文章摘要
郭建花,李静,张欣.石家庄市2007-2017年18岁以下人群急性脑炎脑膜炎流行趋势[J].中华流行病学杂志,2019,40(4):417-421
石家庄市2007-2017年18岁以下人群急性脑炎脑膜炎流行趋势
Trends on the epidemics of acute meningitis and encephalitis among population under 18 years-old in Shijiazhuang city, 2007-2017
投稿时间:2018-11-12  
DOI:10.3760/cma.j.issn.0254-6450.2019.04.009
中文关键词: 急性脑炎脑膜炎;流行趋势
英文关键词: Acute meningitis and encephalitis;Epidemic trends
基金项目:
作者单位E-mail
郭建花 石家庄市疾病预防控制中心 050011 guoflowers@163.com 
李静 河北省疾病预防控制中心, 石家庄 050021  
张欣 河北省儿童医院, 石家庄 050030  
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中文摘要:
      目的 分析2007-2017年石家庄市<18岁人群急性脑炎脑膜炎流行趋势。方法 2007-2011年在石家庄市≥ 42家县级医院开展<18岁人群急性脑炎脑膜炎的流行病学监测,选择6所医院进行病原学监测。定性描述急性脑炎脑膜炎流行特征与病原谱,以年度变化百分比(APC)定量评估发病变化趋势。结果 2007-2017年石家庄市共报告本地病例11 222例,年均发病率为108.62/10万(1 021/939 974),APC为4.81%(95% CI:3.90%~5.93%)(t=23.01,P<0.001);4~5岁组发病率最高,年均发病率为242.96/10万;除0~岁组外,其他年龄组人群发病率APC的差异均有统计学意义(1~岁组t=20.21,P=0.004;2~岁组t=19.41,P=0.006;3~岁组t=23.50,P<0.001;4~岁组t=31.76,P<0.001;5~岁组t=18.53,P=0.008;10~17岁组t=12.82,P=0.023)。男女性别比为1.46:1(6 652/4 570),城乡比为0.28:1(2 456/8 766),每年6-9月病例数占57.73%(6 478/11 222)。病原学确诊率为20.07%(658/3 123),病原谱前5位依次为肠道病毒(44.68%,264/658)、新型隐球菌(9.12%,60/658)、乙型脑炎病毒(8.66%,57/658)、肺炎链球菌(6.99%,47/658)与水痘带状疱疹病毒(6.69%,44/658)。结论 2007-2017年石家庄市<18岁人群急性脑炎脑膜炎的发病强度较高,以3~岁、4~岁组幼托儿童为主。建议加强症候群监测,强化免疫,以有效防控急性脑炎脑膜炎。
英文摘要:
      Objective To understand the trends on the epidemics of acute meningitis and encephalitis (AME) among children under 18 years-old in Shijiazhuang city, 2007-2017. Methods Surveillance programs on acute meningitis and encephalitis (AMES) had been conducted in population less than 18 years-old, since 2007. Hospitals at county level or above in Shijiazhuang had been included to carry out the epidemiologic surveillance, including 6 on pathogens, regarding AMES. Qualitative description was performed to describe the epidemiologic patterns and pathogenic spectrums. Annual percent change (APC) was used to demonstrate the secular trends of AME. Results In 2007-2017, 11 222 locally developed AME cases that younger than 18 years-old, were reported in Shijiazhuang, with the annual average incidence rate as 108.62/100 000 (1 021/939 974) and APC as 4.81%(95% CI:3.90%-5.93%)(t=23.01, P<0.001). Age-specific incidence appeared the highest among 4-5 years-old (242.96 cases per 100 000 children per year). Significant differences were found among children of other aged years except aged 0-years (aged 1-years t=20.21, P=0.004; aged 2-years t=19.41, P=0.006; aged 3-years t=23.50, P<0.001; aged 4-years t=31.76, P<0.001; aged 5-years t=18.53, P=0.008; aged 10-17 years t=12.82, P=0.023). The ratio of male to female was 1.46:1 (6 652/4 570). The ratio of urban to rural cases was 0.28:1 (2 456/8 766). A total of 57.73% (6 478/11 222) of the cases were seen between June and September. The overall positive rate of pathogens was 20.07% (658/3 123) among these patients. The top five pathogens appeared as Enterovirus (44.68%, 264/658), Cryptococcus neoformans (9.12%, 60/658), Japanese encephalitis virus (8.66%, 57/658), Streptococcus pneumoniae (6.99%, 47/658) and Varicella-zoster virus (6.69%, 44/658). Conclusions AME seriously harms the health of population under 18 years-old in Shijiazhuang city, with aged 3-years, aged 4-years in particular. Continued improvement on surveillance and expanded immunization are important to AME prevention and control.
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