| 高峰,唐必成,姜欣丽,尹思宇,常昭瑞,秦颖,李昱,李中杰.2008-2022年中国手足口病死亡病例流行特征和变化趋势[J].中华流行病学杂志,2024,45(12):1626-1632 |
| 2008-2022年中国手足口病死亡病例流行特征和变化趋势 |
| Epidemiological characteristics and trend of mortality on hand, foot and mouth disease in China, 2008-2022 |
| 收稿日期:2023-11-25 出版日期:2024-12-16 |
| DOI：10.3760/cma.j.cn112338-20231125-00317 |
| 中文关键词: 手足口病 死亡 流行病学特征 流行趋势 |
| 英文关键词: Hand, foot and mouth disease Mortality Epidemiology characteristics Epidemic trend |
| 基金项目:首都卫生发展科研专项(首发2022-4G-4222);肠道病毒71型灭活疫苗Ⅳ期临床应用研究(2016ZX09101120-004);北京市自然科学基金(L192014);公共卫生应急反应机制运行项目(102393220020010000017) |
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| 中文摘要: |
| 目的 分析2008-2022年中国手足口病死亡病例的流行特征和变化趋势，为手足口病防治提供参考依据。方法 收集整理2008-2022年中国疾病预防控制信息系统传染病报告信息管理系统中的手足口病死亡病例信息。使用R 4.2.2软件进行描述性分析，使用Joinpoint 4.9.10软件分析病死率和死亡率及其年龄标化调整率的变化趋势。结果 2008-2022年全国共报告手足口病死亡病例3 704例，主要集中在<3岁儿童（83.42%，3 090/3 704），男女性别比为1.82∶1（2 389∶1 315）。按年龄调整病死率的时间变化趋势，2008-2010年年龄调整病死率快速增加［年变化百分比（APC）=41.97%，P<0.05］；2010-2016年稳步下降（APC=-28.57%，P<0.05），2016-2022年下降趋势加快（APC=-39.66%，P<0.05），2020-2022年全国每年仅有个位数死亡病例报告。2 566例实验室确诊死亡病例中，病原以肠道病毒71型（EV71）为主（91.62%，2 351/2 566）。2017年后死亡病例病原构成发生明显变化，EV71占比下降，柯萨奇病毒A组16型、其他肠道病毒死亡病例占比呈明显上升趋势。结论 2008-2022年中国手足口病死亡水平在2010年达到高峰后持续下降，2017年以后的手足口病病死率下降趋势明显加快。手足口病死亡病例中EV71占比下降，但其他病原占比呈上升趋势，需持续监测死亡病例的病原谱构成。 |
| 英文摘要: |
| Objective To analyze the nationwide epidemiological characteristics and trend of hand, foot and mouth disease (HFMD) fatal cases from 2008 to 2022 and provide evidence for the prevention and control of HFMD. Methods The information on HFMD fatal cases during 2008 to 2022 was collected from the National Notifiable Disease Surveillance Reporting System of China. Data of the epidemiological characteristics was analyzed by R 4.2.2 software and the changing trends for the case fatality rates, mortality rates and their age-adjusted rates were analyzed by Joinpoint 4.9.10 software. Results From 2008 to 2022, a total of 3 704 fatal HFMD cases were reported in China. The fatal cases were primarily observed in children aged <3 years (83.42%, 3 090/3 704). The male and female gender ratio was 1.82 ∶1 (2 389 ∶1 315). Regarding the age-adjusted case fatality rates over time, there was a rapid increase from 2008 to 2010 [annual percentage change (APC) =41.97%, P<0.05]. From 2010 to 2016, a steady decline was observed (APC=-28.57%, P<0.05), and the decline accelerated (APC=-39.66%, P<0.05) from 2016 to 2022. Since 2020, less than 10 fatal cases were reported annually nationwide. Among the 2 566 laboratory-confirmed deaths from 2008 to 2022, Enterovirus A71 (EV71) was the predominant pathogen (91.62%,2 351/2 566). There have been noticeable changes in the pathogen composition since 2017, decreasing in EV71 and increasing in the proportion of fatalities caused by Coxsackievirus A16 (CV-A16) and other enteroviruses. Conclusions From 2008 to 2022, the HFMD case fatality rates and mortality rates continuously declined, peaked in 2010. Since 2017, the decline of HFMD case fatality rates has been noticeably accelerated. Along with the decrease in the proportion of EV71 in HFMD fatal cases, the proportion of other enteroviruses appeared increasing. It is essential to continuously monitor the etiological spectrum of the fatal cases. |
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