| 于栓宝,罗垲炜,周永红,戴兵兵,刘凤凤,杨浩,罗莉,刘嘉,王莉莉,李青,任凌霜,廖巧红,余宏杰.湖南省安化县2013-2016年手足口病住院负担估计[J].Chinese journal of Epidemiology,2019,40(1):79-83 |
| 湖南省安化县2013-2016年手足口病住院负担估计 |
| Hospitalization burden of hand, foot and mouth disease in Anhua county of Hunan province, 2013-2016 |
| Received:July 20, 2018 |
| DOI：10.3760/cma.j.issn.0254-6450.2019.01.016 |
| KeyWord: 手足口病 肠道病毒 血清型 住院负担 |
| English Key Word: Hand, foot and mouth disease Enterovirus Serotype Hospitalization burden |
| FundProject:国家杰出青年科学基金（81525023）；国家自然科学基金（81473031）；李嘉诚牛津大学全球卫生科研计划（B9RST00-B900.57）；中华预防医学会科研项目（20101801） |
| Author Name | Affiliation | E-mail | | Yu Shuanbao | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Luo Kaiwei | Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China | | | Zhou Yonghong | School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China | | | Dai Bingbing | Anhua County Center for Disease Control and Prevention of Yiyang City of Hunan Province, Anhua 413513, China | | | Liu Fengfeng | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Yang Hao | Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China | | | Luo Li | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Liu Jia | Institute Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China | | | Wang Lili | School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China
Institute Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China | | | Li Qing | Yiyang Prefectural Center for Disease Control and Prevention of Hunan Province, Yiyang 413000, China | | | Ren Lingshuang | School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China | | | Liao Qiaohong | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China | | | Yu Hongjie | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China | cfetpyhj@vip.sina.com |
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| Abstract: |
| 目的 估计2013年10月至2016年9月湖南省安化县各血清型及分年龄组的手足口病住院负担。方法 收集6家病毒学监测医院的儿童手足口病住院记录及23家乡镇卫生院的手足口病新农合报销记录，估计安化县分年龄组的手足口病住院负担。结合病毒学监测结果，估计各血清型肠道病毒（EV）相关的手足口病住院负担。结果 共纳入手足口病住院病例3 541例，其中实验室确诊病例数为3 146例。仅有1例为手足口病重症，其余均无并发症。临床诊断和实验室确诊手足口病平均住院率分别为723/10万（95% CI：699/10万~747/10万）和642/10万（95% CI：620/10万~665/10万）。柯萨奇病毒（Cox）A组16型（Cox A16）（208/10万）和6型（Cox A6）（202/10万）相关的手足口病住院率高于EV71（130/10万）、Cox A10（38/10万）和其他EV（64/10万），差异有统计学意义（P<0.001）。手足口病住院率在1岁组最高（3 845/10万），之后随年龄增长住院率逐渐降低。与EV71和Cox A16相比，Cox A6相关的手足口病住院率表现出低年龄特点（P<0.001）。结论 湖南省安化县轻症手足口病住院负担严重，尤其在低年龄组儿童中，且主要由EV71、Cox A16、Cox A6和Cox A10导致。 |
| English Abstract: |
| Objective To estimate the serotype and age-specific hospitalization burden associated with hand, foot and mouth disease (HFMD) in Anhua county of Hunan province, between October 2013 and September 2016. Methods We collected hospitalization records of HFMD patients from 6 virological surveillance hospitals, and reimbursement records through new rural cooperative medical system from 23 township health centers to estimate the age-specific hospitalization burden of HFMD in Anhua. Combined with the results of virological surveillance, the serotype-specific hospitalization burden of HFMD in Anhua, was estimated. Results During the three years, it was estimated that 3 541 clinical diagnosed HFMD cases, including 3 146 laboratory-confirmed HFMD cases, were hospitalized in Anhua, but only one was diaguosed as being severe. The estimated average hospitalization rate was 723/100 000(95% CI:699/100 000-747/100 000) for clinical diagnosed HFMD and 642/100 000 (95% CI:620/100 000-665/100 000) for laboratory-confirmed HFMD between October 2013 and September 2016. The cases caused by Cox A16 (208/100 000) and Cox A6 (202/100 000) had higher hospitalization rates compared with the cases caused by EV71 (130/100 000), Cox A10 (38/100 000) and other enterovirus (64/100 000), and the difference was statistically significant (P<0.001). HFMD-associated hospitalization rates peaked in children aged 1 year (3 845/100 000), and then decreased with age. Compared with the hospitalized HFMD caused by EV71 and Cox A16, Cox A6-associated hospitalizations mainly occurred in younger age groups (P<0.001). Conclusion Our study revealed a substantial hospitalization burden associated with mild HFMD caused by EV71, Cox A16, Cox A6 and Cox A10, especially in young children, in Anhua. |
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