目的 掌握云南省4个县（市）登革热暴发疫情特征,为云南省登革热防控提供参考。方法 从“中国疾病预防控制信息系统”收集2023年云南省报告的所有登革热病例,采用圆形分布法分析耿马傣族佤族自治县、景洪市、瑞丽市、勐腊县4个县（市）的登革热暴发时间节律特点,用Excel 2010软件对数据进行整理,数据采用SPSS 19.0软件分析,率或构成比采用χ2检验,两组非正态计量资料相关性采用Spearman相关性检验。运用描述性流行病学方法对4个县（市）登革热暴发疫情特征进行分析。结果 2023年,云南省共计报告登革热病例13 748例,报告发病率为29.42/10万。4个县（市）共计报告登革热病例10 012例,占全省72.83%（10 012/13 748）,报告高峰期时期为6月15日—11月11日,高峰日为8月30日,4个县（市）输入病例、报告本地病例、向外输出病例数在时间分布上基本一致,不同月份3者间报告病例数有一定的相关性（rs 输入-本地=0.901,P=0.006；rs 本地-输出=0.893,P=0.007；rs 输入-输出=0.793,P=0.033）；人群分布方面,报告病例数居前5位的人群为农民、家务及待业、商业服务、自由职业、学生,构成比分别为31.25%（2 795/8 945）、16.88%（1 510/8 945）、14.21%（1 271/8 945）、10.90%（975/8 945）和8.09%（724/8 945）；年龄分布上,20～<70岁组占80.00%（7 818/9 772）,报告发病率最高为70～<80岁组（1 244.41/10万）,最低为0～<10岁组（306.55/10万）,随着年龄增加,报告发病率有增加趋势（χ2趋势=985.310,P<0.001）；病例地区分布呈现以人口密集和流动人口较大的口岸或城区乡镇聚集性为主,边境地区乡镇多发,内陆郊区乡镇多为散发的态势。国家级口岸乡镇报告本地病例最多,为7 054例,发病率为1 341.09/10万,无口岸或地方通道的乡镇报告发病率最低,为250.60/10万。随着开放水平的提升,各乡镇报告的本地病例发病率之间有增长趋势（χ2趋势=4 610.937,P<0.001）。各乡镇报告发病率与当地人口密度有一定的正相关关系（rs =0.446,P=0.006）。结论 2023年云南省4个县（市）登革热病例主要以口岸或城区乡镇聚集性为主,登革热暴发疫情有明显的地区、人群和时间分布特点,应以边境地区人口密集和流动人口较大的城区和口岸乡镇为重点,高度关注传染源和媒介向低风险地区的远距离输出。
关键词：
登革热; 暴发; 特征; 口岸; 云南省
Objective To investigate the characteristics of dengue fever outbreaks in four cities/counties of Yunnan Province, China, and to provide a reference for the prevention and control of dengue fever. Methods The data about dengue fever cases reported in Yunnan Province in 2023 were collected from the China Information System for Disease Control and Prevention. The circular distribution method was used to analyze the temporal patterns of dengue fever outbreaks in Gengma Dai and Wa Autonomous County, Jinghong City, Ruili City, and Mengla County. Excel 2010 software was used for data collation, and SPSS 19.0 software was used for data analysis. The rate or constituent ratio was compared using the Chi-square test. The correlation of non-normally distributed continuous data was examined through Spearman correlation analysis. Descriptive epidemiological method was used to describe the characteristics of dengue fever outbreaks in the four cities/counties. Results A total of 13 748 cases of dengue fever were reported in Yunnan Province in 2023, with a reported incidence rate of 29.42/100 000. The four cities/counties reported a total of 10 012 cases of dengue fever, accounting for 72.83% (10 012/13 748) of the total number in the province. The peak period was from June 15 to November 11, and the peak day was August 30. The temporal distributions of the imported cases, local cases, and exported cases in the four cities/counties were generally consistent, and they were correlated in different months (rsimported-local=0.901, P=0.006; rslocal-exported=0.893, P=0.007; rsimported-exported=0.793, P=0.033). In terms of the reported cases distribution, the top five occupations were farmers, homemakers and the unemployed, business employees, freelancers, and students, accounting for 31.25% (2 795/8 945), 16.88% (1 510/8 945), 14.21% (1 271/8 945), 10.90% (975/8 945), and 8.09% (724/8 945), respectively. By age distribution, the group of 20 to <70 years accounted for 80.00% (7 818/9 772), with the highest reported incidence rate in the group of 70 to <80 years (1 244.41/100 000) and lowest in the group of <10 years (306.55/100 000). There was an increasing trend in the reported incidence rate with age (χ2trend=985.310, P<0.001). By regional distribution, the cases were mainly concentrated in ports or urban townships densely populated and with large numbers of floating people, which were more distributed in the border areas and scattered in the inland and suburban townships. The number of local cases reported in national port townships was largest, with an incidence rate of 1 341.09/100 000, while the lowest incidence rate was 250.60/100 000 in townships without ports or local channels. As the opening level increased, the incidence rate of local cases reported in each township tended to increase (χ2trend=4 610.937, P<0.001). The incidence rate of each township was positively correlated with the local population density (rs=0.446, P=0.006). Conclusions In the four cities/counties of Yunnan Province, dengue fever cases are mainly clustered in ports or urban townships, and show specific distribution patterns by region, population, and time. The focus should be on densely populated urban areas and port townships with large floating populations near the border, and high attention should be paid to the long-distance export of infectious sources and vectors to low-risk areas.
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