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Article(id=1241023940332679975, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202407408, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1721577600000, receivedDateStr=2024-07-22, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773812764485, onlineDateStr=2026-03-18, pubDate=1739116800000, pubDateStr=2025-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773812764485, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773812764485, creator=13701087609, updateTime=1773812764485, updator=13701087609, issue=Issue{id=1241023927812682133, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='3', pageStart='385', pageEnd='576', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773812761500, creator=13701087609, updateTime=1773812858867, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241024336258200259, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241024336258200260, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=541, endPage=546, ext={EN=ArticleExt(id=1241023940718555981, articleId=1241023940332679975, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of the epidemiological characteristics of public health emergencies in Qinghai Province from 2009 to 2023, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the epidemiological characteristics of public health emergencies in Qinghai Province from 2009 to 2023, providing a basis for decision-making in the prevention and control of such events.

Methods

Data on incidents from 2009 to 2023 in Qinghai Province were collected and organized from the “Public Health Emergency Report Management Information System”. Descriptive epidemiological methods were used to analyze the characteristics of these incidents.

Results

A total of 311 public health emergencies were reported in Qinghai Province from 2009 to 2023, with 9 099 cases of illness affecting a total of 480 213 individuals, resulting in 46 deaths. Join point analysis revealed a turning point in infectious disease incidents, with a statistically significant upward trend from 2012 to 2023 (P=0.001). In contrast, non-infectious disease incidents exhibited a notable downward trend, with an annual percentage change (APC) of -8.30% (95%CI: -14.91% to -2.86%, P=0.003). Global spatial autocorrelation results indicated that, except for 2015 when public health emergencies in Qinghai showed a spatial negative correlation (Moran’s I=-0.321, Z=-1.557, P=0.035), no statistical differences were observed in other years (P>0.05). Pearson correlation analysis revealed a positive correlation between the reporting time of incidents and the duration of infectious disease outbreaks (r=0.43, P<0.05), indicating that longer reporting intervals were associated with longer outbreak durations.

Conclusion

There is a correlation between incident reporting and outbreak duration in Qinghai Province. It is recommended to enhance the awareness of timely reporting among medical institutions at all levels and to strengthen epidemic monitoring in key gathering places, such as primary schools, to reduce the occurrence of public health emergencies.

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目的

了解2009—2023年青海省突发公共卫生事件的流行特征，为青海省突发公共卫生事件的防控提供决策依据。

方法

收集整理“突发公共卫生报告管理信息系统”中青海省2009—2023年事件资料数据，并采用描述性流行病学方法分析事件发生特征。

结果

2009—2023年青海省公共卫生突发事件共报告311起，发病人数9 099例，共波及480 213人，合计死亡人数46人。Joinpoint结果显示传染病事件存在1个转折点，其中2012—2023年的上升变化有统计学意义（P=0.001）；非传染病事件下降趋势较为明显，年度变化百分比（APC）为-8.30%（95%CI：-14.91%～-2.86%，P=0.003）。空间全局自相关结果显示，除2015年青海省突发公共卫生事件呈空间负相关（Moran I=-0.321，Z=-1.557，P=0.035），其余年份未发现统计学差异（P均>0.05）。Pearson相关性分析结果显示，事件报告时间与传染病事件疫情持续时间呈正相关（r=0.43，P<0.05），报告时间间隔越长，疫情的持续时间越长。

结论

青海省事件报告与持续时间呈相关性，建议提升各级医疗机构及时报告意识，对小学等重点人群聚集场所加大疫情监测工作，从而减少突发公共卫生事件的发生。

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龙江，E-mail:；
赵金华，E-mail:
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龙江与赵金华为共同通信作者

姜雨淇（2001—），女，硕士在读，研究方向：流行病与卫生统计学

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Countermeasures for occupational safety and health protection of healthcare workers in public health emergencies--a review of occupational safety and health in public health emergencies: guidelines for the protection of healthcare workers and emergency responders[J]. 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Investigation on self-cognition of health emergency response ability of emergency personnel in Disease Control and Prevention institutions at city and county level in Guizhou Province and analysis of its influencing factors[J]. Modern Preventive Medicine, 2023, 50(13): 2459-2464.(In Chinese), articleTitle=Investigation on self-cognition of health emergency response ability of emergency personnel in Disease Control and Prevention institutions at city and county level in Guizhou Province and analysis of its influencing factors, refAbstract=null)], funds=[Fund(id=1241023949002305975, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, awardId=12371503, language=CN, fundingSource=国家自然科学基金委员会(12371503), fundOrder=null, country=null), Fund(id=1241023949098774970, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, awardId=null, language=CN, fundingSource=2024年度公共卫生人才培养支持项目, fundOrder=null, country=null), Fund(id=1241023949199438273, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, awardId=青卫健办[2021]104号, language=CN, fundingSource=青海省“昆仑英才·高原名医”项目(青卫健办[2021]104号), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241023943709093894, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, xref=1., ext=[AuthorCompanyExt(id=1241023943717482504, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, companyId=1241023943709093894, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Medical College, Qinghai University, Xining, Qinghai 810001, China), AuthorCompanyExt(id=1241023943725871112, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, companyId=1241023943709093894, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.青海大学医学院，青海 西宁810001)]), AuthorCompany(id=1241023943834923028, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, xref=2., ext=[AuthorCompanyExt(id=1241023943843311638, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, companyId=1241023943834923028, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.青海省疾病预防控制中心，青海 西宁810000)]), AuthorCompany(id=1241023943969140778, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, xref=3., ext=[AuthorCompanyExt(id=1241023943977529387, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, companyId=1241023943969140778, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.重庆市疾病预防控制中心，重庆 401500)])], figs=[ArticleFig(id=1241023947437830466, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=EN, label=Figure 1, caption=Event report and economic time distribution of Qinghai Province from 2009 to 2023, figureFileSmall=CgqKczP/5686CZl2GzcyTg==, figureFileBig=4Ho+/VvaWYbBa+roxsR0FQ==, tableContent=null), ArticleFig(id=1241023947538493773, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=CN, label=图1, caption=2009—2023年青海省事件报告数及处置费用时间分布图

注：图A为2009—2023年青海省报告事件数月度报告情况堆叠总桥图；图B为2009—2023年青海省年度卫生应急处置费用瀑布图。

, figureFileSmall=CgqKczP/5686CZl2GzcyTg==, figureFileBig=4Ho+/VvaWYbBa+roxsR0FQ==, tableContent=null), ArticleFig(id=1241023947777569115, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=EN, label=Figure 2, caption=Joinpoint regression analysis of the incidence rate of public health emergencies in Qinghai Province from 2009 to 2023, figureFileSmall=eLZe96OyQIy2S+xn4CgE2g==, figureFileBig=spvi8SJcTEcPPYaMUqRNyQ==, tableContent=null), ArticleFig(id=1241023947886621025, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=CN, label=图2, caption=2009—2023年青海省突发公共卫生事件发生率的joinpoint回归分析图

注：*为P<0.05。

, figureFileSmall=eLZe96OyQIy2S+xn4CgE2g==, figureFileBig=spvi8SJcTEcPPYaMUqRNyQ==, tableContent=null), ArticleFig(id=1241023947983090028, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=EN, label=Figure 3, caption=Correlation chart between reporting time intervals and duration of infectious disease outbreaks, figureFileSmall=dte3t+zL76rSbMRB70e1kA==, figureFileBig=GqTzz9jhlgFjflhpzRTTwA==, tableContent=null), ArticleFig(id=1241023948079559027, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=CN, label=图3, caption=传染病疫情报告时间间隔和疫情持续时间相关图, figureFileSmall=dte3t+zL76rSbMRB70e1kA==, figureFileBig=GqTzz9jhlgFjflhpzRTTwA==, tableContent=null), ArticleFig(id=1241023948180222331, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=EN, label=Table 1, caption=

Report on public health emergencies of different categories in Qinghai Province from 2009 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
事件类别病种事件数发病数波及人口数罹患率（%）死亡数病死率（%）
甲类传染病鼠疫2133214.05430.77
乙类传染病新型冠状病毒肺炎548401092080.7700.00
猴痘11714.2900.00
甲型H1N1流感3874363 4141.1760.81
猩红热2392 3841.6400.00
麻疹22396 2630.0200.00
炭疽5161 6200.9900.00
小计1021 662272 8960.6160.36
丙类传染病流行性感冒74276 2246.8600.00
流行性腮腺炎592 28067 9153.3600.00
手足口病1527327 7140.9900.00
其他感染性腹泻31162 1605.3700.00
风疹1144918 1042.4800.00
流感样病例暴发32034 8124.2200.00
小计983 748126 9292.9500.00
其他类传染病水痘783 13875 2864.1700.00
聚集性肠道感染1561 4243.9300.00
出疹性疾病1256737.3100.00
小计803 21976 7774.1900.00
突发中毒事件食物中毒213502 59113.51226.29
急性职业中毒182603.08225.00
气体中毒47036119.39811.43
小计264283 21213.333
2		7.48
环境因素事件空气污染3297837.18413.79
总计3119 099480 2131.894
6		0.51
), ArticleFig(id=1241023948280885634, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=CN, label=表1, caption=

青海省2009—2023年不同类别突发公共卫生事件报告情况

, figureFileSmall=null, figureFileBig=null, tableContent=
事件类别病种事件数发病数波及人口数罹患率（%）死亡数病死率（%）
甲类传染病鼠疫2133214.05430.77
乙类传染病新型冠状病毒肺炎548401092080.7700.00
猴痘11714.2900.00
甲型H1N1流感3874363 4141.1760.81
猩红热2392 3841.6400.00
麻疹22396 2630.0200.00
炭疽5161 6200.9900.00
小计1021 662272 8960.6160.36
丙类传染病流行性感冒74276 2246.8600.00
流行性腮腺炎592 28067 9153.3600.00
手足口病1527327 7140.9900.00
其他感染性腹泻31162 1605.3700.00
风疹1144918 1042.4800.00
流感样病例暴发32034 8124.2200.00
小计983 748126 9292.9500.00
其他类传染病水痘783 13875 2864.1700.00
聚集性肠道感染1561 4243.9300.00
出疹性疾病1256737.3100.00
小计803 21976 7774.1900.00
突发中毒事件食物中毒213502 59113.51226.29
急性职业中毒182603.08225.00
气体中毒47036119.39811.43
小计264283 21213.333
2		7.48
环境因素事件空气污染3297837.18413.79
总计3119 099480 2131.894
6		0.51
), ArticleFig(id=1241023948389937548, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=EN, label=Table 2, caption=

Global autocorrelation analysis results of the number of public health emergencies reported in Qinghai Province from 2009 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）Moran I值Z值P值
2009-0.0360.3140.113
20100.0091.1670.147
2011-0.0020.7880.212
2012-0.208-0.3850.376
2013-0.1340.0270.489
20140.0231.0940.172
2015-0.321-1.5570.035
2016-0.0121.0980.160
2017-0.203-0.6960.258
2018-0.179-0.2660.428
2019-0.0470.6240.246
20200.1111.3850.100
2021-0.172-0.1480.493
2022-0.250-0.5660.312
2023-0.194-0.2550.455
), ArticleFig(id=1241023948486406546, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=CN, label=表2, caption=

2009—2023年青海省突发公共卫生事件报告数的全局自相关分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）Moran I值Z值P值
2009-0.0360.3140.113
20100.0091.1670.147
2011-0.0020.7880.212
2012-0.208-0.3850.376
2013-0.1340.0270.489
20140.0231.0940.172
2015-0.321-1.5570.035
2016-0.0121.0980.160
2017-0.203-0.6960.258
2018-0.179-0.2660.428
2019-0.0470.6240.246
20200.1111.3850.100
2021-0.172-0.1480.493
2022-0.250-0.5660.312
2023-0.194-0.2550.455
), ArticleFig(id=1241023948566098328, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=EN, label=Table 3, caption=

Distribution of public health emergencies in schools in Qinghai Province from 2009 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
场所报告事件数传染病事件食物中毒事件波及人口数发病例数
初等教育1291272124 3824 867
中等教育4341270 8241 731
高等教育11010 15921
幼儿教育2827139 023693
工读教育55011 344134
其他学校1010014 461436
合计2162115270 1937 882
), ArticleFig(id=1241023948662567324, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=CN, label=表3, caption=

2009—2023年青海省学校突发公共卫生事件分布情况

, figureFileSmall=null, figureFileBig=null, tableContent=
场所报告事件数传染病事件食物中毒事件波及人口数发病例数
初等教育1291272124 3824 867
中等教育4341270 8241 731
高等教育11010 15921
幼儿教育2827139 023693
工读教育55011 344134
其他学校1010014 461436
合计2162115270 1937 882
), ArticleFig(id=1241023948754842022, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=EN, label=Table 4, caption=

Segmented table of response effectiveness and economic burden of infectious disease emergencies from 2009 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）疫情处置时间中位数（d）疫情持续时间中位数（d）总经济损失（元）
2009—20136.019.003 588 090
2014—201812.0425.141 093 431
2019—20236.1419.582 038 726
2009—20237.0114.026 720 247
), ArticleFig(id=1241023948842922411, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023940332679975, language=CN, label=表4, caption=

2009—2023年传染病突发事件处置效果和经济负担年份分段表

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）疫情处置时间中位数（d）疫情持续时间中位数（d）总经济损失（元）
2009—20136.019.003 588 090
2014—201812.0425.141 093 431
2019—20236.1419.582 038 726
2009—20237.0114.026 720 247
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2009—2023年青海省突发公共卫生事件流行特征分析
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姜雨淇 1, 2 , 龙江 3 , 赵金华 1, 2 , 邓萍 1 , 覃胜林 1
现代预防医学 | 疾病预防控制 2025,52(3): 541-546
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现代预防医学 | 疾病预防控制 2025, 52(3): 541-546
2009—2023年青海省突发公共卫生事件流行特征分析
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姜雨淇1, 2, 龙江3 , 赵金华1, 2 , 邓萍1, 覃胜林1
作者信息
  • 1.青海大学医学院，青海 西宁810001
  • 2.青海省疾病预防控制中心，青海 西宁810000
  • 3.重庆市疾病预防控制中心，重庆 401500

    • 姜雨淇（2001—），女，硕士在读，研究方向：流行病与卫生统计学

通讯作者:

龙江，E-mail:；
赵金华，E-mail:
Analysis of the epidemiological characteristics of public health emergencies in Qinghai Province from 2009 to 2023
Yu-qi JIANG1, 2, Jiang LONG3 , Jin-hua ZHAO1, 2 , Ping DENG1, Sheng-lin QIN1
Affiliations
  • Medical College, Qinghai University, Xining, Qinghai 810001, China
出版时间: 2025-02-10 doi: 10.20043/j.cnki.MPM.202407408
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摘要
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目的

了解2009—2023年青海省突发公共卫生事件的流行特征，为青海省突发公共卫生事件的防控提供决策依据。

方法

收集整理“突发公共卫生报告管理信息系统”中青海省2009—2023年事件资料数据，并采用描述性流行病学方法分析事件发生特征。

结果

2009—2023年青海省公共卫生突发事件共报告311起，发病人数9 099例，共波及480 213人，合计死亡人数46人。Joinpoint结果显示传染病事件存在1个转折点，其中2012—2023年的上升变化有统计学意义（P=0.001）；非传染病事件下降趋势较为明显，年度变化百分比（APC）为-8.30%（95%CI：-14.91%～-2.86%，P=0.003）。空间全局自相关结果显示，除2015年青海省突发公共卫生事件呈空间负相关（Moran I=-0.321，Z=-1.557，P=0.035），其余年份未发现统计学差异（P均>0.05）。Pearson相关性分析结果显示，事件报告时间与传染病事件疫情持续时间呈正相关（r=0.43，P<0.05），报告时间间隔越长，疫情的持续时间越长。

结论

青海省事件报告与持续时间呈相关性，建议提升各级医疗机构及时报告意识，对小学等重点人群聚集场所加大疫情监测工作，从而减少突发公共卫生事件的发生。

突发公共卫生事件  /  流行病学  /  Joinpoint  /  空间自相关  /  Pearson相关系数
Objective

To understand the epidemiological characteristics of public health emergencies in Qinghai Province from 2009 to 2023, providing a basis for decision-making in the prevention and control of such events.

Methods

Data on incidents from 2009 to 2023 in Qinghai Province were collected and organized from the “Public Health Emergency Report Management Information System”. Descriptive epidemiological methods were used to analyze the characteristics of these incidents.

Results

A total of 311 public health emergencies were reported in Qinghai Province from 2009 to 2023, with 9 099 cases of illness affecting a total of 480 213 individuals, resulting in 46 deaths. Join point analysis revealed a turning point in infectious disease incidents, with a statistically significant upward trend from 2012 to 2023 (P=0.001). In contrast, non-infectious disease incidents exhibited a notable downward trend, with an annual percentage change (APC) of -8.30% (95%CI: -14.91% to -2.86%, P=0.003). Global spatial autocorrelation results indicated that, except for 2015 when public health emergencies in Qinghai showed a spatial negative correlation (Moran’s I=-0.321, Z=-1.557, P=0.035), no statistical differences were observed in other years (P>0.05). Pearson correlation analysis revealed a positive correlation between the reporting time of incidents and the duration of infectious disease outbreaks (r=0.43, P<0.05), indicating that longer reporting intervals were associated with longer outbreak durations.

Conclusion

There is a correlation between incident reporting and outbreak duration in Qinghai Province. It is recommended to enhance the awareness of timely reporting among medical institutions at all levels and to strengthen epidemic monitoring in key gathering places, such as primary schools, to reduce the occurrence of public health emergencies.

Public health emergencies  /  Epidemiology  /  Join point  /  Spatial autocorrelation  /  Pearson correlation coefficient
姜雨淇, 龙江, 赵金华, 邓萍, 覃胜林. 2009—2023年青海省突发公共卫生事件流行特征分析. 现代预防医学, 2025 , 52 (3) : 541 -546 . DOI: 10.20043/j.cnki.MPM.202407408
Yu-qi JIANG, Jiang LONG, Jin-hua ZHAO, Ping DENG, Sheng-lin QIN. Analysis of the epidemiological characteristics of public health emergencies in Qinghai Province from 2009 to 2023[J]. Modern Preventive Medicine, 2025 , 52 (3) : 541 -546 . DOI: 10.20043/j.cnki.MPM.202407408
正文
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突发公共卫生事件（public health emergencies）是指具有突发性，可能造成社会公共健康损害的重大传染病疫情、群体性不明原因疾病、重大食物和职业中毒以及其他严重影响公众健康的事件，提高应对突发公共卫生事件能力已成为保障人民安全的重中之重[1]。青海省地处高原且地广人稀，人口分布不均衡，突发公共卫生事件的响应可能由于地理距离和交通条件的限制而受到延迟[2]。为提升青海省应急管理体系和公共卫生服务水平，本文对2009—2023年青海省突发公共卫生事件流行特征进行分析，以期为青海省突发公共卫生事件防控措施提供科学依据。
1　资料与方法
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1.1　资料来源
数据来源于“突发公共卫生事件报告管理信息系统”，选取2009年1月1日—2023年12月31日青海省报告、审核并结案的突发公共卫生事件相关信息。本文joinpoint分析部分所用到的标准人口数据来源于中国统计年鉴。
1.2　突发公共卫生事件分类及标准
根据《国家突发公共卫生事件应急预案》以及《国家突发公共卫生事件相关报告管理工作规范（实行）》，突发公共卫生事件应被划分为特别重大（Ⅰ级）、重大（Ⅱ级）、较大（Ⅲ级）和一般（Ⅳ级）四级，IV级以下相关信息归类为未分级事件[3]。
1.3　统计分析
Excel 2019进行数据清洗、整理；Origin 2024对每月报告事件数以及年度卫生应急处置费用可视化；Joinpoint Trend Analysis Software（JPR）5.0.2对数据进行年度百分比变化分析（annual percentage change，APC），其中10万人事件发生率=事件数/人口数×100 000；同时用Geoda 1.14进行空间自相关分析；R 4.3.1进行事件报告与持续时间Pearson相关性分析，检验水准α=0.05。
2　结果
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2.1　事件概况
2009—2023年（共15年）青海省突发公共卫生事件共报告311起，发病人数9 099例，共波及480 213人，罹患率1.89%（9 099/480 213），合计死亡人数46人，病死率0.51%（46/9 099）。311起事件中，有282起传染病突发事件，甲类传染病报告事件数为2起，均为鼠疫，占同期青海省突发公共卫生报告总数的0.64%（2/311）；乙类传染病共报告102起，占32.80%（102/311）；丙类传染病共报告98起，占31.51%（98/311）；其他类传染病共报告80起，占25.72%（80/311）。未分级事件报告84起，占27.00%（84/311）；一般事件（IV级）报告209起，占67.20%（209/311）；较大事件（III级）报告17起，占5.47%（17/311）；重大事件（II级）报告1起，占0.32%（1/311）；无特别重大事件（I级）报告。
突发公共卫生事件中病死率前三位的事件分别为鼠疫、急性职业中毒、空气污染，病死率分别为30.77%、25.00%、13.79%；罹患率前三位的事件分别为出疹性疾病、空气污染事件、气体中毒，罹患率分别为37.31%、37.18%、19.39%。见表1。
2.2　时间分布
报告的全部311起突发公共卫生事件中，2009年由于受到甲流疫情暴发影响，报告事件数最多，共53起；其次是2022年，受到新冠疫情的影响，共50起。5月、9月、10月为事件报告高峰，分别为46、43和39起。在事件报告类型中，法定报告传染病所占的比例最高，为64.95%（202/311），其次是其他类传染病，占25.72%（80/311），环境因素事件发生最少，仅在4月、5月、11月各发生1起。见图1A。
卫生应急处置费用中，2009年耗费最多，共计1 777 940元，该年度医疗救治所耗最多，共占27.85%（495 100/1 777 940）；2022年其次，花费1 765 931元，该年度卫生行政管理费用占比多达80.52%，（1 422 000/1 765 931）。不同年份卫生应急处置费用呈不均匀分布，但总体来说卫生行政管理费用耗费最多，占全部应急费用的30.09%（1 994 460/6 628 313）,卫生监督执法所耗最少，占全部应急费用的3.16%（209 350/6 628 313）。见图1B。
采用网格搜索法分析年度趋势变化，joinpoint回归模型分析结果显示，2009—2023年总体事件发生率APC有一个转折点，为2012年。传染病事件转折点和总体事件转折点一致，2012—2023年以APC为15.57%（95%CI：7.03%～41.82%，P=0.001）的速度上升，2009—2012年期间的变化趋势无统计学意义（P>0.05）；非传染病事件无转折点，以APC为-8.30%（95%CI：-14.91%～-2.86%，P=0.003）的速度下降，见图2。
2.3　地区分布
空间自相关可以用来描述某个变量在不同空间位置上的相关性（指标用Moran I来评估）。结果显示2009—2023年全省突发公共卫生事件中海东市的报告数量最多，占全省事件总数的33.76%（105/311）；西宁市其次，占全省事件总数的29.58%（92/311）。
全局自相关结果显示，除2010、2014和2020年Moran I值大于0（空间呈正相关性），其余年份Moran I值小于0（空间呈负相关性），但是有且只有2015年具有统计学意义（P<0.05），说明2015青海省年突发公共卫生事件报告数呈现空间负相关，而其他年份没有出现地区相关性。见表2。
2.4　人群分布
311起事件中216起突发公共卫生事件发生在学校，发病人数7 882例，波及人口数270 193。其中传染病突发事件211起，占学校突发公共卫生事件总数97.69%（211/216）。非传染病事件均为食物中毒事件，分别在初等教育场所（2例）、中等教育场所（2例）、幼儿教育场所（1例）发生。按照学校等级分类可看出，以初等教育为主，占59.72%（129/216）。见表3。
发生在初等教育场所的事件发病例数占全部事件发病例数的61.75%（4 867/7 882）；其次的发生地点为中等教育场所，占全部事件发病例数的21.96%（1 731/7 882）；高等教育场所发生事件数最少，所发病例数占0.27%（21/7 882）。见表3。
2.5　事件报告与疫情持续时间
2009—2023年青海省传染病突发公共卫生事件共有282起，其中疫情处置时间间隔中位数为7.01 d，疫情持续时间中位数为14.02 d。2009—2013年疫情处置时间和疫情持续时间间隔中位数最短，分别为6.01和9.00 d；然而经济负担超过其他年份分段，总经济损失为3 588 090元。见表4。
随后采用Pearson相关性分析疫情报告事件间隔与疫情持续时间的线性关系，结果显示，报告时间与疫情持续时间的相关性为中等强度（r=0.43，P<0.05）。相关传染病突发事件的报告时间越晚，可能会导致疫情的持续时间越长。见图3。
3　讨论
收起
2009—2023年青海省共报告突发公共卫生事件311起，以传染病事件尤其是呼吸道传染病事件为主，与既往研究一致[4]。时间分布上joinpoint结果显示，传染病事件存在1个转折点，以2012—2023年的上升变化有统计学意义（P=0.001）；非传染病下降趋势较为明显，APC为-8.30%（95%CI：-14.91%～-2.86%，P=0.003）。总体事件趋势呈现先下降后上升趋势，较同时期吉林长春[5]、山东潍坊[6]无明显下降趋势有所不同，主要与2009—2012年青海省受甲型H1N1流感影响较大并进行了有效控制有关，2012年之后的上升趋势表明仍需加强传染病监测预警。
空间聚集对地区分析显示，仅2015年呈现空间负相关（P<0.05），其余年份为随机分布，不存在空间聚集性，相较于四川遂宁[7]、江苏南京[8]等地，青海省地域辽阔且人口分布相对分散，更需在加强基础医疗机构应急处置能力的基础上，开发适合高原地区的监测系统。2015年呈现空间负相关可能由于当年事件发生没有明显关联性且较为散发所致。人口密度较大的地区（如西宁、海东）报告事件数量也相对较多，提示在青海省人口聚集性大的地区加大防控措施必不可少[9-11]。
人群分布上，青海省学校突发公共卫生事件以初等教育（小学教育）为主，占59.72%（129/216），提示小学是防控重点[2]。5月、9月、10月的事件发生率最高，与浙江[12]、辽宁[13]的春冬季高峰不同，青海省在开学后的1～2个月产生疫情高峰，说明学校作为密集场所，需要在每学期开学后的2个月做好风险隐患排查工作，以提高学生和教职工的健康意识和防病能力[14-16]。
处置效果和经济负担方面，2009—2023年总体上传染病疫情处置时间间隔中位数为7.01d，疫情持续时间为14.02d，均长于河北[17]，与李永盛等人[18]的结论一致。疫情控制不足可能与青海地广人稀，公共卫生服务半径较大、信息闭塞、县（区）级疾控中心卫生应急人员更换频繁或整体现场流调处置能力均有关[19-21]。2009—2013年（流感大流行）、2019—2023年（新冠大流行）较2014—2018年（正常年份）疫情处置时间有所缩短，这与青海省在甲流和新冠大流行期间有较为严密的顶层设计和严格的卫生政策、管理意识产生联系，表明疫情处置效率受到人的主观意识和大环境影响。
总体来看，呼吸道传染病是青海省突发公共卫生事件的防控重点，建议实施传染病应急处置联动机制，强化各级医疗机构疫情监测能力；其次，小学仍是青海省突发公共卫生事件的重点场所，要完善学校常见传染病的健康宣教工作，做到疫情早发现、早报告、早处置；此外，青海省传染病突发事件疫情处置时间相较于其他省份较长，应进一步加强基层医疗机构应急管理水平，提升疫情处置效率。
基金
收起
  • 国家自然科学基金委员会(12371503)
  • 2024年度公共卫生人才培养支持项目
  • 青海省“昆仑英才·高原名医”项目(青卫健办[2021]104号)
文献
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2025年第52卷第3期
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doi: 10.20043/j.cnki.MPM.202407408
  • 接收时间：2024-07-22
  • 首发时间：2026-03-18
  • 出版时间：2025-02-10
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  • 收稿日期：2024-07-22
基金
国家自然科学基金委员会(12371503)
2024年度公共卫生人才培养支持项目
青海省“昆仑英才·高原名医”项目(青卫健办[2021]104号)
作者信息
    1.青海大学医学院，青海 西宁810001
    2.青海省疾病预防控制中心，青海 西宁810000
    3.重庆市疾病预防控制中心，重庆 401500

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龙江，E-mail:；
赵金华，E-mail:
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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