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中国重庆 2004 年至 2018 年流行性腮腺炎的流行病学特征及时空分析。

Epidemiological Characteristics and Spatiotemporal Analysis of Mumps from 2004 to 2018 in Chongqing, China.

机构信息

Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.

Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400042, China.

出版信息

Int J Environ Res Public Health. 2019 Aug 22;16(17):3052. doi: 10.3390/ijerph16173052.

Abstract

Mumps vaccines have been widely used in recent years, but frequent mumps outbreaks and re-emergence around the world have not stopped. Mumps still remains a serious public health problem with a high incidence in China. The status of mumps epidemics in Chongqing, the largest city in China, is still unclear. This study aimed to investigate the epidemiological and spatiotemporal characteristics of mumps and to provide a scientific basis for formulating effective strategies for its prevention and control. Surveillance data of mumps in Chongqing from January 2004 to December 2018 were collected from the National Notifiable Diseases Reporting Information System. A descriptive analysis was conducted to understand the epidemiological characteristics. Hot spots and spatiotemporal patterns were identified by performing a spatial autocorrelation analysis, a purely spatial scan, and a spatiotemporal scan at the county level based on geographic information systems. A total of 895,429 mumps cases were reported in Chongqing, with an annual average incidence of 36.34 per 100,000. The yearly incidence of mumps decreased markedly from 2004 to 2007, increased sharply from 2007 to 2011, and then tapered with a two-year cyclical peak after 2011. The onset of mumps showed an obvious bimodal seasonal distribution, with a higher peak of mumps observed from April to July of each year. Children aged 5-9 years old, males, and students were the prime high-risk groups. The spatial distribution of mumps did not exhibit significant global autocorrelation in most years, but local indicators of spatial autocorrelation and scan statistics detected high-incidence clusters which were mainly located in the midwestern, western, northeastern, and southwestern parts of Chongqing. The aggregation time frame detected by the purely temporal scan was between March 2009 and July 2013. The incidence of mumps in Chongqing from 2004 to 2018 featured significant spatial heterogeneity and spatiotemporal clustering. The findings of this study might assist public health agencies to develop real-time space monitoring, especially in the clustering regions and at peak periods; to improve immunization strategies for long-term prevention; and to deploy health resources reasonably.

摘要

近年来,腮腺炎疫苗得到了广泛应用,但世界各地仍频繁出现腮腺炎暴发和重现。腮腺炎仍然是一个严重的公共卫生问题,在中国发病率较高。中国最大城市重庆的腮腺炎流行状况仍不清楚。本研究旨在调查腮腺炎的流行病学和时空特征,为制定有效的预防和控制策略提供科学依据。从国家法定传染病报告信息系统收集了 2004 年 1 月至 2018 年 12 月重庆市腮腺炎的监测数据。通过描述性分析了解流行病学特征。基于地理信息系统,通过空间自相关分析、纯空间扫描和县级时空扫描,确定热点和时空模式。重庆市共报告腮腺炎病例 895429 例,年平均发病率为 36.34/10 万。2004 年至 2007 年,腮腺炎年发病率明显下降,2007 年至 2011 年急剧上升,2011 年后呈两年周期性高峰下降。腮腺炎发病呈明显双峰季节性分布,每年 4 月至 7 月为发病高峰。5-9 岁儿童、男性和学生是高危人群。大多数年份腮腺炎的空间分布没有明显的全局自相关,但局部空间自相关指标和扫描统计检测到高发病率的聚集主要位于重庆市中西部、西部、东北部和西南部。纯时间扫描检测到的聚集时间框架在 2009 年 3 月至 2013 年 7 月之间。2004 年至 2018 年,重庆市腮腺炎发病率具有显著的空间异质性和时空聚集性。本研究结果可能有助于公共卫生机构实时开展空间监测,特别是在聚集区域和高峰期;改进长期预防的免疫策略;合理配置卫生资源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f931/6747306/b8dea8e949ad/ijerph-16-03052-g001.jpg

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