渭河流域2005－2015年肾综合征出血热流行特征及环境危险因素分析

目的 了解渭河流域2005－2015年肾综合征出血热（HFRS）流行情况,评估影响HFRS空间分布差异的环境因素。方法 通过“中国疾病预防控制信息系统”收集2005－2015年渭河流域HFRS个案资料,统计描述HFRS流行特征;应用增强回归树模型在5 km×5 km栅格尺度上分析引起疾病地理分布差异的主要因素。结果 2005－2015年,渭河流域共报告HFRS病例18 629例,年均发病率为7.24/10万,2012年HFRS发病率最高,达15.18/10万;HFRS高发区域主要集中在西安市、渭南市等渭河中下游地区;患者年龄集中在16～60岁,但2010年后,>60岁年龄组的发病率超过其他年龄组。增强回归树模型显示区域内建筑用地和农田面积覆盖百分比、海拔高度等因素对HFRS地域分布有较高贡献度。结论 渭河流域HFRS流行特征发生显著变化,>60岁老年人成为发病率最高的人群;建筑用地、农田、海拔高度等环境因素对渭河流域HFRS空间分布发挥着重要影响作用。

Epidemiological characteristics and environmental risk factors of hemorrhagic fever with renal syndrome in Wei River basin, China, 2005-2015

Objective To understand the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Wei River Basin from 2005 to 2015, and analyze the environmental factors that cause the differences of spatial distribution. Methods HFRS reported cases in Wei River Basin from 2005 to 2015 were collected form "National Disease Reporting Information System", and the epidemiological features of HFRS were analyzed. Boosted regression trees (BRT) model was applied to evaluate the environment factors on the geographical distribution of HFRS in Wei River basin at 5 km×5 km gird scale. Results The number of HFRS cases was 18 629, and the average annual incidence from 2005-2015 in Wei River basin was 7.24/100 000. The highest morbidity was 15.18/100 000 in 2012. The middle and lower reaches of Wei River basin had high incidence of HFRS, such as Xi''an, Weinan city. Patients'' age was mainly between 16 to 60, and the largest morbidity occured in people over 60 years old. Boosted regression trees modle identified building land, farmland coverage percentage and altitude had higher contribution to the distribution of HFRS. Conclusions The epidemiological characteristics of HFRS changed significantly. Patients older than 60 years old were having the highest incidence rates. Environmental factors such as buildup land, farmland and altitude played important roles in the geographical distribution of HFRS in the Wei River basin.