中国西北银川市非药物 COVID-19 控制措施对其他传染病的间接影响：一项时间序列研究。
The indirect impacts of nonpharmacological COVID-19 control measures on other infectious diseases in Yinchuan, Northwest China: a time series study.
机构信息
School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
Key Laboratory of Environmental Factors and Chronic Disease Control, No. 1160, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China.
出版信息
BMC Public Health. 2023 Jun 6;23(1):1089. doi: 10.1186/s12889-023-15878-3.
BACKGROUND
Various nonpharmaceutical interventions (NPIs) against COVID-19 continue to have an impact on socioeconomic and population behaviour patterns. However, the effect of NPIs on notifiable infectious diseases remains inconclusive due to the variability of the disease spectrum, high-incidence endemic diseases and environmental factors across different geographical regions. Thus, it is of public health interest to explore the influence of NPIs on notifiable infectious diseases in Yinchuan, Northwest China.
METHODS
Based on data on notifiable infectious diseases (NIDs), air pollutants, meteorological data, and the number of health institutional personnel in Yinchuan, we first fitted dynamic regression time series models to the incidence of NIDs from 2013 to 2019 and then estimated the incidence for 2020. Then, we compared the projected time series data with the observed incidence of NIDs in 2020. We calculated the relative reduction in NIDs at different emergency response levels in 2020 to identify the impacts of NIPs on NIDs in Yinchuan.
RESULTS
A total of 15,711 cases of NIDs were reported in Yinchuan in 2020, which was 42.59% lower than the average annual number of cases from 2013 to 2019. Natural focal diseases and vector-borne infectious diseases showed an increasing trend, as the observed incidence in 2020 was 46.86% higher than the estimated cases. The observed number of cases changed in respiratory infectious diseases, intestinal infectious diseases and sexually transmitted or bloodborne diseases were 65.27%, 58.45% and 35.01% higher than the expected number, respectively. The NIDs with the highest reductions in each subgroup were hand, foot, and mouth disease (5854 cases), infectious diarrhoea (2157 cases) and scarlet fever (832 cases), respectively. In addition, it was also found that the expected relative reduction in NIDs in 2020 showed a decline across different emergency response levels, as the relative reduction dropped from 65.65% (95% CI: -65.86%, 80.84%) during the level 1 response to 52.72% (95% CI: 20.84%, 66.30%) during the level 3 response.
CONCLUSIONS
The widespread implementation of NPIs in 2020 may have had significant inhibitory effects on the incidence of respiratory infectious diseases, intestinal infectious diseases and sexually transmitted or bloodborne diseases. The relative reduction in NIDs during different emergency response levels in 2020 showed a declining trend as the response level changed from level 1 to level 3. These results can serve as essential guidance for policy-makers and stakeholders to take specific actions to control infectious diseases and protect vulnerable populations in the future.
背景
针对 COVID-19 的各种非药物干预（NPIs）继续对社会经济和人口行为模式产生影响。然而，由于疾病谱的可变性、高发地方性疾病和不同地理区域的环境因素，NPIs 对法定传染病的影响仍不确定。因此，探索 NPIs 对中国西北银川市法定传染病的影响具有公共卫生意义。
方法
基于银川市法定传染病（NIDs）、空气污染物、气象数据和卫生机构人员数量的数据，我们首先拟合了 2013 年至 2019 年 NIDs 的动态回归时间序列模型，然后估计了 2020 年的发病率。然后，我们将预测的时间序列数据与 2020 年 NIDs 的实际发病率进行了比较。我们计算了 2020 年不同应急响应级别下 NIDs 的相对减少量，以确定 NPIs 对银川市 NIDs 的影响。
结果
2020 年银川市共报告法定传染病 15711 例，比 2013 年至 2019 年的年平均病例数减少 42.59%。自然焦点疾病和虫媒传染病呈上升趋势，2020 年实际发病率比预测病例高 46.86%。呼吸道传染病、肠道传染病和性传播或血源传染病的实际病例数分别比预期病例数高出 65.27%、58.45%和 35.01%。每个亚组中 NIDs 减少最多的是手足口病（5854 例）、传染性腹泻（2157 例）和猩红热（832 例）。此外，还发现 2020 年不同应急响应级别下预期的 NIDs 相对减少量呈下降趋势，因为相对减少量从 1 级响应时的 65.65%（95%CI：-65.86%，80.84%）下降到 3 级响应时的 52.72%（95%CI：20.84%，66.30%）。
结论
2020 年广泛实施 NPIs 可能对呼吸道传染病、肠道传染病和性传播或血源传染病的发病率产生了显著的抑制作用。2020 年不同应急响应级别下 NIDs 的相对减少量呈下降趋势，应急响应级别从 1 级变为 3 级。这些结果可为决策者和利益相关者提供重要指导，以便他们在未来采取具体行动控制传染病并保护弱势群体。
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