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北京大学学报（医学版） ›› 2021, Vol. 53 ›› Issue (3): 498-505. doi: 10.19723/j.issn.1671-167X.2021.03.010

• 论著 • 上一篇    下一篇

中国6~22岁学生群体甲乙丙类传染病流行趋势

董彦会1,陈曼曼1,王丽萍2,星一1,宋逸1,邹志勇1,董彬1,李中杰2,马军1,Δ()   

  1. 1.北京大学公共卫生学院,北京大学儿童青少年卫生研究所, 北京 100191
    2.中国疾病预防控制中心,传染病预防控制处传染病监测预警重点实验室, 北京 102206
  • 收稿日期:2020-10-22 出版日期:2021-06-18 发布日期:2021-06-16
  • 通讯作者: 马军 E-mail:majunt@bjmu.edu.cn
  • 基金资助:
    国家自然科学基金(91846302);中国博士后科学基金(BX20200019);中国博士后科学基金(2020M680266)

Epidemiological characteristics of infectious diseases of group A, B and C among Chinese students’ population

DONG Yan-hui1,CHEN Man-man1,WANG Li-ping2,XING Yi1,SONG Yi1,ZOU Zhi-yong1,DONG Bin1,LI Zhong-jie2,MA Jun1,Δ()   

  1. 1. Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
    2. Division of Infectious Disease Control and Prevention, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing 102206, China
  • Received:2020-10-22 Online:2021-06-18 Published:2021-06-16
  • Contact: Jun MA E-mail:majunt@bjmu.edu.cn
  • Supported by:
    National Natural Science Foundation of China(91846302);China Postdoctoral Science Foundation(BX20200019);China Postdoctoral Science Foundation(2020M680266)

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摘要：

目的: 分析2008—2017年中国6~22岁学生群体甲乙丙类传染病的长期趋势、顺位变化以及主要传染病在不同年龄组和地区间的变化特征。方法: 选取2008—2017年全国传染病监测数据中诊断为法定报告传染病的学生病例作为研究对象,共涉及到甲乙丙类传染病40种,传染病的发病率和死亡率基于教育部公布年度学生人口数作为分母进行计算,选取各年龄组、各省份在每年度中的发病率最高的传染病作为主要传染病进行分析。结果: 2008—2015年中国6~22岁学生群体传染病发病率和死亡率整体呈波动下降趋势,男生发病率、发病数以及死亡数均高于女生,其中,2008—2015年男女生发病率下降幅度分别为43.4%和40.1%,但在2015—2017年出现反弹,增长幅度分别为47.1%和53.8%,反弹主要由丙类传染病增长导致。10年间,甲乙类传染病发病率的前3位疾病分别由2008年的病毒性肝炎、结核病和痢疾,转变为2017年的结核病、猩红热和病毒性肝炎。甲乙类传染病死亡率的前3位疾病分别由2008年的狂犬病、结核病和人类免疫缺陷病毒(human immunodeficiency virus,HIV)/获得性免疫缺陷综合征(acquired immune deficiency syndrome,AIDS),转变为2017年的HIV/AIDS、狂犬病和结核病。丙类传染病发病率和死亡顺位变化并不明显。在年龄组和地区分析中,甲乙类传染病主要以病毒性肝炎、猩红热和结核病为主,丙类传染病则以流行性腮腺炎和感染性腹泻病为主,但近年来,流感和手足口病在东部地区增长明显。结论: 2008—2017年间,我国在学生群体传染病防控方面成就显著,但传染病变化模式和特征显示出我国未来在防控呼吸道传染病、HIV/AIDS等性传播疾病以及新型突发传染病方面的迫切需求,本研究为全国学校卫生传染病防控机制的政策制定提供了重要基础。

关键词: 传染病, 学生, 流行病学研究

Abstract:

Objective: To analyze the secular trend, ranking change, age- and regional- characteristics of leading infectious diseases among Chinese students population aged 6 to 22 years from 2008 to 2017. Methods: Data were drawn from the national surveillance from 2008 to 2017, and the participants were students aged from 6 to 22 years who were diagnosed with notifiable infectious diseases. A total of 40 infectious diseases were classified into three groups based on national notifiable infectious diseases classification of A, B and C. The morbidity and mortality rates from infectious diseases were calculated using the numbers of students published by the ministry of education as the denominator. The age- and province-specific infectious diseases with the highest incidence were selected as the leading infectious diseases for analysis. Results: From 2008 to 2017, the incidence rate, the number of cases and the number of deaths of infectious diseases among the boys aged 6-22 years in China were higher than that of the girls, and the overall trend was downward during the study period. The incidence rates in the boys and girls decreased from 2008 to 2015 with decrease of 43.4% and 40.1%, respectively. However, by 2017, the increase rate rebounded with the increases of 47.1% and 53.8%. The rebound trend was mainly caused by the increase of group C of infectious diseases. During the past decade, the top leading three diseases of groups A and B of infectious diseases were viral hepatitis, tuberculosis and dysentery in 2018, respectively, which changed to tuberculosis, scarlet fever and viral hepatitis in 2017. The top leading three infectious diseases in terms of mortality were rabies, tuberculosis, and human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) in 2008, which were transformed into HIV/AIDS, rabies, and tuberculosis in 2017. There was no significantly obvious change in the incidence and mortality order of group C of infectious diseases during the decade. In the analysis of age groups and regions, the leading infectious diseases in groups A and B transferred from viral hepatitis to scarlet fever and tuberculosis, while in group C, mumps and infectious diarrhoea almost always dominated the leading infectious diseases. But in recent years, influenza and hand-foot-and-mouth disease increased significantly in the eastern region. Conclusion: During the past decade, China has got remarkable achievements in the prevention and control of children infectious disease. However, the change patterns and characteristics of notifiable infectious diseases among children and adolescents show the urgent need for prevention and control of respiratory tract infectious diseases, HIV/AIDS and other sexually transmitted diseases as well as new emerging infectious diseases in China in the future. This study provides important basis for policy making of Chinese national school-based infectious disease prevention and control mechanism.

Key words: Communicable diseases, Students, Epidemiologic studies

中图分类号: 

  • R181.32

图1

2008—2017年中国6~22岁学生群体男女生甲乙丙类传染病发病率(a~c)、发病例数(d~f)和死亡例数(g~i)趋势"

图2

2008—2017年中国6~22岁学生群体男女生甲乙丙类传染病死亡构成比比较"

表1

2008—2017年中国6~22岁学生群体各甲乙丙类传染病发病数和死亡数前三位病种排序变化"

Infectious diseases groups 2008 2009 2010 2011 2012
Incidence Group A and B Hepatitis Hepatitis Hepatitis TB TB
TB H1N1 TB Hepatitis Hepatitis
Dysentery TB Dysentery SF Dysentery
Group C Mumps Mumps Mumps Mumps Mumps
Rubella SF AHC ID HFMD
ID ID HFMD HFMD ID
Mortality Group A and B Rabies Rabies Rabies Rabies Rabies
TB H1N1 JE HIV/AIDS HIV/AIDS
HIV/AIDS JE HIV/AIDS JE TB
Group C Influenza Influenza HFMD HFMD HFMD
Mumps ID ID Mumps None
None None Mumps None None
Infectious diseases groups 2013 2014 2015 2016 2017
Incidence Group A and B TB TB TB TB TB
Hepatitis SF SF SF SF
Dysentery Hepatitis Hepatitis Hepatitis Hepatitis
Group C Mumps Mumps Mumps Mumps Mumps
HFMD HFMD HFMD HFMD Influenza
ID ID ID Influenza ID
Mortality Group A and B Rabies HIV/AIDS HIV/AIDS HIV/AIDS HIV/AIDS
HIV/AIDS Rabies Rabies Rabies Rabies
TB TB TB TB TB
Group C HFMD Influenza HFMD Influenza Influenza
Influenza HFMD Rubella HFMD ID
None None None None None

图3

2008—2017年中国6~22岁学生群体各年龄段主要传染病变化情况"

图4

2008—2017年中国6~22岁学生群体各省份主要甲乙丙类传染病变化情况"

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CN 11-4691/R
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