SARS后的中国的第一个十年，传染病流行病学特点的变化：一项观察性研究

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SARS后的中国的第一个十年，传染病流行病学特点的变化：一项观察性研究
作者：张雅芝 来源：急诊界 日期：2017-07-28
导读
         SARS后的中国的第一个十年，传染病流行病学特点的变化：一项观察性研究
关键字：  SARS | 传染病 | 流行病学 | 发病率
        Epidemiological features of and changes in incidence of infectious diseases in China in the first decade after the SARS outbreak: an observational trend study
        SARS后的中国的第一个十年，传染病流行病学特点的变化：一项观察性研究
        Background
        The model of infectious disease prevention and control changed significantly in China after the outbreak in 2003 of severe acute respiratory syndrome (SARS), but trends and epidemiological features of infectious diseases are rarely studied. In this study, we aimed to assess specific incidence and mortality trends of 45 notifiable infectious diseases from 2004 to 2013 in China and to investigate the overall effectiveness of current prevention and control strategies.
        中国在2003年严重急性呼吸综合症(SARS)爆发后，传染病的预防与控制有了明显的变化，但对其趋势和传染病流行特征的研究很少。这项研究探讨中国从2004到2013年45种法定传染病的防控策略的整体有效性，评估其具体的发病率和死亡率趋势。
        Methods
        Incidence and mortality data for 45 notifiable infectious diseases were extracted from a Chinese public health science data centre from 2004 to 2013, which covers 31 provinces in mainland China. We estimated the annual percentage change in incidence of each infectious disease using joinpoint regression.
        从中国公共卫生科学数据中心将中国大陆31个省2004-2013年45种法定传染病的发病率和死亡率数据进行提取，采用Joinpoint回归率估计每种传染病的年度变化百分比。
        Findings
        Between January, 2004, and December, 2013, 54 984 661 cases of 45 infectious diseases were reported (average yearly incidence 417·98 per 100 000). The infectious diseases with the highest yearly incidence were hand, foot, and mouth disease (114·48 per 100 000), hepatitis B (81·57 per 100 000), and tuberculosis (80·33 per 100 000). 132 681 deaths were reported among the 54 984 661 cases (average yearly mortality 1·01 deaths per 100 000; average case fatality 2·4 per 1000). Overall yearly incidence of infectious disease was higher among males than females and was highest among children younger than 10 years. Overall yearly mortality was higher among males than females older than 20 years and highest among individuals older than 80 years. Average yearly incidence rose from 300·54 per 100 000 in 2004 to 483·63 per 100 000 in 2013 (annual percentage change 5·9%); hydatid disease (echinococcosis), hepatitis C, and syphilis showed the fastest growth. The overall increasing trend changed after 2009, and the annual percentage change in incidence of infectious disease in 2009–13 (2·3%) was significantly lower than in 2004–08 (6·2%).
        在2004年1月和2013年12月，共报告45种传染病54 984 661例(发病率平均每年417.98每100 000)。每年的发病率最高的传染病是手足口病(114.48每100 000)、乙型肝炎(81.57每100 000)和肺结核(80.33每100 000)。报道54 984 661例中共死亡132 681人(平均年死亡率1.01人每100 000;平均病死率2.4每1000)。每年感染性疾病的发病率男性高于女性，10岁以下儿童发病率最高。20岁以上年总死亡率男性比女性高，年龄在80岁以上的人最高。年平均发病率从300.54每100 000 (2004) 上升483.63每100 000(2013)(年度百分比变化5.9%);细粒棘球蚴病(包虫病)、丙型肝炎、梅毒和呈现增长最快。总的增长趋势在2009年后发生变化，2009～2013年间(2.3%)传染病发病率年变化率明显低于2004～2008(6.2%)。
        Interpretation
        Although the overall incidence of infectious diseases was increasing from 2004, the rate levelled off after 2009. Effective prevention and control strategies are needed for diseases with the highest incidence—including hand, foot, and mouth disease, hepatitis B, and tuberculosis—and those with the fastest rates of increase (including hydatid disease, hepatitis C, and syphilis).
        虽然传染病的总发病率从2004年起呈上升趋势，但2009年以后趋于平稳。发病率最高的疾病为手足口病、乙型肝炎和肺结核，增长率最快的为包虫病、丙型肝炎和梅毒，必须采取有效的预防和控制策略。

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