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目的了解2009-2013年南京市手足口病流行病学特征及病原学特征,为制定有效的防控措施提供依据。方法采用描述性流行病学的研究方法,对南京市近五年手足口病疫情资料进行分析。结果 2009-2013年南京市共报告手足口病71 412例,发病率是192.54/10万,且逐年上升(χ2趋势=648.194,P<0.001);重症1 019例,重症病例占总病例的比例为1.43%,重症率呈现逐年下降的趋势。发病高峰发生在夏季(4-7月),次高峰发生在冬季(11-12月)。城郊、两县人群发病率均高于主城区。男性发病率高于女性。0~5岁儿童占总病例的93.01%。绝大多数病例为散居儿童和幼托儿童。五年间全市共报告实验室诊断病例2 348例,普通病例以Cox A16和EV71感染为主,其他肠道病毒构成比呈现上升趋势;重症病例以EV71感染为主。结论南京市手足口病季节、地区、性别、年龄及人群分布特征明显。延迟就诊的病例发展成重症病例的风险更大。手足口病防控应以散居儿童和幼托儿童为重点人群,加强病原学、血清流行病学以及相关疫苗的研究,将有助于提出更好的预防控制措施。
Objective To understand the epidemiological and etiological characteristics of hand, foot and mouth disease from 2009 to 2013 in Nanjing, and to provide basis for effective prevention and control measures. Methods Descriptive epidemiological methods were used to analyze the epidemic situation of HFMD in Nanjing during the past five years. Results A total of 71 412 hand-foot-mouth disease cases were reported in Nanjing from 2009 to 2013, with a prevalence of 192.54 / 100 000 and a year-on-year increase (χ2 trend = 648.194, P <0.001). In severe cases, 1 019 cases were severe cases, 1.43%, severe rate showed a downward trend year by year. Peak incidence occurred in the summer (April-July), and sub-peak occurred in the winter (November-December). Outskirts, two counties were higher than the main urban population. The incidence of males is higher than that of females. 0 to 5 years old children accounted for 93.01% of the total cases. The vast majority of cases are diaspora and kindergarten children. In the past five years, a total of 2 348 laboratory-diagnosed cases were reported in the city. Cox A16 and EV71 were the most common infections in the city, and the proportions of other enteroviral viruses showed an upward trend. Severe cases were mainly EV71. Conclusions The seasonal, regional, gender, age and population distribution of hand-foot-mouth disease in Nanjing are obvious. Postponed cases have a greater risk of developing severe cases. Prevention and control of hand, foot and mouth disease should focus on diaspora and preschool children. Strengthening etiology, serological epidemiology and related vaccines will help to propose better prevention and control measures.