目的 分析南京市新冠感染疫情协查信息的特征,为优化协查信息系统功能、完善疫情处置流程提供参考.方法 利用《江苏省突发急性传染病接触者追踪管理系统》查询2021年1月1日—10月31日期间与南京市相关的新冠感染疫情协查信息,下载数据并做分析.结果 2021年1月1日—10月31日期间,南京市共处理协查信息函件16 239件,其中密切接触者函件7 464件,密切接触者的密切接触者函件7 633件,一般接触者函件1 142件.函件数量逐月缓慢上升,但7、8月份呈现突破性急剧增多.函件涉及全国除港澳台之外的31个省(自治区、直辖市).本省外市发南京协查的密接人员,当日管控率高于外省发南京协查的密接人员(80.15％vs.48.63％,X2=38.002,P＜0.05);次日管控率、延期管控率均低于外省发南京协查的密接人员(11.76％vs.38.70％,x2=31.967,P＜0.05;2.21％vs.10.27％,X2=8.488,P＜0.05).结论 有必要建立一套可供全国各省市区直接使用的、可实现协查信息实时传递的应用系统,进一步提升协查信息录入、传输、反馈的速率,为疫情防控赢得宝贵时间.各地应当持续做好能力储备,随时应对新冠感染突发疫情.

Objective To analyze the epidemiological characteristics of Public Health Emergencies（PHEs） in Nanjing from2004 to 2021, so as to provide a scientific evidence for targeted prevention and control measures in Nanjing city. Methods The data were collected and downloaded from National Public Health Emergency Reporting System and analyzed by descriptive method. Results From 2004 to 2021, a total of 302 PHEs were reported in Nanjing, of which more than 95%（287 PHEs） were infectious disease emergencies, including 106 cases of chickenpox, accounting for 35.10% of the total events, followed by infectious diarrhea, influenza, and mumps PHEs. Join-point analysis showed that there were three turning points, among which the increase from 2012 to 2019 was statistically significant（t=2.8, P=0.03）, September to October was the platform period for public health emergencies, and November to December was the peak months. No statistical difference was found in spatial autocorrelation analysis of public health emergencies in Nanjing（global Moran’s I =-0.03, Z =0.58, P =0.56）. There was a negative correlation between the proportion of ungraded events and the cumulative incidence of reported events（r=-0.768, P=0.04）. Public health emergencies mainly occurred in schools and kindergartens（217/302, 71.85%）. The types of infectious diseases involved in public health emergencies varied in different years and in schools. Conclusion The types of diseases in different years and stage vary greatly, and schools are the key places for prevention and control. Follow-up monitoring and analysis should be strengthened to keep track of the changes of the characteristics of public health emergencies in time.

目的 了解儿童家长对水痘知识认知情况和疫苗接种意愿,为制定健康促进和疫苗接种策略提供依据.方法 利用多阶段随机抽样方法,通过"问卷星"网络平台,对2 963名新入学一年级学生家长开展问卷调查.结果 一年级学生家长水痘知识知晓率为49.63％(95％CI:47.10％～52.26％),8个问题的知晓率在34.52％～97.63％,对水痘的典型临床特征(34.52％)和感染后能持久免疫(42.69％)知晓率最低.多因素分析显示,受教育程度高者(OR=2.09,95％CI:1.87～2.33)、受访者为母亲(OR=1.45,95％CI:1.21～1.73)、年人均收入高者(OR=1.19,95％CI:1.09～1.29)知晓率更高;水痘疫苗接种意愿为94.17％(95％CI:90.67％～97.78％).结论 南京一年级学生家长水痘疫苗接种意愿较高,有利于开展水痘疫苗扩大免疫工作;但水痘知识知晓率较低,应加强水痘防治知识宣传.

目的:了解柯萨奇病毒A6(coxsackievirusA6,CV-A6)感染情况和排毒时长,指导科学制定防控策略和措施.方法:制定病例定义,搜索病例.经过知情同意,采集某幼儿园所有病例和罹患率较高的小1班、中2班全体儿童的咽拭子和肛拭子标本,RT-PCR检测肠道病毒核酸,对检测阳性的儿童,每间隔1周再次采集标本开展检测,直至连续两次均为阴性时终止采样.结果:儿童罹患率为8.2％(17/208),发现隐性感染者17例.小1班和中2班流行曲线都呈现单峰分布,卫生学调查排除饮食和饮水传播.病原检测显示为CV-A6型肠道病毒核酸阳性.检测阳性者中隐性感染比例为52％(95％CI:34％～69％).排毒时长中位数为18 d(95％CI:16～25 d),最短为1周内(4 d),最长为5.5周(39 d),Log-rank检验显示病例与隐性感染者、男性与女性、咽部与肠道排毒时长差异无统计学意义(P＞0.05).结论:此轮由CV-A6肠道病毒引起的手足口病暴发疫情中,CV-A6隐性感染比例高,排毒时间长.建议提高监测敏感性,病例解除隔离返园(校)、班级复课后应开展持续的健康监测和防控措施.

Objective:To predict the mosquito density in 2019 by using the seasonal trend model of the moving average method based on the mosquito density in Nanjing from 2015 to 2018 to guide mosquito-borne diseases and mosquito control.Methods:Excel software was used to fit the seasonal trend of the mosquito density in Nanjing during the first half of 2015-2018 on the basis of the regression equation to predict the mosquito density in 2019.Results:The regression equation after fitting was: y=0.0091x+ 0.5207, and the relative error of the model was -0.04%.Conclusion:In the 9th and 21st half months of 2019 (that is, from late April to late October), the measured and predicted values are close to each other, and both are lower than the warning value. The model fitting effect is better. This method has guiding significance for the formulation of patriotic health campaign policies and the prevention and control of mosquito-borne diseases.

目的 分析南京市水痘突发公共卫生事件流行特征,揭示水痘疫情防控的关键环节,为疫情防控工作提供参考.方法 通过中国疾病预防控制信息系统收集2006-2020年南京市水痘突发公共卫生事件信息,使用描述性流行病学方法进行统计与分析.结果 2006-2020年间,南京市共报告104起水痘突发公共卫生事件,共计确诊患者3 255例,暴露人数132 109人,发病率为2.5％;事件数量呈现9月一次年1月主峰及3-6月次峰;小学(51.9％)、幼儿园(27.9％)的事件数占比最高,发病年龄以5～9岁组最多(56.0％);事件的持续时间(r=0.663,P＜0.001)及报告病例数(r=0.383,P＜0.001)均与事件的响应时间呈正相关.结论 水痘疫情防控应当重点关注冬季、小学及幼儿园、涉农区;建议加强水痘疫情监测,及时处置暴发疫情,做好学生及家长人群的健康教育,进一步完善适龄儿童水痘疫苗接种方案、提高水痘疫苗保护效果.

目的 研究新型冠状病毒肺炎疫情相关的网络舆情特征及公众诉求,为类似突发公共卫生事件的舆情引导及诉求回应提供参考.方法 使用新浪舆情通大数据平台收集网络舆情信息,依托研究单位的疫情咨询电话收集咨询信息,相关数据整理统计后以供分析.结果 舆情信息数量经历了酝酿期、暴发期、持续进展期;舆情信息主要来自于微博、客户端、微信和网站等;每周的星期五、每天的10～12时和22～24时产生的微博信息数量最多.咨询数量较多的话题主要为疫情的社区管理办法、隔离措施、防疫交通管制、核酸检测和出入境人员管理等.结论 舆情应对部门应充分利用公众关注度高的主流媒体、公众参与度高的关键时间段及时发布权威信息,积极应对负面信息,使公众及时调整生产、生活计划,积极配合防疫管控措施.

目的 调查水痘暴发事件,了解水痘疫苗保护效果,为制定科学防控策略和措施提供依据.方法 搜索2018年9月1日至2019年1月23日,该幼儿园儿童和教职员工中出现典型的水痘样皮疹(丘疹或疱疹或结痂)者.采集8例患者的咽拭子标本开展病原学检测;利用"问卷星"和"江苏省预防接种综合服务管理信息系统"平台,收集6个班级的所有儿童的水痘疫苗接种等信息,调查疫苗的保护效果.结果 共搜索到水痘患者106例,儿童罹患率为14.5％(104/717),教职工罹患率为2.8％(2/72);首例患者为小6班儿童,2018年9月6日发病,疫情持续4个月,流行曲线显示为增殖模式,患者可分为8代.暴发波及8个班级,班级罹患率17.5％ ～58.5％;接种水痘疫苗者中的水痘罹患率为12.9％(8/62),未接种水痘疫苗者中水痘罹患率为54.4％(81/149),水痘疫苗保护率为76％(95％CI=54％ ～88％);37.5％(3/8)患者咽拭子标本水痘-带状疱疹病毒核酸阳性.结论 在低免疫水平人群中暴发水痘的防控难度大,水痘疫苗保护效果较好,建议进一步加强水痘疫苗接种宣传,将儿童水痘疫苗接种纳入扩大免疫规划.

目的 明确2019年南京市登革热的输入和本地传播风险,科学制定防控策略和措施,指导应急准备,提早部署防控工作.方法 采用定量与定性相结合的方法对境外输入的病例数进行估计,对境内输入风险进行定性分析,对影响登革热本地传播的各种因素分别进行赋值并确定权重,采用量化指标对本地传播风险进行分析和评价.结果 2019年南京市境外输入病例数估计为7例(2 ～12例),存在境内输入风险但较低.2019年7-10月南京市有7个地区本地传播风险为“可能”,5-6月除秦淮区本地传播风险为“可能”外,其他地区本地传播的风险均为“不太可能”,1-3月和11-12月无本地传播风险.结论 南京市2019年仍会有登革热病例输入,7-10月需重点关注登革热本地传播,建议采取病例发现、规范处置、持续监测、健康宣教等综合措施,科学防控登革热疫情.

目的 了解南京市2020年登革热病例输入风险和蚊媒本地传播风险,为登革热本地传播防控策略的制定提供依据.方法 采用描述性流行病学方法对2015-2019年南京市登革热流行情况进行分析,通过实验和现场调查等方式收集南京市登革热蚊媒密度、抗药性和控制效果数据并用定性方法进行风险分析和评估.结果 6-11月为南京市登革热发病高峰期,登革热蚊媒幼虫和成蚊密度高峰期分别为7月和9月,白纹伊蚊对5种常用杀虫剂均已出现抗药性,蚊媒应急处置点平均处置次数10.3次,规范化处置达标率为55.56％.结论 南京市2020年仍会出现输入性登革热病例,7-9月是本地传播和流行的高峰期,要加强口岸和医院管理,科学、规范地使用杀虫剂开展登革热蚊媒应急处置,建立动态分级预警系统,科学防控登革热疫情.

目的 分析2009-2018年南京市主要虫媒传染病流行病学特征,为制定防控策略提供参考.方法 收集2009-2018年南京市主要虫媒传染病监测数据,进行描述流行病学分析.结果 2009-2018年南京市主要报告6种虫媒传染病,累计报告病例767例,年均发病率0.98/10万(0.65/10万～1.27/10万),除2011年外,发病率总体呈上升趋势(x2 =27.07,P＜0.001),报告发病率从高到低依次是肾综合征出血热、恙虫病、疟疾、发热伴血小板减少综合征、登革热和流行性乙型脑炎.发病时间集中在4-7月和10月、11月,占40.29％(309/767)和27.25％(209/767).发病率居前3位的为高淳区(3.52/10万)、溧水区(2.50/10万)和江宁区(1.22/10万).发病年龄主要集中在25 ～69岁,占82.92％(636/767);男性发病率高于女性;职业以农民为主,占44.20％(339/767).结论 南京市近十年主要虫媒传染病发病总体呈上升趋势,发病具有明显的季节性、地域性和人群特征.应根据不同疾病的特点,对高发地区和高发人群制定相应的防控措施.

目的 了解南京市2008-2017年手足口病的发病趋势和流行特征,为进一步制定手足口病预防策略和措施提供依据.方法 采用描述性流行病学方法分析手足口病病例和病原的分布特征.结果 2008-2017年南京市共报告手足口病157 698例,年均报告发病率为206.61/10万(94.06/10万～305.02/10万),累计报告死亡病例2例.2008-2013年报告发病率呈现升高趋势(t=3.481,P=0.025),2014年开始,发病率呈现隔年高发的周期性.2008-2017年累计报告重症病例2 307例,重症率为1.46％.手足口病发病呈现双峰模式,全年发病有2个高峰:4-7月(春夏高峰)和11-12月(秋冬高峰),男性发病率为258.78/10万,女性发病率为187.44/10万.实验室检测病例共计8 373例,病原学分型结果显示,普通病例病原构成中其他肠道病毒占比37.17％,CoxA16占比33.04％,EV71％占比29.78％.重症病例则以EV71病原为主,其次是其他肠道病毒,占比19.46％,CoxA16占比3.97％.结论 南京地区手足口病的流行具有明显的季节、地区、人群分布和病原构成特点,针对重点人群做好疾病防控将有利于手足口病的整体控制.

Objective To analyze the incidence rate of varicella outbreak in a kindergarten in Nanjing city, to find out the risk factors of varicella outbreak and to evaluate the protection effect of varicella vaccine. Methods A retrospective case analysis was conducted on 54 patients with varicella who appeared in a kindergarten in Nanjing between March 19, 2018 and June 27, 2018. Among them, there were 33 boys and 21 girls, aged from 3 to 25 years, with infants aged from 3 to 6 years, and the average age of infants was (5.30±0.88) years. The incidence and vaccination of varicella among the kindergarten students and teachers were collected through active search and questionnaire survey. Descriptive study and cohort study were used for analysis. Results A total of 54 cases were reported, with an incidence rate of 7.74%. The outbreak involved 10 classes and 2 teachers, with the highest incidence rate of 34.3%. The first case occurred on March 26, 2018, and the epidemic lasted for 68 days. In this outbreak, the protection rate of varicella vaccine was 58% (RR=0.42, 95CI% : 0.22~0.80). Conclusions The incidence of varicella outbreaks is relatively high in kindergartens and other collective units. Relevant institutions should strengthen the monitoring and management of infectious diseases in schools, kindergartens and other collective units, and strengthen the training of knowledge related to infectious diseases. Key words: Varicella; Outbreak; Investigation

目的 查明此次水痘暴发的原因,制定有效地防控措施,预防类似事件的再次发生.方法 通过查看健康监测记录,访谈各班级管理人员等方式,搜索2018年4月10日至7月31日,某集体单位儿童、工作人员中出现典型的水痘样皮疹者,利用病例一览表收集病例信息,采集部分病例的咽拭子标本开展病原学检测.结果 共搜索到水痘病例68例,某生活老师是首例病例,也是本次暴发的传染来源;儿童罹患率为33.5％ (67/200).疫情持续68天,流行曲线显示为增殖模式,病例可分为五代.发病儿童参加公共课导致疫情跨班级传播,共波及6个班,A班(90.0％)和C班(76.5％)罹患率最高,A班和C班的罹患率(82.8％)高于采取有效病例隔离措施的其他班级(13.2％,x2=80.97,P＜0.001).5份病例咽拭子标本都为水痘-带状疱疹病毒核酸阳性.结论 这是一起发生在免疫空白人群的水痘暴发,未采取有效地病例隔离措施导致疫情的扩散,建议进一步加强对集体单位工作人员的健康筛查和监测,强化相关人员传染病业务培训.

目的 了解南京市重症手足口病(hand-foot-mouth disease,HFMD)的流行特征,并分析时空聚集性,为HFMD的重点防控工作提供依据.方法 采用描述流行病学方法,分析2009-2016年南京市报告的重症HFMD流行病学和病原学特征,采用时空重排扫描分析时空聚集性特征.结果 2009-2016年南京市共报告重症病例1 526例,年均报告191例(93～284例);重症病例占HFMD比例为11‰(6‰ ～ 20‰),无趋势变化(Z=1.5,P=0.125),5岁及以下儿童重症病例报告发病率为53/10万(21/10万～ 76/10万).4～7月报告病例占54％;病例中男性占64％,年龄中位数为2岁(0～13岁),5岁及以下占97％,1～3岁占75％;散居儿童占67％,幼托儿童占31％.除2013年外,其他各年均探测到时空聚集区域(均有P＜0.001),聚集地区由中心城区向南部江宁、雨花台和溧水转移,聚集时间多为3～7月.重症病例肠道病毒阳性检出率为39％(17％ ～ 70％),阳性标本中75％(54％ ～89％)为EV71,5％(0～ 17％)为CoXA16.结论 南京市重症HFMD流行特征与普通病例一致,但病原以EV71为主,应加强重点地区和人群监测,宣传接种EV71疫苗.

目的 了解南京市水痘的发病趋势和流行特征,为进一步制定水痘防控策略和措施提供依据.方法 采用描述流行病学方法,分析突发公共卫生事件和水痘病例的分布特征.结果 2006-2017年南京市共报告水痘病例27 367例,年均报告发病率为29/10万(9.1/10万～115/10万),报告发病率呈升高趋势(t=2.79,P＜0.05),2017年报告病例数最多(9 478例);时间分布呈现双峰,分别为10月～次年1月(54％)和3～6月(28％);男性占55％;病例年龄中位数为9岁(0～90岁),35岁以下占99％,15岁以下占68％,有5岁和9岁两个发病高峰;学生(53％)、幼托儿童(21％)和散居儿童(9.3％)共占84％.报告32起水痘引起的突发公共卫生事件,都发生在学校、托幼机构等集体单位.结论 在2017年纳入丙类传染病管理后,南京市报告水痘病例显著增加,监测敏感性得到提高,应加强水痘的持续监测,同时建议将水痘疫苗纳入免疫规划.

Objective To analyze the epidemiological characteristic of public health emergencies in Nanjing City so as to provide evidences for outlining prevention and control measures. Methods The information of public health emergencies was selected from Public Health Emergency Reporting System (the subsystem of Chinese Disease Prevention and Control Information System) reported from January 1, 2004 to December 31, 2014. Descriptive epidemiology method was used to analyze the three-dimensional distribution (population, time, district) and the epidemiological characteristics of public health emergencies in Nanjing from 2004 to 2014. Results A total of 105 public health emergencies were reported in Nanjing from 2004 to 2014, including 3 162 cases of illness and 9 deaths. Of all the events, there was 1 case at grade Ⅱ (0.95%), 1 at grade Ⅲ (0.95%), 52 at grade Ⅳ (49.52%), with 51 non-graded (48.57%) and no case at grade Ⅰ. The mayor type of events was infectious diseases (91.43%), which mainly included chickenpox (28.13%), mumps (25.00%), influenza A (H1N1) (15.63%)and influenza (13.54%). Peak months of public health emergencies appeared in March, June and December. As high as 63.81% (67/105) of the public health events took place in school. Conclusions Contagion events are the major type of public health emergencies in Nanjing from 2004 to 2014. Prevention and control of school infectious diseases during peak periods need to be particularly strengthened. Key words: Public health emergency; Epidemiology analysis; Descriptive study

Objective To explore the mental health status and related factors of acquired immunodeficiency syndrome (AIDS) individuals receiving antiviral therapy (ART) in Anhui Province,and to provide appropriate measures for improving their physical and mental health.Methods Quantitative questionnaire survey was conducted among AIDS patients with positive CD4 + T cell who have received treatment in 3 cities of Anhui Province to collect the general demographic characteristics and mental health status of patients from January 2013 to June 2014.Results 63 (21.1％) patients were equipped with anxiety syndrome and 126 (42.3％) with depression.Multivariate Logistic regression analysis showed that holding religious belief was related to anxiety (OR =2.221,95％ CI:1.094-4.509),good ART adherence,marital status was married or cohabitation,educational level was junior high school or college and above,area in Huaibei and knowing antiviral treatment was a lifelong process on medication were influencing factors of depression (all P ＜ 0.05).Conclusions Anxiety and depression were common syndrome among AIDS patients in 3 cities of Anhui Province and were related to multiple factors.It was important to increase ART adherence and the awareness of lifelong medication to reduce anxiety and depression incidence.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的了解安徽省沿江地区居民超重肥胖的流行现状及其影响因素,为肥胖的预防控制提供参考依据。方法于2014年4—10月采用分层整群随机抽样方法对在安徽省沿江地区抽取的7 183名居民进行问卷调查和体格检查。结果安徽省沿江地区居民超重率和肥胖率分别为27.8%和6.5%,腹型肥胖率为36.9%;多因素非条件logistic回归分析结果显示,饮酒是安徽省沿江地区居民超重肥胖的危险因素,文化程度大专及以上和单身是安徽省沿江地区居民超重肥胖的保护因素;年龄≥65岁、女性、居住在农村和饮酒是安徽省沿江地区居民腹型肥胖的危险因素,文化程度大专及以上和单身是安徽省沿江地区居民腹型肥胖的保护因素。结论安徽省沿江地区居民肥胖率低于腹型肥胖率,年龄、性别、文化程度、婚姻状况、居住地区和饮酒情况是该地区居民超重肥胖和腹型肥胖的主要影响因素。</span>

目的 应用伤残调整寿命年(disability-adjusted life year,DALY)对安徽省某县2010-2012年的恶性肿瘤疾病负担情况进行综合评价.方法 以该县2010-2012年恶性肿瘤登记系统的监测资料为基础,计算和分析恶性肿瘤的发病率、死亡率和DALY,以此评价该县的恶性肿瘤疾病负担.结果 2010-2012年该县年均粗发病率222.10/10万、年均标化发病率133.75/10万、年均粗死亡率137.54/10万、年均标化死亡率78.31/10万.恶性肿瘤发病的前五位是气管,支气管,肺(C33-C34)、肝脏(C22)、胃(C16)、食管(C15)、结直肠肛门(C18-C21)恶性肿瘤,占所有恶性肿瘤发病的71.31％.恶性肿瘤所致的疾病负担为14.22 DALYs/千人,其中死亡损失寿命年(years of life lost,YLL)为13.23 DALYs/千人(93.01％),伤残损失寿命年(years lived with disability,YLD)为0.99DALYs/千人(6.99％),恶性肿瘤所致疾病负担的前五位依次是肝脏(C22)、气管,支气管,肺(C33-C34)、胃(C16)、食管(C15)、乳房(C50).结论 恶性肿瘤疾病负担主要是由早死所致,疾病负担主要集中在年龄≥45岁人群,恶性肿瘤的防治重点癌种是肝癌、肺癌、胃癌、食管癌和乳腺癌.