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[2007 - 2017年石家庄市18岁以下人群急性脑膜炎和脑炎流行趋势]

[Trends on the epidemics of acute meningitis and encephalitis among population under 18 years-old in Shijiazhuang city, 2007-2017].

作者信息

Guo J H, Li J, Zhang X

机构信息

Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang 050011, China.

Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang 050021, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2019 Apr 10;40(4):417-421. doi: 10.3760/cma.j.issn.0254-6450.2019.04.009.

Abstract

To understand the trends on the epidemics of acute meningitis and encephalitis (AME) among children under 18 years-old in Shijiazhuang city, 2007-2017. 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. 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: 3.90-5.93)(=23.01, <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 =20.21, =0.004; aged 2- years =19.41, =0.006; aged 3- years =23.50, <0.001; aged 4- years =31.76, <0.001; aged 5- years =18.53, =0.008; aged 10-17 years =12.82, =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). 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.

摘要

为了解2007 - 2017年石家庄市18岁以下儿童急性脑膜炎和脑炎(AME)的流行趋势。自2007年以来,针对18岁以下人群开展了急性脑膜炎和脑炎(AMES)监测项目。石家庄市县级及以上医院被纳入开展流行病学监测,包括6种关于AMES病原体的监测。采用定性描述来描述流行病学模式和病原谱。用年度变化百分比(APC)来展示AME的长期趋势。2007 - 2017年,石家庄市报告了11222例18岁以下本地发生的AME病例,年平均发病率为108.62/10万(1021/939974),APC为4.81(95%CI:3.90 - 5.93)(χ² = 23.01,P < 0.001)。年龄别发病率在4 - 5岁儿童中最高(每年每10万名儿童中有242.96例)。除0 - 岁儿童外,其他年龄段儿童之间存在显著差异(1 - 岁儿童χ² = 20.21,P = 0.004;2 - 岁儿童χ² = 19.41,P = 0.006;3 - 岁儿童χ² = 23.50,P < 0.001;4 - 岁儿童χ² = 31.76,P < 0.001;5 - 岁儿童χ² = 18.53,P = 0.008;10 - 17岁儿童χ² = 12.82,P = 0.023)。男女比例为1.46∶1(6652/4570)。城乡病例比例为0.28∶1(2456/8766)。共有57.73%(6478/11222)的病例出现在6月至9月。这些患者中病原体总体阳性率为20.07%(658/3123)。前五位病原体依次为肠道病毒(44.68%,264/658)、新型隐球菌(9.12%,60/658)、日本脑炎病毒(8.66%,57/658)、肺炎链球菌(6.99%,47/658)和水痘 - 带状疱疹病毒(6.69%,44/658)。AME严重危害石家庄市18岁以下人群的健康,尤其是3 - 岁和4 - 岁儿童。持续加强监测和扩大免疫接种对AME的预防和控制至关重要。

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