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目的了解四川省高县钩端螺旋体病(钩体病)流行特征,为制定控制策略提供科学依据。方法采用描述性流行病学方法对1976-2013年高县钩体病疫情报告及其相关资料进行分析。结果 1976-2013年累计发病3 814例,死亡16例,年均死亡率和发病率为0.09/10万和21.42/10万,年均发病率经趋势卡方检验,χ2=604.74,P<0.01。1976-1983年发病率波动在5.39/10万~38.10/10万之间,年均发病率为27.63/10万;1984-1993年发病呈现3次暴发流行,发病率波动在7.55/10万~169.95/10万之间,年均发病率为58.43/10万;1994-2013年发病率波动在0.21/10万~7.84/10万之间,年均发病率为1.34/10万。发病主要集中在8~10月,占病例总数的94.87%,流行形式以稻田型为主,流行菌群以黄疸出血群为主。病例集中在10~34岁,年均发病率为66.05/10万,男女病例性别比2.63∶1,职业主要集中在农民,其次是学生分别占总病例数的77.66%和14.55%。结论四川省高县钩体病年均发病率呈现逐年下降趋势,提示钩体病综合防治措施成效显著。8~10月为高发季节,男性发病高于女性,10~35岁的农民和学生是高危人群。
Objective To understand the epidemic characteristics of Leptospirosis (Leptospirosis) in Gaoxian County of Sichuan Province and provide a scientific basis for making control strategy. Methods Descriptive epidemiological method was used to analyze the report of the high level leptospirosis in high counties from 1976 to 2013 and its related data. Results A total of 3 814 cases and 16 deaths were recorded from 1976 to 2013. The average annual mortality and morbidity were 0.09 / 100 000 and 21.42 / 100 000 respectively. The annual average incidence was tested by trend chi square test (χ2 = 604.74, P <0.01) . The incidence fluctuated between 5.39 / 100,000 and 38.10 / 100,000 in 1976-1983 with an annual average incidence of 27.63 / 100 000. The incidence of the outbreak was three outbreaks in 1984-1993 with a prevalence of 7.55 / 100 000 ~ 169.95 / 100,000, with an average annual incidence of 58.43 / 100 000; the incidence of fluctuation in 1994-2013 ranged from 0.21 / 100 000 to 7.84 / 100 000 with an average annual incidence of 1.34 / 100 000. The incidence mainly concentrated in 8 to 10 months, accounting for 94.87% of the total number of cases, the prevalence of rice-based forms, the prevalence of jaundice bleeding group based. The cases were concentrated in 10 to 34 years old with an average annual incidence rate of 66.05 / 100000. The sex ratio of men and women was 2.63:1. The occupations mainly concentrated on peasants, followed by the students accounting for 77.66% and 14.55% of the total cases respectively. Conclusions The annual incidence of leptospirosis in Gaoxian County, Sichuan Province, shows a declining trend year by year, suggesting that the comprehensive prevention and control measures for leptospirosis are effective. 8 to October for the high season, the incidence of men than women, 10 to 35-year-old farmers and students are at high risk.