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目的分析1999-2015年红塔区伤寒与副伤寒(typhoid and paratyphoid fever,TPF)地方病区域流行特征和气象变量的关系,为TPF监测控制和危险因素评价提供科学依据。方法采用描述流行病学方法和自主研发计算机软件建立中国疾病预防控制信息系统红塔区TPF病例分布与流行特征数据库,用Pearson相关分析和多元线性逐步回归分析研究TPF发病和气象变量关系。结果 1999-2015年报告TPF病例数为8 398例,1999、2015年分别报告23、44例。1999-2015年期间每年3~5月、6~10月、11月~次年2月分别为发病上升期(月均增长率63.8%)、高峰期(月均降低率2.0%)和下降期(月均降低率25.7%),每年度病例数都呈现3月~10月季节性升高和11月~次年2月季节性降低;2000年8月至2010年12月每月病例数都大于8例,2000-2002、2004-2005、2005-2007、2007-2008、2008-2010年出现五个高强度流行峰,峰期范围是12~24个月,周期范围是11~40个月;2001、2004、2006、2007、2009年五个高峰年度6~10月病例数范围分别为86~217、67~215、125~216、97~131、63~95例;1999、2000、2002、2003、2005、2008、2010、2015年八个低峰年度6~10月病例数范围分别为1~3、1~17、32~60、30~43、46~55、43~78、22~61、2~11例。单因素分析TPF月平均发病率与月平均降雨量(r=0.825,P<0.01)、月平均气温(r=0.797,P<0.01)和月平均相对湿度(r=0.706,P<0.05)呈正相关;经多元逐步回归分析建立TPF月平均发病率(Y)与月平均降雨量(X)的拟合模型方程Y=4.563+0.051X。结论红塔区TPF发病呈现季节性升高与降低、周期性流行、长期趋势特点;发病率与降雨量、气温、相对湿度呈正相关;传染源积累、重污染源形成、暴露人群增加驱动着流行特征与气象变量关系;相应规律、机制、政策、评估有助TPF的监测控制。
Objective To analyze the relationship between epidemiological features and meteorological variables in endemic areas of typhoid and paratyphoid fever (TPF) in Hongta district from 1999 to 2015, and to provide a scientific basis for TPF monitoring and control and risk factor evaluation. Methods Descriptive epidemiological methods and self-developed computer software were used to establish the database of distribution and epidemiological characteristics of TPF in Hongta District of China. The relationship between TPF incidence and meteorological variables was analyzed by Pearson correlation analysis and multivariate linear stepwise regression analysis. Results The number of TPF cases reported in 1999-2015 was 8 398 cases, with 23,44 cases reported in 1999 and 2015 respectively. From March to May, from June to October, from November to February of the following year, the incidences of disease were respectively rising (average monthly growth rate 63.8%), peak period (average monthly rate 2.0%) and decreasing period (Average monthly reduction rate of 25.7%). The annual number of cases showed a seasonal increase from March to October and a seasonal decrease from November to February of the following year. The monthly number of cases from August 2000 to December 2010 was There were five high intensity epidemic peaks in 2000-2002, 2004-2005, 2007-2007 and 2008-2010. The peak period ranged from 12 to 24 months and the period ranged from 11 to 40 months ; The number of cases from June to October in 2001, 2004, 2006, 2007 and 2009 were 86-217, 67-215, 125-216, 97-131 and 63-95 respectively; 1999, 2000 and 2002 In 2003, 2005, 2008, 2010 and 2015, the number of cases from January to October in the eight low peak years were 1 ~ 3,1 ~ 17,32 ~ 60,30 ~ 43,46 ~ 55,43 ~ 78,22 ~ 61,2 ~ 11 cases. Univariate analysis showed that the average monthly incidence of TPF was positively correlated with monthly average rainfall (r = 0.825, P <0.01), monthly mean temperature (r = 0.797, P <0.01) and monthly average relative humidity (P <0.05). The fitting model equation (Y = 4.563 + 0.051X) of monthly mean incidence of TPF (Y) and monthly average rainfall (X) was established by multivariate stepwise regression analysis. Conclusion The incidence of TPF in Hongta District shows a seasonal increase and decrease, periodic epidemic and long-term trend. The incidence is positively correlated with rainfall, temperature and relative humidity. The accumulation of infectious agents and the formation of heavy pollution sources increase the population-driven epidemic characteristics and The relationship between meteorological variables; the corresponding rules, mechanisms, policies, and assessments help to monitor and control the TPF.