| Rubella is an acute respiratory infectious disease infected by rubella virus which was discovered at the end of the eighteenth century.Rubella is highly infectious and harmful,and its transmission route is mainly through respiratory tract and vertical transmission.The infectious period is usually 7 days before the onset and 21 days after the eruption.The dominant infection rate is 20%-30%,mostly in schools and other gathering places.Pregnant women infected with rubella virus during pregnancy can cause abortion,stillbirth,deformity,congenital schizophrenia and so on.Especially in the first three months of pregnancy,the probability of transmission of rubella virus to the fetus is 80%.Rubella virus is one of the main causes of congenital defects.There are about 100,000 infants with congenital rubella syndrome all year round.Although the national rubella vaccine has been included in the national immunization plan,it has not been eliminated,which has a high potential risk to the health of the population and a great challenge to prenatal and postnatal care.Objective:To explore the epidemiological characteristics and spatial distribution of rubella in Jilin Province from 2004 to 2018,and to provide effective scientific basis for the prevention and control of rubella in Jilin Province.Methods:The data of rubella cases in Jilin Province from 2004 to 2018(including the region of rubella cases,time of onset,age,sex,occupation,etc.)came from the Infectious Disease Reporting Information Management System.According to the date of onset,18785 cases of rubella were found after deleting duplicate cases with basically identical information.Excel 2007 software was used to organize the data in this study and describe the epidemiological characteristics of rubella from 2004 to 2018.To compares the epidemic characteristics and development of rubella before and after the implementation of EPI in Jilin Province in 2009,and analyses and evaluates the control effect of EPI on rubella in Jilin Province.Spatial autocorrelation analysis of rubella in Jilin Province was carried out by using ArcGIS 10.2 software.The spatial characteristics of rubella in Jilin Province from 2004 to 2018 were explored,and relevant measures were formulated as soon as possible in areas with high incidence of rubella.Results:From 2004 to 2018,a total of 18785 cases of rubella were reported in Jilin Province.There were no deaths.The average annual incidence was 4.59/100,000.The incidence of rubella was unstable from 2004 to 2012.In 2008,the rubella outbreak in Jilin Province reached 36.66/100,000.Since 2012,the incidence of rubella has declined.From 2004 to 2018,the top three areas in Jilin Province ranked 6081 cases in Changchun City,2638 cases in Siping City and 2225 cases in Yanbian Prefecture.It accounted for 58.4%.Yanbian Prefecture,Changchun City and Siping City ranked the top three areas with the reported incidence,while Baishan City ranked the lowest.There were rubella cases in every season of Jilin Province from 2004 to 2018.The proportion of rubella cases in January to December was 2.58%、2.67%、8.33%、 25.30%、28.89%、15.35%、5.13%、1.85%、1.78%、2.64%、3.15%、2.34% respectively.The proportion of rubella cases was the highest in April to June and the lowest in August to September.From 2004 to 2018,18785 cases of rubella were reported in Jilin Province.There were 10867 males and 7918 females with a sex ratio of 1.37:1.The incidence of male is higher than that of female except 2017.The highest sex ratio was 3.41:1 in 2018 and the lowest was 0.74:1 in 2017.Age distribution,all stages of the disease,of which the highest incidence of the three age stages in turn is 15~19、10~14、20~24 years old;the main cases are concentrated in students(11532),scattered children(2322),kindergarten children(1436).The occupational composition of the cases accounted for 61.39%、12.36% and 7.64% respectively.The three occupations accounted for 81.39% of the total cases.In 2009,rubella vaccine was included in the immunization program in Jilin Province.Compared with the incidence of rubella before and after the expanded immunization program,the incidence of rubella in 2004~2008 was 9.79/100,000,and the incidence of rubella in 2009~2018 was 1.99/100,000.Global Moran’s I index of total rubella incidence in 2004~2018 showed that the spatial distribution of rubella incidence presented high(and/or low)value clustering,while Getis-Ord General G index showed that the spatial distribution of rubella incidence did not present high value clustering.The results of the local autocorrelation Getis-Ord General G* index analysis show that two hot spots are located in the central and western parts of Jilin Province and two cold spots are located in the central and eastern parts of Jilin Province.The Local Moran’s I index shows that nine HH counties are located in the central and Eastern parts,and one LH County is located in the central and Western parts.The results of Global Moran’s I index analysis before and after immunization in Jilin Province showed that the spatial distribution of rubella incidence in 2004-2008 and 2009-2018 showed high(and/or low)value clustering.The results of the Getis-Ord General G index analysis showed that the spatial distribution of rubella incidence in 2004-2008 did not show high-value clustering and 2009-2018 show high-value clustering.From 2004 to 2008,there was a hot spot in the central and western part of Jilin Province.From 2009 to 2018,there is a hot spot in the eastern part of Jilin Province.The results of Local Moran’s I index from 2004 to 2008 show that 4 of the LH areas are located in the central and western parts of Jilin Province,and 7 HHs are located in the central and western parts of Jilin Province.The results of the Local Moran’s I index from 2009 to 2018 show that 4 of the HH counties are located in Eastern and Southwestern Jilin provinces.Conclusion:1.The incidence of rubella in Jilin Province was unstable from 2004 to 2011.The incidence of rubella decreased year by year from 2012 to 2018.On the time distribution,there were incidences throughout the year,and the peak incidence was from April to June;2.The incidence rate of rubella reported in Jilin Province from 2004 to 2018 ranked in the first three cities: Yanbian、Changchun and Siping.The lowest incidence rate is Baishan City;3.The incidence of rubella in males is higher than that of female in Jilin Province;the incidence of rubella is the highest in the age group of 10 to 24 years old;the occupational distribution of the disease is mainly students,followed by scattered children and young children;4.Since Jilin Province expanded its national immunization program in 2009,the prevention and control of rubella has achieved good results.After 2014,the incidence of rubella was below 1/100,000.5.Most of the incidence years of rubella in Jilin Province are spatially clustered.More arrention should be pay on the LH county.Because thease areas needs to be focused on prevention and control. |
PDF Full Text Request