Pathogens of patients with fever with rash syndrome in Gansu province, 2009 – 2019: a multiple correspondence analysis
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摘要:
目的 了解甘肃省2009 — 2019年发热伴出疹症候群(RFIs)的病原分布特征,为有针对性地实施预防策略及开展病原学监测提供参考依据。 方法 收集“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项传染病监测技术平台信息管理系统中甘肃省2009年1月 — 2019年12月哨点医院监测的5822例RFIs病例相关数据,对主要病原分布特征进行多重对应分析。 结果 甘肃省2009 — 2019年监测的5822例RFIs病例中,肠道病毒感染者1653例(28.39 %),麻疹病毒感染者548例(9.41 %),风疹病毒感染者201例(3.45 %),水痘带状疱疹病毒感染者495例(8.50 %),阴性病例者2925例(50.24 %)。多重对应分析结果显示,肠道病毒在河西和陇中地区、夏秋季节、≤ 5岁散居儿童和幼托儿童、省级和县区级医院住院病例中检出较高,麻疹病毒在陇东和陇南地区、冬春季节、≥ 18岁其他职业成年人、市级医院中检出较高,6~17岁学生易感染水痘带状疱疹病毒和风疹病毒,门急诊病例多为阴性病例。 结论 甘肃省2009 — 2019年RFIs主要病原包括肠道病毒、麻疹病毒、水痘带状疱疹病毒和风疹病毒,不同病原分布特征不同。 -
关键词:
- 发热伴出疹症候群(RFIs) /
- 病原 /
- 分布特征 /
- 多重对应分析
Abstract:Objective To examine characteristics of pathogens identified among patients with fever and rash syndrome (RFIs) in Gansu province from 2009 to 2019, and to provide a reference for implementing targeted prevention measures and conducting pathogen surveillance. Methods Sentinel surveillance data on 5 822 RFIs cases reported in Gansu province from 2009 through 2019 were extracted from the Information Management System for Prevention and Treatment of AIDS and Viral Hepatitis and other Major Infectious Diseases. Multiple correspondence analysis was adopted to analyze characteristics of pathogens isolated from the RFIs patients. Results Enterovirus infection was confirmed in 1 653 (28.39%) of the all RFIs patients reported during the period and the number (proportion) of the patients confirmed with other pathogen infections were 548 (9.41%) for measles virus, 201 (3.45%) for rubella virus, and 495 (8.50%) for varicella-zoster virus, respectively. No pathogen infection was confirmed in 2 925 (50.24%) RFIs patients. The results of multiple correspondence analysis showed that enteroviruses infection was more frequently diagnosed in hospitalized cases in western and central Gansu province, during summer/autumn season, among scattered children aged ≤ 5 years and kindergarten children, among patients hospitalized in provincial and county-level hospitals; measles virus infection was more frequently confirmed among the patients in eastern and southern areas of Gansu province, during winter/spring season, in the adults (≥ 18 years) with some specific occupations, and among patients seeking medication at municipal hospitals; and more varicella-zoster virus and rubella virus infections were detected among the students aged 6 to 17 years. No pathogen infection was identified among the majority of the RFIs patients visiting doctors in outpatient/emergency departments. Conclusion The main pathogens inducing RFIs incidents in Gansu province from 2009 to 2019 include enterovirus, measles virus, varicella-zoster virus and rubella virus, and there were disparities in the detection rate of the pathogens among various populations, in different seasons and in various geographical areas. -
表 1 甘肃省不同特征RFIs病例病原感染类型分布情况比较
特征 肠道病毒 麻疹病毒 风疹病毒 水痘带状疱疹病毒 阴性 χ2 值 P 值 例数 % 例数 % 例数 % 例数 % 例数 % 性别 男性 1085 30.47 305 8.57 123 3.45 292 8.20 1756 49.31 23.485 < 0.001 女性 568 25.12 243 10.75 78 3.45 203 8.98 1169 51.70 年龄(岁) ≤ 5 1502 40.51 351 9.47 24 0.65 111 2.99 1720 46.39 1377.481 < 0.001 6~17 134 11.21 31 2.59 136 11.38 225 18.83 669 55.98 ≥ 18 17 1.85 166 18.06 41 4.46 159 17.30 536 58.32 职业 散居儿童 910 39.50 297 12.89 20 0.87 47 2.04 1030 44.70 1259.231 < 0.001 幼托儿童 604 41.92 45 3.12 3 0.21 74 5.14 715 49.62 学生 97 8.24 29 2.46 152 12.91 221 18.78 678 57.60 其他 42 4.67 177 19.67 26 2.89 153 17.00 502 55.78 地区 河西地区 394 33.16 46 3.87 26 2.19 64 5.39 658 55.39 288.359 < 0.001 陇中地区 682 28.73 158 6.66 33 1.39 244 10.28 1257 52.95 陇东和陇南地区 577 25.53 344 15.22 142 6.28 187 8.27 1010 44.69 病例类型 门急诊病例 1263 28.07 277 6.16 174 3.87 432 9.60 2353 52.30 278.431 < 0.001 住院病例 390 29.48 271 20.48 27 2.04 63 4.76 572 43.24 哨点医院级别 省级 337 30.55 52 4.71 9 0.82 58 5.26 647 58.66 247.403 < 0.001 市级 895 24.75 458 12.67 169 4.67 323 8.93 1771 48.98 县区级 421 38.17 38 3.45 23 2.09 114 10.34 507 45.97 发病季节 春季 427 23.58 301 16.62 116 6.41 140 7.73 827 45.67 732.690 < 0.001 夏季 841 42.80 106 5.39 56 2.85 153 7.79 809 41.17 秋季 318 26.54 23 1.92 5 0.42 83 6.93 769 64.19 冬季 67 7.90 118 13.92 24 2.83 119 14.03 520 61.32 -
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