阳县报告发病例数最多（1 888例,发病率为47.22/10万）,屏边县报告发病率最高（1 280例,发病率为82.53/10万）；恙虫病发病有较强的季节性,发病高峰集中在6－9月（5 854例,占72.86%）；以30～<70岁年龄组（4 848例,占60.33%）和0～<10岁年龄组（1 778例,占22.13%）为主；男女发病性别比为0.98∶1；职业以农民为主（5 588例,占69.55%）,发病至诊断时间中位数为10 d,不同年份发病至诊断时间差异有统计学意义（H=102.812,P=0.001）,南、北区（以北回归线为界）发病至诊断时间差异有统计学意义（H=1 087 686.000,P=0.025）,南区短于北区,报告病例主要来源于县（市）级及以上综合医院,以临床诊断病例为主,占95.16%。结论红河州恙虫病发病呈上升趋势,农村中老年人群和儿童高发,发病地区差异明显,夏秋季流行,发病至诊断为恙虫病时间间隔较长,建议加强恙虫病监测并将其重新列为法定报告传染病,以降低其造成的疾病经济负担。

关键词: 中越边境, 恙虫病, 流行特征, 集中度分布

Abstract: Objective To analyze the epidemiological characteristics of scrub typhus in Honghe Hani and Yi Autonomous Prefecture (Honghe Prefecture), Yunnan Province on the border of China and Vietnam, so as to provide a scientific basis for formulating scrub typhus control strategies in the future.Methods The information on cases of scrub typhus in Honghe Prefecture from 2013 to 2022 were collected from the China Information System for Disease Control and Prevention. The data were analyzed using descriptive epidemiological methods, the Chi-squared test, the rank sum test, and concentration distribution analysis.Results A total of 8 035 cases of scrub typhus were reported in Honghe Prefecture in the past 10 years, with an average annual incidence of 17.37/100 000, including 1 death. The reported incidence of scrub typhus showed an increasing trend over the years (χ²_trend=3 044.855, P<0.001). Yuanyang County reported the highest number of cases (1 888 cases, an incidence of 47.22/100 000), and Pingbian County reported the highest incidence (1 280 cases, an incidence of 82.53/100 000). The occurrence of scrub typhus had strong seasonality, with the peak period concentrated during June to September (5 854 cases, 72.86%). The cases of scrub typhus were mainly aged 30-<70 years (4 848 cases, 60.33%) and 0-<10 years (1 778 cases, 22.13%). The male-to-female ratio was 0.98:1. A majority of the cases were farmers among occupations (5 588 cases, 69.55%). The median time from disease onset to diagnosis was 10 days. The time from disease onset to diagnosis was statistically different between years (H=102.812, P=0.001) and between the northern and southern regions (bounded by the Tropic of Cancer) (H=1 087 686.000, P=0.025), with a shorter time interval in the southern region than in the northern region. The reported cases were mainly from general hospitals at the county (city) level or above, and 95.16% of them were clinically diagnosed cases.Conclusions The incidence of scrub typhus is on the rise in Honghe Prefecture, more frequent in children and middle-aged and elderly people in rural areas, with significant regional difference and significant seasonality with the peak in summer and autumn, and the time interval from onset to diagnosis is relatively long. It is necessary to strengthen scrub typhus surveillance and to reclassify it as a notifiable infectious disease to reduce the economic burden of the disease.

Key words: China-Vietnam border, Scrub typhus, Epidemiological characteristic, Concentration distribution

中图分类号:

R513.2

高雄, 邓淑珍, 苏桂琴, 沈秀莲. 中越边境云南省红河州2013－2022年恙虫病流行特征分析[J]. 中国媒介生物学及控制杂志, 2023, 34(6): 782-787.

GAO Xiong, DENG Shu-zhen, SU Gui-qin, SHEN Xiu-lian. Epidemiological characteristics of scrub typhus in Honghe Hani and Yi Autonomous Prefecture, Yunnan Province on China-Vietnam border, 2013-2022[J]. Chinese Journal of Vector Biology and Control, 2023, 34(6): 782-787.

参考文献

[1] Li LJ,Ren H. Infectious diseases[M]. 9th ed. Beijing:People’s Medical Publishing House,2018:147-149. （in Chinese）李兰娟,任红. 传染病学[M]. 9版. 北京:人民卫生出版社,2018.:147-149
[2] Li W,Li GC,Liu XB,et al. Research progress in epidemiological characteristics and influencing factors of scrub typhus[J]. Chin J Vector Biol Control,2020,31（6）:738-743. DOI:10.11853/j.issn.1003.8280.2020.06.025.（in Chinese）李文,李贵昌,刘小波,等. 恙虫病流行特征及影响因素研究进展[J]. 中国媒介生物学及控制杂志,2020,31（6）:738-743. DOI:10.11853/j.issn.1003.8280.2020.06.025.
[3] He K,Huang DS,An L,et al. An epidemiological analysis of scrub typhus in Baoshan,Yunnan province,China from 2006-2016[J]. Chin J Vector Biol Control,2019,30（1）:87-90. DOI:10.11853/j.issn.1003.8280.2019.01.021.（in Chinese）何恺,黄东升,安丽,等. 云南省保山市2006－2016年恙虫病流行特征分析[J]. 中国媒介生物学及控制杂志,2019,30（1）:87-90. DOI:10.11853/j.issn.1003.8280.2019.01.021.
[4] Yuan QH,Chen M,Yang XD. Epidemiological analysis of scrub typhus in Yunnan province during 2006-2017[J]. Chin J Vector Biol Control,2018,29（6）:613-616. DOI:10.11853/j.issn.1003.8280.2018.06.015.（in Chinese）袁庆虹,陈敏,杨向东. 云南省2006－2017年恙虫病流行病学分析[J]. 中国媒介生物学及控制杂志,2018,29（6）:613-616. DOI:10.11853/j.issn.1003.8280.2018.06.015.
[5] Chinese Center for Disease Control and Prevention. Technical guidelines for the prevention and control of tsutsugamushi diseas（trial）[Z]. Beijing:Chinese Center for Disease Control and Prevention,2009. （in Chinese）中国疾病预防控制中心. 恙虫病预防控制技术指南（试行）[Z]. 北京:中国疾病预防控制中心,2009.
[6] Ya HX,Zhang YZ,Wang JL. Investigation of Orientia tsutsugamushi infection in rodents and human in Yunnan[J]. Dis Surveill,2016,31（2）:145-148. DOI:10.3784/j.issn.1003-9961.2016.02.014.（in Chinese）亚红祥,张云智,王静林. 云南省部分地区鼠类与人自然感染恙虫病东方体调查[J]. 疾病监测,2016,31（2）:145-148. DOI:10.3784/j.issn.1003-9961.2016.02.014.
[7] Hu TS,Li Y,Hu QL,et al. Epidemiological characteristics of scrub typhus and genotyping of the pathogen Orientia tsutsugamushi in Chuxiong prefecture,Yunnan province,China[J]. Chin J Vector Biol Control,2020,31（3）:282-288. DOI:10.11853/j.issn.1003.8280.2020.03.008.（in Chinese）胡挺松,李应,胡秋凌,等. 云南省楚雄州恙虫病流行特征及其病原体东方体基因分型研究[J]. 中国媒介生物学及控制杂志,2020,31（3）:282-288. DOI:10.11853/j.issn.1003.8280. 2020.03.008.
[8] Qin L,Zhang YZ,Li X,et al. Epidemiological,clinical,serotype and genotype analysis of scrub typhus in Xiangyun county,Yunnan province[J]. Infect Dis Info,2022,35（6）:551-554,565. DOI:10.3969/j.issn.1007-8134.2022.06.014.（in Chinese）秦莲,张云智,李翔,等. 云南省祥云县恙虫病流行病学特点、临床特点及血清型和基因型分析[J]. 传染病信息,2022,35（6）:551-554,565. DOI:10.3969/j.issn.1007-8134.2022.06.014.
[9] Yang X,Wang Q,Wang J,et al. Epidemiological characteristics and disease burden of scrub typhus in Yunnan province,2015-2019[J]. Chin J Front Health Quar,2021,44（1）:44-46. DOI:10.16408/j.1004-9770.2021.01.011.（in Chinese）杨雪,王青,王珏,等. 2015－2019年云南省恙虫病流行病学特征及疾病负担分析[J]. 中国国境卫生检疫杂志,2021,44（1）:44-46. DOI:10.16408/j.1004-9770.2021.01.011.
[10] Qi YB,Jia YC. Underreporting and report quality analysis of statutory infectious diseases in Yunnan province in 2019[J]. Mod Prev Med,2021,48（8）:1511-1514. （in Chinese）戚艳波,贾豫晨. 2019年云南省法定传染病漏报与报卡质量分析[J]. 现代预防医学,2021,48（8）:1511-1514.
[11] Xin HL,Zhang YJ,Zu RQ,et al. Diagnosis and treatment of tsutsugamushi disease in Jiangsu province from 2011-2015[J]. Occup Health,2017,33（17）:2408-2409,2413. DOI:10.13329/j.cnki.zyyjk.2017.0719.（in Chinese）辛化雷,张永杰,祖荣强,等. 2011－2015年江苏省恙虫病诊疗情况[J]. 职业与健康,2017,33（17）:2408-2409,2413. DOI:10.13329/j.cnki.zyyjk.2017.0719.
[12] Zhao AY. Epidemiological characteristics of tsutsugamushi disease in Pingbian county,Yunnan province[J]. Soft Sci Health,2014,28（2）:116-118. （in Chinese）赵安云. 云南省屏边县恙虫病流行特征分析[J]. 卫生软科学,2014,28（2）:116-118.
[13] An N,Lyu L,Huang R,et al. Clinical and epidemiological characteristics of tsutsugamushi disease in Menghai county from 2008 to 2018[J]. J Trop Med,2020,20（6）:832-835. （in Chinese）安娜,吕磊,黄戎,等. 云南省勐海县2008－2018年恙虫病临床与流行病学特征分析[J]. 热带医学杂志,2020,20（6）:832-835.
[14] Yue YJ,Wang YJ,Li GC,et al. Epidemiological characteristics of scrub typhus in high-incidence areas in the mainland of China,2006-2018[J]. Dis Surveill,2020,35（4）:301-306. DOI:10.3784/j.issn.1003-9961.2020.04.007.（in Chinese）岳玉娟,王玉姣,李贵昌,等. 2006－2018年中国大陆恙虫病高发区流行病学特征分析[J]. 疾病监测,2020,35（4）:301-306. DOI:10.3784/j.issn.1003-9961.2020.04.007.
[15] Li GC,Wang YJ,Yue YJ,et al. Division of epidemic areas for summer- and autumn-type scrub typhus in China[J]. Chin J Vector Biol Control,2019,30（3）:233-236. DOI:10.11853/j.issn.1003.8280.2019.03.001.（in Chinese）李贵昌,王玉姣,岳玉娟,等. 我国恙虫病夏季型和秋季型疫区划分研究[J]. 中国媒介生物学及控制杂志,2019,30（3）:233-236. DOI:10.11853/j.issn.1003.8280.2019.03.001.
[16] Chen AX,Kong WR,Tian Y,et al. Epidemiological characteristics of scrub typhus in Changzhou,Jiangsu province,China,2012-2021[J]. Chin J Vector Biol Control,2023,34（3）:372-377. DOI:10.11853/j.issn.1003.8280.2023.03.015.（in Chinese）陈安喜,孔卫荣,田野,等. 江苏省常州市2012－2021年恙虫病流行特征分析[J]. 中国媒介生物学及控制杂志,2023,34（3）:372-377. DOI:10.11853/j.issn.1003.8280.2023.03.015.
[17] Liao Y,Huang RF,Hu XJ,et al. Epidemiological characteristics of scrub typhus in Jiangxi,2006-2017[J]. Mod Prev Med,2019,46（7）:1167-1170. （in Chinese）廖勇,黄仁发,胡晓军,等. 2006－2017年江西省恙虫病流行病学分析[J]. 现代预防医学,2019,46（7）:1167-1170.
[18] Shangguan ZY,Wu FL,Yan XY,et al. Analysis on the epidemiological characteristics of scrub typhus in Fuzhou from 2011 to 2015[J]. Chin J Dis Control Prev,2018,22（2）:153-156. DOI:10.16462/j.Cnki.Zhjbkz.2018.02.012.（in Chinese）上官致洋,吴斐琳,严秀英,等. 2011－2015年抚州市恙虫病流行特征分析[J]. 中华疾病控制杂志,2018,22（2）:153-156. DOI:10.16462/j.cnki.zhjbkz.2018.02.012.