| 聂陶然,崔金朝,任敏睿,刘凤凤,孙军玲,张静,常昭瑞.应用移动流行区间法确定我国南方地区手足口病流行强度阈值[J].中华流行病学杂志,2020,41(7):1047-1053 |
| 应用移动流行区间法确定我国南方地区手足口病流行强度阈值 |
| Application of moving epidemic method in establishing epidemic intensity threshold of hand, foot, and mouth disease in southern China |
| 收稿日期:2020-01-14 出版日期:2020-07-15 |
| DOI：10.3760/cma.j.cn112338-20200114-00030 |
| 中文关键词: 手足口病 移动流行区间法 流行强度 流行阈值 |
| 英文关键词: Hand,foot,and mouth disease Moving epidemic method Incidence intensity Epidemic threshold |
| 基金项目:肠道病毒71型灭活疫苗Ⅳ期临床应用研究（2016ZX09101120-004） |
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| 中文摘要: |
| 目的 使用移动流行区间法评价我国南方地区2018-2019年手足口病流行强度，并进行强度比较，为优化公共卫生资源配置提供依据。方法 从中国CDC疾病监测信息报告系统收集我国南方地区2012年3月1日至2019年2月28日≤5岁儿童手足口病周发病率，使用移动流行区间法（MEM）计算2018-2019年南方地区各省市强度阈值，评价手足口病流行强度。结果 南方地区2018-2019年第1个流行季中，≤5岁儿童周报告发病率处于极高流行水平的6个省份分别为江苏省、浙江省、江西省、重庆市、四川省和云南省，广东省、广西壮族自治区、海南省为低流行水平；第2个流行季中，有6个省份达到极高流行水平，分别为上海市、江苏省、浙江省、重庆市、四川省和云南省，其余各省份也均达到中或高流行水平；多数省份第1个流行季各阈值高于第2个流行季相应阈值，但重庆和四川等省份不同。模型验证结果表明，除海南、重庆和云南外，灵敏度及特异度均高于70%。结论 对于1个流行季内呈现双峰流行特征的南方地区，可使用MEM模型，通过拆分流行季的方法分别确定不同流行季流行强度阈值。MEM模型建立的流行强度阈值综合了历史数据，识别出的极高流行水平的省份代表此省份较历史发病水平有异常的增高，更需要各地的关注以及及时实施防控措施。 |
| 英文摘要: |
| Objective To evaluate the incidence intensity of hand, foot, and mouth disease (HFMD) in 2018/2019 season in southern China by Moving Epidemic Method (MEM), and compare the intensity among provinces, so as to provide basis for optimizing the allocation of public health resources. Methods The weekly incidence data of HFMD of children under 5 years old in 15 provinces of southern China from March 1, 2012 to February 28, 2019 were collected from Disease Surveillance Reporting System of Chinese Center for Disease Control and Prevention, and the epidemic intensity threshold of each province in southern China during this period was calculated and evaluated by MEM. Results In the first incidence peak of 2018/2019 HFMD season, in 15 provinces in the south China, 6 provinces (Jiangsu, Zhejiang, Jiangxi, Chongqing, Sichuan and Yunnan) reported very high incidence rates in children under 5 years old while Guangdong, Guangxi and Hainan provinces had low incidence level. In the second incidence peak, the incidences in 6 provinces (Shanghai, Jiangsu, Zhejiang, Chongqing, Sichuan and Yunnan) reached very high levels. The incidences in remaining provinces also reached medium or high levels. In most provinces, the thresholds in the first incidence peak were higher than those in the second incidence peak, but Chongqing and Sichuan were different. The results of model validation showed that the sensitivity and specificity of MEM were higher than 70% except for Hainan, Chongqing and Yunnan. Conclusions For southern provinces with two incidence peaks in HFMD season, MEM can be used to determine the epidemic intensity thresholds of different incidence peaks by dividing the disease season to analyze the incidence intensity of HFMD in different stages. The epidemic intensity threshold established by MEM integrates the historical data, and the province (city) with extremely high epidemic level identified represents that the province (city) has an abnormal increase compared with the historical incidence level, which requires more attention from all areas and timely implementation of prevention and control measures. |
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