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Article(id=1325500942791094354, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325500677975318675, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025049, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1730649600000, receivedDateStr=2024-11-04, revisedDate=1733846400000, revisedDateStr=2024-12-11, acceptedDate=null, acceptedDateStr=null, onlineDate=1793953651377, onlineDateStr=2026-11-06, pubDate=1740412800000, pubDateStr=2025-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793953651377, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793953651377, creator=13701087609, updateTime=1793953651377, updator=13701087609, issue=Issue{id=1325500677975318675, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='2', pageStart='153', pageEnd='304', issueExtLink='null', onlineDate='null', pubDate='1740412800000', pubDateStr='2025-02-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793953588241, creator='13701087609', updateTime=1793953588241, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=272, endPage=275, ext={EN=ArticleExt(id=1325500943529291859, articleId=1325500942791094354, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Analysis of epidemiological trend and spatial aggregation characteristics from 2016 to 2023 of varicella in Shaanxi Province, columnId=1325500884406379444, journalTitle=Chinese Journal of School Health, columnName=Disease Control, runingTitle=null, highlight=null, articleAbstract=
Objective

To grasp the distribution characteristics and incidence trend of varicella in Shaanxi Province, so as to provide a reference for scientific and accurate prevention and control strategies.

Methods

Data of 161 377 varicella cases in Shaanxi Province from 2016 to 2023 were collected and described from Surveillance Report Management System, a subsystem of National Disease Control and Prevention Information Systems of Chinese Center for Disease Control and Prevention. FlexScan 3.1.2 software was used to determine irregular spatial clustering, and spatial clustering area was detected for each year.

Results

The incidence of varicella in Shaanxi Province showed a seasonal bimodal distribution with peaks from April to July (36.68%) and from October to next January (48.07%). The cases were mainly concentrated in the 3-12 years old group (60.50%), and there was a trend of high incidence age shift within the 0-19 age group from 2021. Most of the cases were students (62.40%) and preschool children (17.78%). The outbreaks mainly occurred in primary schools (76.47%). The regional distribution was mainly concentrated in some areas of southern Shaanxi and Guanzhong. Through spatial analysis, the primary clusters were primarily concentrated in Ankang and Hanzhong cities in southern Shaanxi from 2016 to 2023, and the secondary clusters were mainly found in some areas of Guanzhong (Xi'an, Baoji and Weinan cities).

Conclusions

Prevention and control of varicella should be focused on students and kindergartens aged 3-12 years in southern and Guanzhong areas of Shaanxi Province. Continuous varicella surveillance and vaccination measures should be carried out, and the two-dose vaccination strategy and intensive vaccination of key groups should be actively promoted.

, authors=Ni ZHU, Guojing YANG, Shu WANG, Xinxin LI*, authorsList=Ni ZHU, Guojing YANG, Shu WANG, Xinxin LI, authorCompany=null, correspAuthors=Xinxin LI, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1325500945899073626, articleId=1325500942791094354, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=陕西省2016—2023年水痘流行趋势与空间聚集特征分析, columnId=1325500884628677558, journalTitle=中国学校卫生, columnName=疾病控制, runingTitle=null, highlight=null, articleAbstract=
目的

掌握陕西省水痘病例分布特征和发病趋势，为指导制定科学精准的防控策略和措施提供参考。

方法

使用中国疾病预防控制中心“中国疾病预防控制信息系统”子系统“监测报告管理系统”中的2016—2023年陕西省161 377份水痘病例资料进行描述性分析；利用FlexScan 3.1.2软件开展不规则空间聚集性扫描，探测各年份空间聚集区域。

结果

陕西省水痘发病呈现季节性双峰分布，主要集中在4—7月(36.68%)和10月至次年1月(48.07%)；病例主要集中在3~12岁组(60.50%)，2021年起0~19岁年龄组内部出现高发年龄后移的趋势；发病人群分布以学生(62.40%)和幼托儿童(17.78%)为主；暴发疫情主要发生在小学(76.47%)。地区分布主要集中在陕南和关中部分地区；通过空间探测，2016—2023年一级聚集区主要集中在陕南的安康市和汉中市，次级聚集区主要聚集在与其相邻的关中部分地区(西安市、宝鸡市和渭南市)。

结论

陕南和关中地区、3~12岁学生和幼托儿童是陕西省水痘防控的重点。各地应持续开展水痘监测和疫苗接种措施，积极推进2剂次疫苗接种策略和重点人群强化接种工作。

, authors=朱妮, 杨国婧, 王舒, 李欣欣*, authorsList=朱妮, 杨国婧, 王舒, 李欣欣, authorCompany=null, correspAuthors=李欣欣, authorNote=

朱妮(1985-)，女，陕西宝鸡人，硕士，副主任医师，主要从事传染病监测及防控工作

, correspAuthorsNote=
李欣欣，E-mail：
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朱妮(1985-)，女，陕西宝鸡人，硕士，副主任医师，主要从事传染病监测及防控工作

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(in Chinese), articleTitle=null, refAbstract=null)], funds=[Fund(id=1325500950315675778, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500942791094354, awardId=null, language=CN, fundingSource=三秦英才特殊支持计划创新创业团队项目(2023-12), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1325500946112983131, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500942791094354, xref=null, ext=[AuthorCompanyExt(id=1325500946121371740, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500942791094354, companyId=1325500946112983131, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Infectious Disease Prevention and Control Institute, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an (710054), Shaanxi Province, China), AuthorCompanyExt(id=1325500946129760349, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500942791094354, companyId=1325500946112983131, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=陕西省疾病预防控制中心传染病预防控制所，西安 710054)])], figs=[ArticleFig(id=1325500949481009274, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500942791094354, language=EN, label=Fig.1, caption=Gender distribution of chickenpox incidence in Shaanxi Province from 2016 to 2023, figureFileSmall=D+JLWr4BGJvIBnmp+Ret6w==, figureFileBig=S+ZIy5heqglxeC0XzvIJ8A==, tableContent=null), ArticleFig(id=1325500949590061179, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500942791094354, language=CN, label=图1, caption=2016—2023年陕西省水痘发病性别分布, figureFileSmall=D+JLWr4BGJvIBnmp+Ret6w==, figureFileBig=S+ZIy5heqglxeC0XzvIJ8A==, tableContent=null), ArticleFig(id=1325500949791387772, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500942791094354, language=EN, label=Fig.2, caption=Age distribution of chickenpox incidence in Shaanxi Province from 2016 to 2023, figureFileSmall=RnxA2eZityLxC/Gljx2uIQ==, figureFileBig=EGRX8dpLgOBI8nijdnbrqQ==, tableContent=null), ArticleFig(id=1325500949850108029, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500942791094354, language=CN, label=图2, caption=陕西省2016—2023年水痘发病年龄分布, figureFileSmall=RnxA2eZityLxC/Gljx2uIQ==, figureFileBig=EGRX8dpLgOBI8nijdnbrqQ==, tableContent=null), ArticleFig(id=1325500949925605502, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500942791094354, language=EN, label=Fig.3, caption=Temporal distribution of varicella outbreaks in Shaanxi Province from 2016 to 2023, figureFileSmall=1DuXaOWyNm8VaQOENyBLyA==, figureFileBig=Rhai4yBYPK0+/jzERowGVg==, tableContent=null), ArticleFig(id=1325500950005297279, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500942791094354, language=CN, label=图3, caption=陕西省2016—2023年水痘暴发疫情时间分布, figureFileSmall=1DuXaOWyNm8VaQOENyBLyA==, figureFileBig=Rhai4yBYPK0+/jzERowGVg==, tableContent=null), ArticleFig(id=1325500950093377664, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500942791094354, language=EN, label=Tab.1, caption=

Spatial clusters of varicella cases reported in Shaanxi Province from 2016 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年份类型地区RR值LLR值P值
2016一级聚集区陕南(汉台区/南郑县/城固县/洋县/勉县/镇巴县/佛坪县/汉滨区/汉阴县/石泉县/宁陕县/紫阳县/平利县)2.401 472.06< 0.01
次级聚集区1关中(碑林区/灞桥区/未央区/雁塔区/长安区/蓝田县/华县)1.87682.67< 0.01
次级聚集区2关中(渭滨区/金台区/岐山县/扶风县/凤县/太白县//杨陵区)；陕南(留坝县)1.86269.04< 0.01
次级聚集区3关中(潼关县/华阴市)2.1786.96< 0.01
2017一级聚集区关中(雁塔区/长安区)；陕南(佛坪县/汉阴县/石泉县/宁陕县)2.41996.80< 0.01
次级聚集区1关中(渭滨区/金台区/凤县/太白县)；陕南(汉台区/南郑县/城固县)2.36881.53< 0.01
次级聚集区2陕南(汉滨区/紫阳县/岚皋县/平利县/镇坪县)1.65135.97< 0.01
次级聚集区3关中(灞桥区/未央区/蓝田县/高陵县)1.52121.09< 0.01
次级聚集区4关中(凤翔县/扶风县/千阳县/麟游县)1.4956.82< 0.01
2018一级聚集区陕南(汉台区/南郑县/城固县/洋县/镇巴县/汉滨区/汉阴县/石泉县/宁陕县/紫阳县/岚皋县/平利县)2.121 426.92< 0.01
次级聚集区1关中(碑林区/灞桥区/未央区/雁塔区/长安区/户县/高陵县)2.051 419.94< 0.01
次级聚集区2陕南(汉滨区)；关中(渭滨区/金台区/凤县/太白县)1.87192.95< 0.01
2019一级聚集区关中(碑林区/灞桥区/未央区/雁塔区/阎良区/临潼区/长安区/蓝田县/高陵县)1.891 676.94< 0.01
次级聚集区1陕南(佛坪县/汉滨区/汉阴县/宁陕县/紫阳县/平利县)2.34848.43< 0.01
次级聚集区2关中(渭滨区/凤县)；陕南(汉台区/南郑县/留坝县)1.93419.92< 0.01
次级聚集区3陕北(吴起县/定边县)1.5242.09< 0.01
2020一级聚集区陕南(汉滨区/汉阴县/岚皋县)4.603 621.31< 0.01
次级聚集区1陕南(汉台区/留坝县)5.882 556.25< 0.01
次级聚集区2关中(临潼区/临渭区)1.78289.03< 0.01
次级聚集区3陕北(榆阳区/神木县/府谷县)1.61183.51< 0.01
次级聚集区4陕南(南郑县/城固县)1.4873.65< 0.01
次级聚集区5陕南(石泉县/宁陕县)1.9161.45< 0.01
2021一级聚集区陕南(城固县/洋县/佛坪县/汉滨区/汉阴县/宁陕县/紫阳县/平利县/镇坪县)2.15766.59< 0.01
次级聚集区1关中(灞桥区/阎良区/临潼区/长安区/高陵县/泾阳县)1.54294.21< 0.01
次级聚集区2关中(周至县/户县/太白县/杨陵区)1.80189.070.001
次级聚集区3关中(渭滨区/凤县)；陕南(汉台区/南郑县/留坝县)1.4487.59< 0.01
次级聚集区4陕北(吴起县/定边县)1.8172.290.001
2022一级聚集区陕南(汉滨区/汉阴县/宁陕县/紫阳县/岚皋县/平利县/镇坪县/旬阳县/白河县)2.12514.98< 0.01
次级聚集区1关中(长安区/周至县/户县/杨陵区)2.03495.71< 0.01
次级聚集区2关中(碑林区/灞桥区/雁塔区/阎良区/临潼区/蓝田县/高陵县)1.37164.62< 0.01
次级聚集区3关中(渭滨区/凤县)1.7948.73< 0.01
次级聚集区4陕北(吴起县/定边县)1.6940.79< 0.01
2023一级聚集区陕南(汉滨区/汉阴县/岚皋县)2.75655.55< 0.01
次级聚集区1关中(新城区/碑林区/灞桥区/未央区/长安区/蓝田县/户县/高陵县)；陕南(柞水县)1.58598.46< 0.01
次级聚集区2关中(渭滨区/凤县)；陕南(南郑县/勉县/略阳县)1.4056.57< 0.01
次级聚集区3陕南(平利县/旬阳县/白河县)1.4124.59< 0.01
), ArticleFig(id=1325500950181458049, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500942791094354, language=CN, label=表1, caption=

陕西省2016—2023年报告水痘病例空间聚集地区

, figureFileSmall=null, figureFileBig=null, tableContent=
年份类型地区RR值LLR值P值
2016一级聚集区陕南(汉台区/南郑县/城固县/洋县/勉县/镇巴县/佛坪县/汉滨区/汉阴县/石泉县/宁陕县/紫阳县/平利县)2.401 472.06< 0.01
次级聚集区1关中(碑林区/灞桥区/未央区/雁塔区/长安区/蓝田县/华县)1.87682.67< 0.01
次级聚集区2关中(渭滨区/金台区/岐山县/扶风县/凤县/太白县//杨陵区)；陕南(留坝县)1.86269.04< 0.01
次级聚集区3关中(潼关县/华阴市)2.1786.96< 0.01
2017一级聚集区关中(雁塔区/长安区)；陕南(佛坪县/汉阴县/石泉县/宁陕县)2.41996.80< 0.01
次级聚集区1关中(渭滨区/金台区/凤县/太白县)；陕南(汉台区/南郑县/城固县)2.36881.53< 0.01
次级聚集区2陕南(汉滨区/紫阳县/岚皋县/平利县/镇坪县)1.65135.97< 0.01
次级聚集区3关中(灞桥区/未央区/蓝田县/高陵县)1.52121.09< 0.01
次级聚集区4关中(凤翔县/扶风县/千阳县/麟游县)1.4956.82< 0.01
2018一级聚集区陕南(汉台区/南郑县/城固县/洋县/镇巴县/汉滨区/汉阴县/石泉县/宁陕县/紫阳县/岚皋县/平利县)2.121 426.92< 0.01
次级聚集区1关中(碑林区/灞桥区/未央区/雁塔区/长安区/户县/高陵县)2.051 419.94< 0.01
次级聚集区2陕南(汉滨区)；关中(渭滨区/金台区/凤县/太白县)1.87192.95< 0.01
2019一级聚集区关中(碑林区/灞桥区/未央区/雁塔区/阎良区/临潼区/长安区/蓝田县/高陵县)1.891 676.94< 0.01
次级聚集区1陕南(佛坪县/汉滨区/汉阴县/宁陕县/紫阳县/平利县)2.34848.43< 0.01
次级聚集区2关中(渭滨区/凤县)；陕南(汉台区/南郑县/留坝县)1.93419.92< 0.01
次级聚集区3陕北(吴起县/定边县)1.5242.09< 0.01
2020一级聚集区陕南(汉滨区/汉阴县/岚皋县)4.603 621.31< 0.01
次级聚集区1陕南(汉台区/留坝县)5.882 556.25< 0.01
次级聚集区2关中(临潼区/临渭区)1.78289.03< 0.01
次级聚集区3陕北(榆阳区/神木县/府谷县)1.61183.51< 0.01
次级聚集区4陕南(南郑县/城固县)1.4873.65< 0.01
次级聚集区5陕南(石泉县/宁陕县)1.9161.45< 0.01
2021一级聚集区陕南(城固县/洋县/佛坪县/汉滨区/汉阴县/宁陕县/紫阳县/平利县/镇坪县)2.15766.59< 0.01
次级聚集区1关中(灞桥区/阎良区/临潼区/长安区/高陵县/泾阳县)1.54294.21< 0.01
次级聚集区2关中(周至县/户县/太白县/杨陵区)1.80189.070.001
次级聚集区3关中(渭滨区/凤县)；陕南(汉台区/南郑县/留坝县)1.4487.59< 0.01
次级聚集区4陕北(吴起县/定边县)1.8172.290.001
2022一级聚集区陕南(汉滨区/汉阴县/宁陕县/紫阳县/岚皋县/平利县/镇坪县/旬阳县/白河县)2.12514.98< 0.01
次级聚集区1关中(长安区/周至县/户县/杨陵区)2.03495.71< 0.01
次级聚集区2关中(碑林区/灞桥区/雁塔区/阎良区/临潼区/蓝田县/高陵县)1.37164.62< 0.01
次级聚集区3关中(渭滨区/凤县)1.7948.73< 0.01
次级聚集区4陕北(吴起县/定边县)1.6940.79< 0.01
2023一级聚集区陕南(汉滨区/汉阴县/岚皋县)2.75655.55< 0.01
次级聚集区1关中(新城区/碑林区/灞桥区/未央区/长安区/蓝田县/户县/高陵县)；陕南(柞水县)1.58598.46< 0.01
次级聚集区2关中(渭滨区/凤县)；陕南(南郑县/勉县/略阳县)1.4056.57< 0.01
次级聚集区3陕南(平利县/旬阳县/白河县)1.4124.59< 0.01
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陕西省2016—2023年水痘流行趋势与空间聚集特征分析
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朱妮 , 杨国婧 , 王舒 , 李欣欣 *
中国学校卫生 | 疾病控制 2025,46(2): 272-275
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中国学校卫生 |疾病控制 2025 , 46 (2) : 272 -275
陕西省2016—2023年水痘流行趋势与空间聚集特征分析
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朱妮, 杨国婧, 王舒, 李欣欣*
作者信息
  • 陕西省疾病预防控制中心传染病预防控制所，西安 710054
通讯作者:
李欣欣，E-mail：
作者简介:

朱妮(1985-)，女，陕西宝鸡人，硕士，副主任医师，主要从事传染病监测及防控工作

Analysis of epidemiological trend and spatial aggregation characteristics from 2016 to 2023 of varicella in Shaanxi Province
Ni ZHU, Guojing YANG, Shu WANG, Xinxin LI*
Affiliations
  • Infectious Disease Prevention and Control Institute, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an (710054), Shaanxi Province, China
出版时间: 2025-02-25 doi: 10.16835/j.cnki.1000-9817.2025049
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摘要
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目的

掌握陕西省水痘病例分布特征和发病趋势，为指导制定科学精准的防控策略和措施提供参考。

方法

使用中国疾病预防控制中心“中国疾病预防控制信息系统”子系统“监测报告管理系统”中的2016—2023年陕西省161 377份水痘病例资料进行描述性分析；利用FlexScan 3.1.2软件开展不规则空间聚集性扫描，探测各年份空间聚集区域。

结果

陕西省水痘发病呈现季节性双峰分布，主要集中在4—7月(36.68%)和10月至次年1月(48.07%)；病例主要集中在3~12岁组(60.50%)，2021年起0~19岁年龄组内部出现高发年龄后移的趋势；发病人群分布以学生(62.40%)和幼托儿童(17.78%)为主；暴发疫情主要发生在小学(76.47%)。地区分布主要集中在陕南和关中部分地区；通过空间探测，2016—2023年一级聚集区主要集中在陕南的安康市和汉中市，次级聚集区主要聚集在与其相邻的关中部分地区(西安市、宝鸡市和渭南市)。

结论

陕南和关中地区、3~12岁学生和幼托儿童是陕西省水痘防控的重点。各地应持续开展水痘监测和疫苗接种措施，积极推进2剂次疫苗接种策略和重点人群强化接种工作。

水痘  /  疾病暴发流行  /  发病率  /  流行病学研究
Objective

To grasp the distribution characteristics and incidence trend of varicella in Shaanxi Province, so as to provide a reference for scientific and accurate prevention and control strategies.

Methods

Data of 161 377 varicella cases in Shaanxi Province from 2016 to 2023 were collected and described from Surveillance Report Management System, a subsystem of National Disease Control and Prevention Information Systems of Chinese Center for Disease Control and Prevention. FlexScan 3.1.2 software was used to determine irregular spatial clustering, and spatial clustering area was detected for each year.

Results

The incidence of varicella in Shaanxi Province showed a seasonal bimodal distribution with peaks from April to July (36.68%) and from October to next January (48.07%). The cases were mainly concentrated in the 3-12 years old group (60.50%), and there was a trend of high incidence age shift within the 0-19 age group from 2021. Most of the cases were students (62.40%) and preschool children (17.78%). The outbreaks mainly occurred in primary schools (76.47%). The regional distribution was mainly concentrated in some areas of southern Shaanxi and Guanzhong. Through spatial analysis, the primary clusters were primarily concentrated in Ankang and Hanzhong cities in southern Shaanxi from 2016 to 2023, and the secondary clusters were mainly found in some areas of Guanzhong (Xi'an, Baoji and Weinan cities).

Conclusions

Prevention and control of varicella should be focused on students and kindergartens aged 3-12 years in southern and Guanzhong areas of Shaanxi Province. Continuous varicella surveillance and vaccination measures should be carried out, and the two-dose vaccination strategy and intensive vaccination of key groups should be actively promoted.

Chickenpox  /  Disease outbreaks  /  Incidence  /  Epidemiologic studies
朱妮, 杨国婧, 王舒, 李欣欣. 陕西省2016—2023年水痘流行趋势与空间聚集特征分析. 中国学校卫生, 2025 , 46 (2) : 272 -275 . DOI: 10.16835/j.cnki.1000-9817.2025049
Ni ZHU, Guojing YANG, Shu WANG, Xinxin LI. Analysis of epidemiological trend and spatial aggregation characteristics from 2016 to 2023 of varicella in Shaanxi Province[J]. Chinese Journal of School Health, 2025 , 46 (2) : 272 -275 . DOI: 10.16835/j.cnki.1000-9817.2025049
正文
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水痘是由水痘-带状疱疹病毒引起的以发热及皮肤黏膜斑疹、丘疹、疱疹为主要临床特征的急性传染病，重症水痘可引发肺炎、脑炎等并发症，严重时可导致死亡[1]。水痘具有较强的传染性，易在幼托机构、学校等集体机构引起暴发疫情[2]。既往研究显示，水痘在我国具有较高的发病负担和经济负担，已成为目前亟待解决的公共卫生问题[3-4]。
自2004年实施传染病网络直报以来水痘在陕西省监测报告数逐年上升[5]，因水痘导致的学校突发公共卫生事件也处于本省监测传染病类突发公共卫生事件首位[6]，严重影响儿童的身体健康和学习生活。因此，本研究通过全面分析陕西省水痘疫情特征及发病趋势，为今后水痘疫情防控提供指导。
1　资料来源与方法
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1.1　资料来源
2016—2023年陕西省水痘病例资料来源于中国疾病预防控制中心“中国疾病预防控制信息系统”的子系统“监测报告管理系统”，统计规则为按现住址和发病日期，包括临床诊断病例和确诊病例；同期人口数据来源于中国疾病预防控制信息系统的“基本信息系统”。利用发病数及人口数计算各年份、不同性别和不同年龄发病率；水痘暴发疫情资料来源于中国疾病预防控制信息系统的“突发公共卫生事件信息管理系统”，对每起疫情开展详细的流行病学调查。
1.2　统计学分析
利用SPSS 22.0软件对数据进行整理清洗及描述性分析；利用FlexScan 3.1.2软件开展不规则空间聚集性扫描，探测各年空间聚集区域，该方法基于各地报告病例数和常住人口数，通过构建检验统计量对数似然比(log-likelihood ration，LLR)，利用蒙特卡罗模拟法计算概率P值，将LLR最大的定义为一级聚集区，其他有统计学意义的聚集区域为次级聚集区[7]，基于泊松分布模型，得到不同聚集区发病风险的相对危险度(relative risk，RR)。检验水准α=0.05。
2　结果
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2.1　疫情概况
陕西省2016—2023年共报告水痘病例161 377例，无死亡病例。年平均发病率为52.07/10万，各年报告发病率分别为39.65/10万，46.30/10万，62.98/10万，72.26/10万，47.56/10万，56.09/10万，43.13/10万，48.25/10万。发病率在2016—2019年呈上升趋势，2020年开始有所回落。
2.2　时间分布
陕西省2016—2023年水痘发病具有明显的季节分布特征，每年4—7月、10月至次年1月为发病高峰，病例报告数分别占报告总数的36.68%(59 197/161 377)，48.07%(77 572/161 377)，2020年未出现春夏季发病高峰。
2.3　人群分布
2.3.1　年龄性别分布
男性报告发病85 969例，女性75 408例，性别比为1.14∶1，男性年均报告发病率为53.91/10万，略高于女性(50.02/10万)，各年男性报告发病水平均略高于女性。见图1。发病年龄中位数为9岁，最大发病年龄92岁，最小10 d，主要集中在0~19岁年龄组，尤其以3~12岁发病最多[占60.50%(97 634/161 377)]。2021年起0~19岁年龄组内部出现高发年龄后移的趋势，其中15~19岁报告发病率由2016—2020年的99.28/10万上升至2023年的232.70/10万，而0~4岁、5~9岁、10~14岁报告发病率分别由2016—2020年的174.97/10万、412.57/10万、268.60/10万下降至2023年的94.47/10万、221.85/10万、201.40/10万。见图2。
2.3.2　职业分布
报告病例以学生(62.40%，100 703/161 377)、幼托儿童(17.78%，28 687/161 377)和散居儿童(8.27%，13 343/161 377)为主，共占88.45%。10月至次年1月学生发病所占比例(68.12%，52 840/77 572)高于4—7月(58.15%，34 421/59 197)和其余月份(54.62%，13 442/24 608)，非流行期散居儿童报告病例占比(12.82%，3 154/24 608)高于发病高峰期(7.45%，10 189/136 769)。
2.4　空间聚集性
2016—2023年均探测到一级和次级空间高发聚集区域，整体呈陕南和关中地区高发，陕北地区低发的特征。各年的一级聚集区主要集中在陕南的安康市(汉阴县、石泉县、宁陕县等)和汉中市(汉台区、城固县、洋县、佛坪县等)，次级聚集区主要聚集在与其相邻的关中部分地区，包括西安市(碑林区、城灞桥区、未央区、长安区、高陵县等)、宝鸡市(渭滨区、凤县等)和渭南市(潼关县、华阴市)；2019—2022年陕北西部(吴起县、定边县)、北部县区(榆阳区、神木县、府谷县)也有聚集区出现。见表1。
2.5　暴发疫情特征分析
2016—2023年共调查水痘暴发疫情136起，涉及病例3 419例，波及216 553人，总体罹患率为1.58%(各起疫情介于0.19%~40.63%)。各起疫情均发生在学校，主要集中在小学，占76.47%(104/136)。疫情发生具有明显双峰分布特征，主峰为10—12月，涉及病例2 000人，占58.50%；次峰为4—6月，涉及病例1 161人，占33.96%。见图3。暴发疫情中病例年龄集中在6~13岁，占85.17%(2 912/3 419)，学生占96.05%(3 284/3 419)。
3　讨论
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陕西省水痘发病率2016—2019年呈逐年上升趋势，与全国及其他省份研究结果相似[8-9]，可能与疾病重视程度增加和报告敏感性的不断提高有关。2020年开始发病有所回落，可能与新型冠状病毒感染疫情期间呼吸道感染防控措施的实施有关[10]。陕西省水痘发病及暴发疫情的时间分布均呈明显的双峰特征，发病高峰与学校开学时间高度同步，主要与学生、幼托儿童等高风险人群在校园聚集性活动增加、暴露风险增高有关[11]。
本研究结果显示，男性水痘发病报告率高于女性，各省份大致相同，可能与男性活动范围相对更广、卫生习惯较差等有关[12]。水痘发病年龄主要集中在3~12岁，且自2021年0~19岁年龄组内部开始出现高发年龄向后位移的趋势，尤其是15~19岁发病率有明显升高。一方面，可能与该年龄组儿童水痘疫苗接种率尤其是2剂次接种率较低有关；另一方面，考虑随着疫苗接种时间推移，人群抗体水平逐渐降低，易感性增加，同时日常活动增加聚集机会，从而增加了水痘的感染传播风险[13]。0~9岁年龄组水痘报告发病率下降幅度较大主要考虑与入学入托水痘疫苗接种查验有关，该措施有助于降低低年龄组人群感染和发病风险。
空间聚集性探测能够帮助探索疾病聚集的位置和确切范围，为探寻病因提供线索[14]。本研究使用FlexScan软件开展不规则空间聚集性扫描，发现陕西省水痘发病存在明显空间异质性，聚集区域相对固定，一级聚集区主要集中在陕南的安康市和汉中市，次级聚集区主要聚集在与其相邻的关中部分地区(西安市、宝鸡市和渭南市)，近几年陕北西部、北部县区也有聚集区出现。然而由于影响水痘空间聚集的因素十分复杂，本研究未能深入分析并探讨水痘在陕西省不同地域间聚集性分布存在差异的可能原因，下一步可结合疫苗接种水平、人口密度、医疗机构诊断能力、气象等因素[15]进行深层次探讨。
本研究仍存在一定的局限性：未能收集病例疫苗接种信息，无法分析疫苗接种与发病水平的相关性；水痘作为非法定传染病，虽然陕西省自2019年12月将其纳入法定管理，但各地监测报告敏感性差异仍然较大，从而对疫情整体趋势估计造成一定影响。
基金
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  • 三秦英才特殊支持计划创新创业团队项目(2023-12)
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2025年第46卷第2期
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doi: 10.16835/j.cnki.1000-9817.2025049
  • 接收时间：2024-11-04
  • 首发时间：2026-11-06
  • 出版时间：2025-02-25
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  • 收稿日期：2024-11-04
  • 修回日期：2024-12-11
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三秦英才特殊支持计划创新创业团队项目(2023-12)
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    陕西省疾病预防控制中心传染病预防控制所，西安 710054

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李欣欣，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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