玉溪市红塔区伤寒与副伤寒流行特征和气象因素之间的相关性研究

发布时间：2018-01-21 05:34

本文关键词： 伤寒与副伤寒地方病区域流行特征气象变量相关分析　出处：《大理大学》2017年硕士论文　论文类型：学位论文

【摘要】：背景伤寒与副伤寒(Typhoid and Paratyphoid fever,TPF)是由肠沙门氏菌肠亚种伤寒血清型(Salmonella enterica subsp.enterica serotype typhi)和肠沙门氏菌肠亚种副伤寒甲或乙或丙血清型(Salmonella enterica subsp.enterica serotype paratyphi A,B,C)引起的急性肠道传染病,该病仍然是全球重要公共卫生问题之一。我国TPF被列为法定报告的乙类传染病之一,1990年以前,TPF发病率在10-50/10万之间,到2009年已下降至1.28/10万,但部分地区发病仍居高不下,且时有暴发。气象因素是影响传染病爆发和流行的因素之一。例如传染源的粪便污水受雨水和气温等气象因素影响,导致饮用水、食物污染,从而增加人群感染病原体的风险。目的描述1999-2015年云南省玉溪市红塔区TPF地方病区域流行特征和分析气象因素对红塔区TPF流行规律的影响,为TPF监测控制和危险因素评价提供科学依据。材料与方法 1999-2015年红塔区TPF的病例数据来源于中国疾病预防和控制信息系统。人口资料来源于红塔区统计局和红塔区统计年鉴。月气象资料从中国气象科学数据共享服务系统获得,主要气象指标包括月平均降雨量、月平均气温、月平均相对湿度、月平均气压、月平均降雨日数、月平均日照时数。采用描述性流行病学方法对本研究区域1999-2015年TPF病例数据进行统计分析,使用卡方检验、圆形分布深入分析病例的时间、区域和人群分布等流行特征;采用Pearson相关分析研究TPF月发病率和相应月份各气象要素关系,求出相关系数r值和P值,P≤0.05为差异有统计学意义;经单因素分析初选后,采用主成分回归分析确定影响发病的主要气象因素。以上资料的统计分析使用Excel2010和SPSS17.0软件完成。结果 1999-2015年红塔区报告8398例TPF病例,每年度、月份均报告TPF病例,年度发病率范围在6.26/10万~355.11/10万之间,流行有周期性,1999、2015年分别报告23、44例,2015年回归2000年以前的发病水平。1999-2015年期间每年3-5、6-10、11-2月分别为发病上升期(月均增长率63.3%)、高峰期(月均减少率2%)和下降期(月均减少率25.7%),每年度病例数都呈现3-10月季节性升高和11月至次年2月季节性降低;经圆形分布分析显示,红塔区TPF发病呈现出明显的季节性,发病高峰日为8月7日,峰期为5月5日~11月10日;2000-2002、2004-2005、2005-2007、2007-2008、2008-2010出现五个流行高峰,峰期范围是12~24月,周期范围是11~40月;2001、2004、2006、2007、2009年五个高峰年度6-10月份病例数范围分别为86~217、67~215、125~216、97~131、63~95例;1999、2000、2002、2003、2005、2008、2010、2015年八个流行低峰年度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。州城(中心城区所在地)报告TPF病例最多,共报告5403例,其它乡镇共报告病例2995例,州城发病率高于其它乡镇(χ2=3628.386,P0.05),男女病例比例为1.09:1,男性发病率高于女性发病率(χ2=25.850,P0.05),发病率居前三名的年龄组为20~29、30~39、10~19岁,主要发病的职业人群依次为农民、学生、工人、干部职员。单因素分析得月平均发病率与月平均降雨日数(r=0.864,P0.01)、月平均降雨量(r=0.833,P0.01)、月平均气温(r=0.806,P0.01)和月平均相对湿度(r=0.706,P0.05)呈正相关,与日照时数(r=-0.642,P0.05)呈负相关,与月平均气压无线性关系(r=-0.186,P0.05);主成分分析显示第一主成分(C1)反映当月平均降雨量、气温、降雨日数等信息,第二主成分(C2)反映相对湿度等信息;经主成分回归分析显示,降雨量、降雨日数、气温是影响TPF发病的主要气象因素。结论 1999-2015年红塔区报告TPF病例数多、发病率高、流行时间长,发病率逐年下降,流行呈现季节性升高与降低、周期性流行、长期趋势特点;TPF发病与气象因素有相关性,月平均发病率与月平均降雨日数、降雨量、气温和相对湿度呈正相关,其中,降雨量、降雨日数和气温对该病发病有较大影响;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、评估、政策有助全球类似TPF地方病与非地方病区域的监测与控制。
[Abstract]:The background of typhoid and paratyphoid fever (Typhoid and Paratyphoid fever, TPF) is a subspecies of intestinal typhoid Salmonella enteria serotype (Salmonella enterica subsp.enterica serotype Typhi) and Salmonella enteria intestinal subspecies of paratyphoid A or B or C serotype (Salmonella enterica subsp.enterica serotype paratyphi A, B, C) of acute intestinal infectious disease caused. The disease is still one of the important global public health problem. One of the class B infectious disease in China TPF is listed as a statutory report before 1990, the incidence of TPF between 10-50/10 million, to 2009 has dropped to 1.28/10 million, but in some areas the incidence remains high, and when the outbreak is one of the effects of meteorological factors. The outbreak of infectious diseases and epidemic factors. For example, the source of infection of fecal sewage affected by meteorological factors such as temperature and rainfall, resulting in drinking water, food contamination, thereby increasing the group of pathogens in the wind Objective to describe the risk. 1999-2015 endemic area of Hongta District of Yuxi City, Yunnan province TPF epidemic characteristics and meteorological factors affecting on the epidemic of TPF in Hongta District, TPF monitoring and control and to assess risk factors and provide scientific basis. Materials and methods the number of cases in Hongta District 1999-2015 TPF sources from China disease prevention and control information system. Population from Hongta district and Hongta District Bureau of statistics statistical yearbook. Monthly meteorological data from the meteorological data sharing service system China, main meteorological indicators include the average monthly rainfall, monthly mean temperature, monthly mean relative humidity, monthly average atmospheric pressure, average monthly rainfall days, monthly average sunshine hours. Descriptive epidemiological analysis was conducted on the study area 1999-2015 TPF case data, using the chi square test, in-depth analysis of the case of circular distribution of time, area and population The epidemic characteristics of distribution; using Pearson correlation analysis of TPF incidence and the corresponding month of various meteorological elements, calculate the correlation coefficient r value and P value of P is less than or equal to 0.05, there was statistically significant difference; univariate analysis after the primaries, using principal component regression analysis to determine the effects of main meteorological factors of the disease. The above information statistics the analysis using Excel2010 and SPSS17.0 software. The report of Hongta area 1999-2015 of 8398 TPF cases, every year, the month reported TPF cases, the annual incidence rate in the range between 6.26/10 million ~355.11/10 million, fashion is cyclical, 19992015 years were reported 23,44 cases, before returning in 2015 2000 the incidence level of.1999-2015 a year during 3-5,6-10,11-2 month respectively the onset of rise period (monthly average growth rate of 63.3%), peak period (monthly average reduction rate of 2%) and decline period (monthly average reduction rate of 25.7%), the number of cases each year are 3-10 The seasonal increase in November and August to February of the following year seasonal decrease; the circular distribution analysis showed that the incidence of TPF in Hongta district showed a significant seasonal incidence peak, on August 7th, the peak period for the May 5th ~11 10; 2000-20022004-20052005-20072007-20082008-2010 five flow line peak, the peak period is in the range of 12~24 month period is in the range of 11~40 five months; 20012004200620072009 peak annual 6-10 month the number of cases were 86~217,67~215125~216,97~131,63~95 cases; 19992000200220032005200820102015 eight popular low peak annual 6-10 month the number of cases were 1~3,1~17,32~60,30~43,46~55,43~78,22~61,2~11 cases. The range of city (city center location) report TPF most cases, 5403 cases were reported in other towns, a total of 2995 cases, the incidence rate of city higher than that of other towns (x 2=3628.386, P0.05), the ratio of male and female patients was 1 9:1, the incidence of male is higher than female incidence rate (2=25.850, P0.05), the incidence of age group in the top three for 20~29,30~39,10~19 years, the incidence of main occupation population are farmers, students, workers, cadres and staff by single factor analysis. The average incidence rate was from month to month, average number of rainy days (r=0.864, P0.01) and the average monthly rainfall (r=0.833, P0.01), the monthly mean temperature (r=0.806, P0.01) and monthly average relative humidity (r=0.706, P0.05) were positively correlated with sunshine duration (r=-0.642, P0.05) was negatively correlated, no linear relationship with the monthly average atmospheric pressure (r=-0.186, P0.05); principal component analysis showed that the first principal component (C1) reflect the month average rainfall, temperature, rainfall information days, the second principal component (C2) reflects the relative humidity information; by principal component regression analysis showed that the number of rainfall, rainfall, temperature is the main meteorological factors in the pathogenesis of TPF. Conclusion the newspaper in Hongta District 1999-2015 Sue TPF case number, the disease incidence rate is high, the popular long time incidence rate decreased year by year, seasonal epidemic has increased and reduced, periodic epidemic, long-term trend; there is a correlation between TPF incidence and meteorological factors, the average monthly incidence rate and average monthly number of rainfall, rainfall, air temperature and relative humidity was positively related to the the number of days of rainfall, rainfall and temperature have great influence on the incidence of the disease; the infectious source of accumulation, heavy pollution formation, the population exposed to increase the driving relationship of epidemiological characteristics and meteorological variables; the corresponding evaluation rules, mechanism, policy, monitoring and control of the global TPF like endemic and non endemic areas.

【学位授予单位】：大理大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R181.3;R516.3

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