Department of Epidemiology and the Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University, Xi'an, China.
Department of Mathematics and Physics, School of Biomedical and Engineering, Fourth Military Medical University, Xi'an, China.
Vaccine. 2014 Feb 3;32(6):740-5. doi: 10.1016/j.vaccine.2013.11.024. Epub 2013 Nov 16.
The incidence of hemorrhagic fever with renal syndrome (HFRS) in Hu County ranked third of all counties in China in 2010. Although this county has provided a HFRS vaccination program freely since 1994, the impact of HFRS remains quite substantial. In order to continue the vaccination program effectively and control HFRS, a detailed understanding of the effect of the vaccination program should be undertaken. The Cochran-Armitage trend test was employed to examine the temporal trends of HFRS incidences, mortality rate and vaccination compliance. Temporal cluster analysis was performed to detect time periods of high HFRS risk. Cross correlation analysis was conducted to detect the correlation between HFRS incidence and vaccination compliance. Wavelet analysis was employed to detect the shift of the periodicity of HFRS. Between 1971 and 2011, the HFRS incidence and mortality rate ranged from 9.53/100,000 to 300.57/100,000 and 0 to 24.91/100,000, respectively, with a fluctuating but distinctly declining trend (incidence: Z=-34.38, P<0.01; mortality rate: Z=-23.44, P<0.01). The vaccination compliance ranged from 4.55% to 83.67%, with a distinctly increasing trend (Z=1621.70, P<0.01). The most likely temporal cluster of the HFRS epidemic was between 1983 and 1988 (RR=3.44, P<0.01) or 1979-1988 (RR=3.18, P<0.01) with different maximum temporal cluster size. There was a negative correlation between HFRS incidence and vaccination compliance when the lagged year was 1 and 2 (cross correlation coefficient=-0.51 and -0.55). The periodicity of HFRS epidemic was prolonged from about 5 years during 1976-1988 to 15 years after 1988, especially after the start of HFRS vaccination in 1994. In conclusion, the increase in vaccination compliance may play an important role in HFRS control and prevention in Hu County, China.
1971 年至 2011 年间，河北省蔚县肾综合征出血热（HFRS）发病率和死亡率分别波动于 9.53/100000 至 300.57/100000 及 0 至 24.91/100000，呈下降趋势（发病率：Z=-34.38，P<0.01；死亡率：Z=-23.44，P<0.01）。疫苗接种率波动上升，从 4.55%上升至 83.67%（Z=1621.70，P<0.01）。HFRS 流行的最可能时间聚类在 1983 年至 1988 年（RR=3.44，P<0.01）或 1979 年至 1988 年（RR=3.18，P<0.01）之间，且最大时间聚类大小不同。HFRS 发病率与滞后 1 年和 2 年的疫苗接种率呈负相关（交叉相关系数=-0.51 和-0.55）。HFRS 流行的周期性从 1976 年至 1988 年的大约 5 年延长至 1988 年后的 15 年，尤其是 1994 年开始 HFRS 疫苗接种后。总之，疫苗接种率的增加可能在中国河北省蔚县 HFRS 的防控中发挥了重要作用。
