Chongqing Center for Disease Control and Prevention, No. 187 Tongxing North Road, Beibei district, Chongqing Municipality, China.
School of Public Health and Management, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong district, Chongqing Municipality, China.
BMC Public Health. 2024 Sep 30;24(1):2674. doi: 10.1186/s12889-024-20116-5.
This study aimed to investigate the epidemiological changes in scarlet fever before, during and after the COVID-19 pandemic (2005-2023) and predict the incidence of the disease in 2024 and 2025 in Chongqing Municipality, Southwest China.
Descriptive analysis was used to summarize the characteristics of the scarlet fever epidemic. Spatial autocorrelation analysis was utilized to explore the distribution pattern of the disease, and the seasonal autoregressive integrated moving average (SARIMA) model was constructed to predict its incidence in 2024 and 2025.
Between 2005 and 2023, 9,593 scarlet fever cases were reported in Chongqing, which resulted in an annual average incidence of 1.6694 per 100,000 people. Children aged 3-7 were the primary victims of this disease, with the highest average incidence found among children aged 6 (5.0002 per 100,000 people). Kindergarten children were the dominant infected population, accounting for as much as 54.32% of cases, followed by students (34.09%). The incidence for the male was 1.51 times greater than that for the female. The monthly distribution of the incidence showed a bimodal pattern, with one peak occurring between April and June and another in November or December. The spatial autocorrelation analysis revealed that scarlet fever cases were markedly clustered; the areas with higher incidence were mainly concentrated in Chongqing's urban areas and its adjacent districts, and gradually spreading to remote areas after 2020. The incidence of scarlet fever increased by 106.54% and 39.33% in the post-upsurge period (2015-2019) and the dynamic zero-COVID period (2020-2022), respectively, compared to the pre-upsurge period (2005-2014) (P < 0.001). During the dynamic zero-COVID period, the incidence of scarlet fever decreased by 68.61%, 25.66%, and 10.59% (P < 0.001) in 2020, 2021, and 2022, respectively, compared to the predicted incidence. In 2023, after the dynamic zero-COVID period, the reported cases decreased to 1.5168 per 100,000 people unexpectedly instead of increasing. The cases of scarlet fever are predicted to increase in 2024 (675 cases) and 2025 (705 cases).
Children aged 3-7 years are the most affected population, particularly males, and kindergartens and primary schools serving as transmission hotspots. It is predicted that the high incidence of scarlet fever in Chongqing will persist in 2024 and 2025, and the outer districts (counties) beyond urban zone would bear the brunt of the impact. Therefore, imminent public health planning and resource allocation should be focused within those areas.
本研究旨在调查 2005-2023 年新冠疫情前后猩红热的流行病学变化，并预测 2024 年和 2025 年重庆市猩红热的发病率。
采用描述性分析总结猩红热疫情特征，运用空间自相关分析探讨疾病的分布模式，构建季节性自回归求和移动平均（SARIMA）模型预测 2024 年和 2025 年的发病率。
2005-2023 年，重庆市共报告猩红热病例 9593 例，年均发病率为 1.6694/10 万。3-7 岁儿童是主要发病人群，6 岁儿童的平均发病率最高（5.0002/10 万）。幼儿园儿童是主要感染人群，占病例的 54.32%，其次是学生（34.09%）。男性发病率是女性的 1.51 倍。发病率的月度分布呈双峰模式，4-6 月和 11-12 月各有一个高峰。空间自相关分析显示，猩红热病例明显呈聚集性分布，发病率较高的地区主要集中在重庆市城区及其周边地区，2020 年后逐渐向偏远地区蔓延。疫情上升期（2015-2019 年）和动态清零期（2020-2022 年）的猩红热发病率分别比疫情上升前（2005-2014 年）增加了 106.54%和 39.33%（P<0.001）。在动态清零期，2020 年、2021 年和 2022 年猩红热发病率分别较预测发病率下降了 68.61%、25.66%和 10.59%（P<0.001）。2023 年，动态清零期后，猩红热报告病例意外减少至 1.5168/10 万，而非增加。预计 2024 年（675 例）和 2025 年（705 例）重庆市猩红热发病率将增加。
3-7 岁儿童是受影响最严重的人群，尤其是男性，幼儿园和小学是传播的热点。预计 2024 年和 2025 年重庆市猩红热发病率仍将居高不下，城区以外的（县）区将首当其冲。因此，应立即在这些地区进行公共卫生规划和资源配置。
