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2015 年至 2019 年中国福建北部恙虫病的流行病学和临床特征。

Epidemiological and clinical characteristics of scrub typhus in northern Fujian, China, from 2015 to 2019.

机构信息

Department of Infectious Diseases, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Wusi Road, Fuzhou, China.

Department of Traditional Chinese Medicine, First Hospital of Nanping City, Nanping, China.

出版信息

BMC Infect Dis. 2023 Jul 18;23(1):479. doi: 10.1186/s12879-023-08451-1.

Abstract

BACKGROUND

This study aimed to analyze the epidemiological and clinical characteristics of scrub typhus in northern Fujian Province on the southeast coast of China.

METHODS

A retrospective analysis was performed on 303 patients with scrub typhus admitted to the First Hospital of Nanping City, Fujian Province, from January 2015 to December 2019. The epidemic characteristics were analyzed, such as the annual number of cases, age distribution, sex distribution, and seasonal distribution in each region. The patient's clinical manifestations, signs, complications, auxiliary examinations, and prognosis were analyzed.

RESULTS

From 2015 to 2019, the age distribution of scrub typhus cases was mainly concentrated in 40-49 y (17.16%), 50-59 y (24.09%), and 60-69 y (26.73%). There were no sex differences among the patients. 68.98% of the cases were concentrated in rural areas, with farmers having the highest proportion. However, this study compared prognostic factors in the cured and uncured groups, and found significant differences in non-farmer occupation and diagnosis time ≥ 8 days. Scrub typhus showed two peaks north of Fujian; the prominent peak was from June to July, and the other slight rise was from October to November. The SDE plot showed that the cases were mainly concentrated in Yanping, Shunchang, Zhenghe, and Songxi counties. The number of cases in hilly and mountainous areas was higher than in plain areas. The main diagnostic methods in this area are based on specific eschar and epidemiology, while the positive rate of the Weil-Felix test is low.

CONCLUSIONS

The results of this study can guide primary care institutions to improve the level of diagnosis and treatment of scrub typhus and take effective public health intervention measures in endemic areas.

摘要

背景

本研究旨在分析中国东南沿海福建省北部恙虫病的流行病学和临床特征。

方法

对 2015 年 1 月至 2019 年 12 月福建省南平市第一医院收治的 303 例恙虫病患者进行回顾性分析。分析了该病的流行特征,如每年病例数、年龄分布、性别分布和各地区的季节性分布。分析了患者的临床表现、体征、并发症、辅助检查和预后。

结果

2015 年至 2019 年,恙虫病病例年龄分布主要集中在 40-49 岁(17.16%)、50-59 岁(24.09%)和 60-69 岁(26.73%)。患者无性别差异。68.98%的病例集中在农村地区,农民比例最高。然而,本研究比较了治愈组和未治愈组的预后因素,发现非农民职业和诊断时间≥8 天存在显著差异。福建北部有两个恙虫病高发期;突出的高峰是 6 月至 7 月,另一个轻微上升是 10 月至 11 月。SDE 图显示,病例主要集中在延平、顺昌、政和和松溪等县。丘陵和山区的病例数高于平原地区。该地区主要的诊断方法是基于特定的焦痂和流行病学,而 Weil-Felix 试验的阳性率较低。

结论

本研究结果可为基层医疗机构提高恙虫病的诊治水平提供指导,并在疫区采取有效的公共卫生干预措施。

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