Abstract:
Objective: To elucidate the epidemiological characteristics, dynamic evolution of the pathogen spectrum, and spatial distribution patterns of other infectious diarrhea (excluding cholera, typhoid fever, paratyphoid fever, and bacillary dysentery) in Yangpu District of Shanghai from 2005 to 2024, thereby providing a scientific basis for the formulation of targeted prevention and control strategies.
Methods: Case information for other infectious diarrhea cases with a current address in Yangpu District of Shanghai, and onset dates from January 1, 2005 to December 31, 2024, was extracted from the Chinese Center for Disease Control and Prevention Information System. Data on cases, including gender, age, occupation, and pathogen testing results, were collected. Descriptive epidemiological methods were employed to analyze the time, place, and population distributions of reported incidence rates and the epidemiological characteristics of pathogens for other infectious diarrhea in Yangpu District from 2005 to 2024. Spatial autocorrelation analyses of reported incidence rates for viral and bacterial diarrhea were conducted using Moran’s
Index (Moran’s
I). Local spatial autocorrelation analysis was performed using local indicators of spatial association (LISA), with a first-order Queen contiguity spatial weight matrix, and significance was tested via 999 random permutations. Time-series and radar chart analyses were used to examine the temporal patterns of other infectious diarrhea cases caused by major pathogens.
Results: From 2005 to 2024, a total of 5211 cases of other infectious diarrhea were reported in Yangpu District. The cases were predominantly males (2714 cases, accounting for 52.08%) and children under 5 years of age (1639 cases, accounting for 31.45%). The primary occupational groups were scattered children (1433 cases, accounting for 27.50%) and retired personnel (1403 cases, accounting for 26.92%). The annual average reported incidence rate was 20.36/100000, showing an overall fluctuating trend with peaks around 2009 and 2024. Peak incidence occurs in summer and autumn, with the highest reported incidence rate observed in summer (June-August) (7.31/100000). Children under 5 years of age (116.00/100000) and adults aged 60 and older (21.39/100000) were the top two age groups in terms of reported incidence. Global spatial autocorrelation analyses showed that the reported incidence rates of viral diarrhea across sub-districts in Yangpu District in 2020 exhibited a significant positive spatial correlation (Moran’s
I=0.30,
P=0.016). The spatial autocorrelation of reported incidence rates of viral diarrhea in each sub-district for the periods 2008-2019 and 2021-2024 was not statistically significant (all
P>0.05). Local spatial autocorrelation analyses of viral diarrhea incidence in 2020 revealed that Xinjiangwancheng Sub-district exhibited a low-low clustering trend (local Moran’s
I=0.49,
P=0.018), while Dinghai Road Sub-district exhibited a high-high clustering trend (local Moran’s
I=1.33,
P=0.024). The global spatial autocorrelation of reported incidence rates of bacterial diarrhea across the sub-districts of Yangpu District from 2005 to 2024 was not statistically significant (all
P>0.05). Among the 5211 cases, 4049 had definitive pathogen test results. Regarding pathogen composition, bacterial diarrhea accounted for a relatively high proportion (55.52%, 2248/4049). The pathogens with the highest proportions were rotavirus (32.33%, 1309/4049),
Vibrio spp. (31.69%, 1283/4049),
Salmonella spp. (19.63%, 795/4049), and norovirus (9.16%, 371/4049). The radar chart showed that diarrhea cases caused by norovirus had no obvious seasonality, rotavirus cases were mainly concentrated in winter, and cases caused by
Salmonella spp. and
Vibrio spp. were mainly concentrated in summer and autumn. Among cases under 20 years of age, rotavirus accounted for a relatively high proportion, especially in children under 5 years; among cases aged 20 years and older,
Vibrio spp. and
Salmonella spp. accounted for relatively high proportions.
Conclusion: From 2005 to 2024, other infectious diarrhea in Yangpu District of Shanghai was most prevalent in summer and autumn; children under 5 years of age and adults aged 60 years and older were high-risk groups; and in 2020, Dinghai Road Sub-district was a high-risk area for viral diarrhea. Rotavirus,
Vibrio spp.,
Salmonella spp., and norovirus were the dominant pathogens. Prevention and control efforts for other infectious diarrhea should be strengthened among key populations (e.g., children under 5 years of age and adults aged 60 years and older) and in high-risk areas such as Dinghai Road Sub-district. During summer and autumn, priority should be given to preventing and controlling bacterial diarrhea caused by
Salmonella spp. and
Vibrio spp., especially among individuals aged 20 years and older (particularly those aged 60 and above). During winter, priority should be given to preventing and controlling diarrhea caused by rotavirus infection among individuals under 20 years of age, particularly children under 5 years of age.