2013—2022年河北省张家口市手足口病流行趋势Joinpoint回归分析

Joinpoint regression analysis of hand， foot， and mouth disease trends in Zhangjiakou City， Hebei Province from 2013 to 2022

    摘要
  • 摘要:
    目的 分析河北省张家口市2013—2022年手足口病流行特征，为手足口病防控及防治效果评价提供依据。
    方法 收集张家口市2013—2022年手足口病数据，采用描述统计学和Joinpoint回归模型对疫情变化趋势进行分析。
    结果 模型预测张家口市手足口病发病率呈下降趋势，2013—2022年年度变化百分比（APC）=-14.86%。发病率前5位的地区为桥东区（APC=-26.21%）、桥西区（APC=-18.29%）、宣化区（APC=-14.28%）、赤城县（APC=-18.68%），涿鹿县（2013—2016年APC=51.43%，2016—2022年APC=-14.27%），总体呈下降趋势。3个年龄组0岁组（2013—2016年APC=-42.82%，2016—2022年APC=16.54%）、7岁组（AAPC=9.60%）、9岁组（AAPC=12.76%）发病率出现上升趋势。张家口市手足口病全年发病，6—8月达到发病高峰，以7月为主。患者男女性别比为1.40∶1，差异无统计学意义（χ2=5.932，P>0.05）；5岁以下高发，1~4岁是主要发病人群；以散居儿童（6 245人，57.65%）和托幼儿童（3 653人，33.72%）为主。实验室共确诊504人，检出率4.65%（504/10 832），其中CoxA16为193人（38.29%），EV71为75人，（14.88%），其他肠道病毒为236人（46.83%）。
    结论 2013—2022年张家口市手足口病呈下降趋势，有明显的季节性、地区分布和职业分布。建议加强疫情监测工作，加强病原学检测，重点场所做好宣教工作。高发县区应研判数据，做好风险评估工作。

     

    Abstract:
    Objective To analyze the epidemiological characteristics of hand, foot, and mouth disease (HFMD) in Zhangjiakou City, Hebei Province from 2013 to 2022, so as to provide a basis for HFMD prevention, control, and evaluation of intervention effectiveness.
    Methods HFMD data of Zhangjiakou City from 2013 to 2022 were collected. Descriptive statistics and the Joinpoint regression model were used to analyze the trend of the epidemic.
    Results The incidence of HFMD in Zhangjiakou was predicted to decrease with APC=-14.86% in 2013‒2022. The top five regions with the highest incidence showed varying trends: Qiaodong District (APC=-26.21%), Qiaoxi District (APC=-18.29%), Xuanhua District (APC=-14.28%), Chicheng District (APC=-18.68%), and Zhuolu County (APC=51.43% in 2013‒2016, APC=-14.27% in 2016‒2022), indicating a downward trend. Three age groups showed an upward trend in incidence: the 0-year-old group (APC=-42.82% in 2013‒2016, APC=16.54% in 2016‒2022), the 7-year-old group (AAPC=9.60%), and the 9-year-old group (AAPC=12.76%). HFMD cases occurred throughout the year, peaking from June to August, with July being the most significant month. The male-to-female ratio was 1.40∶1, with no statistical difference (χ2=5.932, P>0.05). A high incidence was in children under 5 years old, with those aged 1‒4 years being the main affected group. In terms of occupation, scattered children (6 245 cases, 57.65%) and preschool children (3 653 cases, 33.72%) were the most affected. A total of 504 laboratory-confirmed cases were reported, with a detection rate of 4.65% (504/10 832). The composition of confirmed cases included CoxA 16 (193 cases, 38.29%), EV71 (75 cases, 14.88%), and other enteroviruses (236 cases, 46.83%).
    Conclusion From 2013 to 2022, HFMD in Zhangjiakou City showed a downward trend with clear seasonal, regional, and occupational distributions. It is suggested that epidemic monitoring should be strengthened, etiological detection should be enhanced, and education efforts in key areas should be improved. High-incidence counties should analyze data and conduct risk assessments effectively.

     

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