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2007年至2022年山东省百日咳的流行病学特征及临床特点

[Epidemiological characteristics and clinical features of pertussis in Shandong Province from 2007 to 2022].

作者信息

Feng L, Zhang Y, Liu X M, Liu G F, Liu X D, Li M S, Zhang L, Xu A Q

机构信息

Expanded Program Immunization Division, Shandong Center for Disease Control and Prevention,Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Jinan 250014, China.

Infectious Disease Control and Prevention Division, Dongying Center for Disease Control and Prevention, Dongying 257091, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2024 Jan 6;58(1):33-39. doi: 10.3760/cma.j.cn112150-20230426-00325.

Abstract

To analyze the epidemiological characteristics and clinical features of pertussis cases reported in Shandong Province of China. Data on pertussis cases in Shandong Province from 2007 to 2022 were collected from China Information System for Disease Control and Prevention. At the same time, some case information was collected from the database of notifiable pertussis in Shandong Province from 2007 to 2022. The distribution characteristics and clinical features of pertussis were analyzed. A spatial distribution map of pertussis cases in Shandong Province was drawn. A total of 26 122 pertussis cases were reported in Shandong Province during 2007-2022, with an annual incidence rate ranging from 0.11 to 5.77 cases per 100 000 people. Cases occurred throughout the whole year, with a seasonal peak occurring in spring and summer, especially in July and August. In recent years, reported cases were mainly distributed in the central and western regions of Shandong Province, with fewer cases in the eastern region. The hot spots of the disease shifted from Heze and Dezhou City in 2007-2013 to Jinan and Tai'an city in 2014-2022. The age range of onset was from 1 day to 93 years old. The proportion of cases with age≤1 year was the largest (41.81%, 10 922/26 122), and the proportion of cases aged 0-6 months decreased from 32.21% (67/208)-55.67% (157/282) within the period of 2007 to 2013 to 16.78% (883/5 263)-41.97% (444/1 058) within the period of 2014 to 2022, with a statistically significant trend (² trend=670.01, <0.001). There were 13 682 male cases and 12 440 female cases, with a male-female ratio of 1.10∶1. The male-female ratio was 1.45∶1 (806∶556) from 2007 to 2013 and 1.08∶1 (12 876∶11 884) from 2014 to 2022. The proportion of women increased from 42.31% (88/208) in 2007 to 47.84% (2 518/5 263) in 2022, and with a significant trend (² trend=22.25, <0.001). In pertussis cases, the proportions of scattered children, kindergarten children and students were 71.38% (18 645/26 122), 15.13% (3 951/26 122), and 11.60% (3 031/26 122), respectively. The top five clinical symptoms of pertussis cases were paroxysmal spasmodic cough (86.33%, 21 411 cases), flushing (39.61%, 9 824 cases), restless sleep (34.51%, 8 558 cases), fever (30.80%, 7 638 cases), and crowing (27.53%, 6 829 cases). Among 24 802 cases, there were 15 542 cases (62.66%) with a history of immunization against pertussis vaccine. From 2007 to 2022, the incidence rate of pertussis cases in Shandong Province shows an upward trend, with the majority being young children, and the clinical symptoms are relatively typical.

摘要

分析中国山东省报告的百日咳病例的流行病学特征和临床特点。从中国疾病预防控制信息系统收集2007年至2022年山东省百日咳病例的数据。同时,从山东省2007年至2022年法定报告百日咳数据库中收集部分病例信息。分析百日咳的分布特征和临床特点,绘制山东省百日咳病例空间分布图。2007年至2022年山东省共报告百日咳病例26122例,年发病率为每10万人0.11至5.77例。病例全年均有发生,春夏季出现季节性高峰,尤其在7月和8月。近年来,报告病例主要分布在山东省中西部地区,东部地区病例较少。疾病热点从2007 - 2013年的菏泽市和德州市转移至2014 - 2022年的济南市和泰安市。发病年龄范围为1天至93岁。年龄≤1岁的病例比例最大(41.81%,10922/26122),年龄在0 - 6个月的病例比例从2007年至2013年期间的32.21%(67/208) - 55.67%(157/282)降至2014年至2022年期间的16.78%(883/5263) - 41.97%(444/1058),差异有统计学意义(χ²趋势 = 670.01,P < 0.001)。男性病例13682例,女性病例12440例,男女比例为1.10∶1。2007年至2013年男女比例为1.45∶1(806∶556),2014年至2022年为1.08∶1(12876∶11884)。女性比例从2007年的42.31%(88/208)增至2022年的47.84%(2518/5263),差异有统计学意义(χ²趋势 = 22.25,P < 0.001)。百日咳病例中,散居儿童、幼儿园儿童和学生的比例分别为71.38%(18645/26122)、15.13%(3951/26122)和11.60%(3031/26122)。百日咳病例的前五位临床症状为阵发性痉挛性咳嗽(86.33%,21411例)、面红(39.61%,9824例)、睡眠不安(34.51%,8558例)、发热(30.80%,7638例)和鸡鸣样吼声(27.53%,6829例)。24802例病例中,有15542例(62.66%)有百日咳疫苗接种史。2007年至2022年,山东省百日咳病例发病率呈上升趋势,以幼儿为主,临床症状较为典型。

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