石家庄市2007-2017年18岁以下人群急性脑炎脑膜炎流行趋势

郭建花; 李静; 张欣

Abstract

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].Chinese journal of Epidemiology,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

Received:November 12, 2018

DOI：10.3760/cma.j.issn.0254-6450.2019.04.009

KeyWord: 急性脑炎脑膜炎流行趋势

English Key Word: Acute meningitis and encephalitis Epidemic trends

FundProject:

Author Name	Affiliation	E-mail
Guo Jianhua	Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang 050011, China	guoflowers@163.com
Li Jing	Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang 050021, China
Zhang Xin	Hebei Provincial Children Hospital, Shijiazhuang 050030, China

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Abstract:

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。

English Abstract:

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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