山东省滨州市手足口病的流行特征及影响因素

doi:10.6040/j.issn.1671-7554.0.2025.0548

摘要/Abstract

摘要： 目的基于区县尺度分析山东省滨州市手足口病的流行特征,以及其发病影响因素,为卫生行政部门制定手足口病防控计划提供科学依据。方法选取2015年1月1日至2019年12月31日山东省滨州市手足口病报告病例24 147例,收集同期的气象、污染物和社会经济数据;描述手足口病的时间、空间和人群分布特征;采用全局莫兰指数评估手足口病的空间聚集性;通过构建贝叶斯时空模型探索发病的影响因素。结果 2015—2019年山东省滨州市手足口病整体呈波动性下降的趋势,年均报告发病率为122.57/10万。发病具有季节性,主要发病高峰出现在5—7月,随后在秋季出现小高峰。发病存在明显的空间自相关,中部地区发病率最高,北部地区发病率较低。人群分布显示,男女性别比为1.55:1,发病主要集中在1—3岁儿童,且散居儿童发病数大于幼托儿童。贝叶斯时空模型结果显示,平均温度和地区生产总值(gross domestic product, GDP)与滨州市手足口病的发病风险呈正相关,相对危险度分别为1.146(95%CI:1.102~1.193)和1.001(95%CI:1.000~1.003);平均风速与手足口病的发病风险呈负相关,相对危险度为0.593(95%CI:0.360~0.976)。温度对0~2岁人群的影响更强,风速对0~2岁和男性的影响更强。结论滨州市手足口病呈波动下降趋势且存在空间聚集性。高温和低风速是手足口病发病的危险因素,高GDP水平与手足口病发病呈正相关。建议卫生部门在每年流行高峰和高温季节加强重点区域和人群的监测,合理配置医疗资源降低发病风险。

关键词: 手足口病, 时空分析, 贝叶斯时空模型, 影响因素, 发病风险

Abstract: Objective To investigate the epidemiological characteristics and influencing factors of hand, foot and mouth disease(HFMD)at the county level in Binzhou City, Shandong Province, in order to provide a scientific basis for health administrative departments in developing prevention and control strategies. Methods A total of 24,147 reported cases of HFMD in Binzhou City, Shandong Province, were collected from January 1,2015 to December 31,2019, along with meteorological, pollutant and socio-economic data. The temporal, spatial and population distribution characteristics of HFMD were described. Spatial clustering was assessed using the global Morans I index. Bayesian spatio-temporal model was used to identify influencing factors associated with HFMD incidence. Results HFMD incidence in Binzhou City showed a fluctuating downward trend from 2015 to 2019, with an average annual reported incidence rate of 122.57/100,000. The incidence exhibited distinct seasonality characterized by a primary peak from May to July and a secondary autumn peak. Spatial autocorrelation analysis revealed a distinct pattern of incidence, with the central region exhibiting the highest rates and the northern area the lowest. The population distribution showed that the sex ratio was 1.55:1, with HFMD cases was mainly concentrated in children aged 1-3 years, while the number of cases among scattered children was higher than that among kiudergarten children. Bayesian spatio-temporal modeling identified positive associations for mean temperature(RR=1.146; 95%CI: 1.102-1.193)and gross domestic product(GDP)(RR=1.001; 95%CI: 1.000-1.003), and a negative association for mean wind speed(RR=0.593; 95%CI: 0.360-0.976). Temperature had a stronger effect on 0-2 years old, and wind speed had a stronger effect on 0-2 years old and males. Conclusion The incidence of HFMD in Binzhou City shows a fluctuating downward trend, with distinct spatial clustering. High temperature and low wind speed are risk factors for HFMD occurrence, with high GDP levels showing a positive correlation with its incidence. It is recommended that health departments enhance monitoring in high-risk areas and vulnerable populations during seasonal epidemic peaks and periods of high temperature, and optimize the allocation of medical resources to reduce the risk of transmission.

Key words: Hand, foot and mouth disease, Spatio-temporal analysis, Bayesian spatio-temporal model, Influencing factors, Incidence risk

中图分类号:

R122

徐欣颖,颜伟,石兴龙,岳芳,吕婧,乔颖异,张宇琦,程传龙,左慧,李秀君. 山东省滨州市手足口病的流行特征及影响因素[J]. 山东大学学报 (医学版), 2026, 64(1): 118-125.

XU Xinying, YAN Wei, SHI Xinglong, YUE Fang, LYU Jing, QIAO Yingyi, ZHANG Yuqi, CHENG Chuanlong, ZUO Hui, LI Xiujun. Epidemiological characteristics and influencing factors of hand, foot and mouth disease in Binzhou City, Shandong Province, China[J]. Journal of Shandong University (Health Sciences), 2026, 64(1): 118-125.

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