三峡库区宜昌监测点传染病发病趋势的Joinpoint回归分析

目的 了解三峡库区宜昌监测点2004－2017年传染病发病率趋势变化情况。方法 收集2004－2017年三峡库区宜昌监测点传染病发病资料及人口资料,应用Joinpoint转折点回归分析对传染病数据进行时间趋势分析。结果 三峡库区蓄水运行后,2004－2017年库区监测点累计报告传染病7 409例,年均发病率564.48/10万,报告发病率在2004－2009年间呈现明显上升(APC=15.00%, P=0.009),2009年后发病率趋于平稳(P=0.532)。男性发病明显高于女性(χ²=326.52, P<0.001)。库区传染病主要以乙型肝炎、肺结核、手足口病、其他感染性腹泻和流行性腮腺炎为主,占发病总数的89.70%。按病种分析显示库区乙肝发病率在2004－2010年间呈现快速上升(APC=30.75%,P=0.006),肺结核在2007－2017年呈现缓慢下降趋势(APC=-6.53%,P=0.011)。 结论 三峡库区宜昌监测点2004－2017年法定传染病报告发病率未发生特异性变化,与我国传染病流行的情况基本一致。需针对库区乙型肝炎、肺结核和手足口病等重点传染病制定相应的预防控制策略。

Joinpoint regression analysis of incidence trend of notifiable infectious diseases at Yichang surveillance sites in the Three Gorges Reservoir Area

Objective To investigate the changes in the incidence trend of notifiable infectious disease at Yichang surveillance sites in the Three Gorges Reservoir Area during 2004-2017. Methods We collected the data about the incidence of notifiable infectious diseases and demography at Yichang surveillance sites during 2004-2017. Joinpoint regression analysis was employed to estimate the time trends of various infectious diseases. Results A total of 7,409 cases of infectious diseases at Yichang surveillance sites during 2004-2017 were cumulatively reported after the impoundment of the Three Gorges Reservoir Area, and the annual average incidence rate was 564.48/100,000. The reported incidence rates of notifiable infectious diseases from 2004 to 2009 showed an increasing trend (APC=15.00%, P=0.009), but the rates stayed stable after the year of 2009 (P=0.532). The incidence was significantly higher in the males than in the females (χ²=326.52, P<0.001). The infectious diseases prevalent in the Three Gorges Reservoir Area mainly included hepatitis B, tuberculosis, hand, foot and mouth disease (HFMD), other infectious diarrhea and epidemic parotitis, accounting for 89.70% of the total cases. Analysis of different types of the diseases indicated that the incidence rates of hepatitis B from 2004 to 2010 presented a rapid upward trend (APC=30.75%, P=0.006), but the rates of pulmonary tuberculosis from 2007 to 2017 showed a slowly downward trend (APC=-6.53%,P=0.011). Conclusions There was no specific change in the reported incidence rates of notifiable infectious diseases at Yichang surveillance sites in the Three Gorges Reservoir Area during 2004-2017, which was basically consistent with the epidemic situation of infectious diseases in China. We should formulate relevant prevention and control strategies based on the priority infectious diseases such as hepatitis B, pulmonary tuberculosis and HFMD in the Three Gorges Reservoir Area.