基于移动流行区间法建立重庆市手足口病预警模型

刘天; 李勤; 漆莉; 李柏松; 夏宇; 杨琳; 赵寒

doi:10.3784/j.issn.1003-9961.2020.11.013

引用本文: 刘天, 李勤, 漆莉, 李柏松, 夏宇, 杨琳, 赵寒. 基于移动流行区间法建立重庆市手足口病预警模型[J]. 疾病监测. DOI: 10.3784/j.issn.1003-9961.2020.11.013 shu

Citation: Tian Liu, Qin Li, Li Qi, Bosong Li, Yu Xia, Lin Yang and Han Zhao. Establishment of early warning model of hand, foot and mouth disease based on moving epidemic method in Chongqing[J]. Disease Surveillance. DOI: 10.3784/j.issn.1003-9961.2020.11.013 shu

基于移动流行区间法建立重庆市手足口病预警模型

刘天 ^{1,2

,} ,
李勤 ^{3

,

,} ,
漆莉 ³ ,
李柏松 ³ ,
夏宇 ³ ,
杨琳 ³ ,
赵寒 ³

1.
荆州市疾病预防控制中心，湖北荆州 434000
2.
中国现场流行病学培训项目，北京 100050
3.
重庆市疾病预防控制中心，重庆 400042

作者简介: 刘天，男，湖北省荆州市人，主管医师，主要从事急性传染病防控工作，Email：jzcdclt@163.com;

通信作者: 李勤, 503568313@qq.com

摘要: 目的探讨基于移动流行区间法（MEM）建立重庆市手足口病预警模型的可行性。方法收集2013年第1周至2019年第26周重庆市手足口病发病率数据。通过绘制手足口病周平均发病率流行曲线将手足口病双高峰拆分为春夏季流行季节和秋冬季流行季节。分别建立春夏季和秋冬季MEM模型，并筛选模型参数δ，采用灵敏度、特异度和约登指数评价模型拟合效果。利用建立模型预警重庆市各县（市、区）2018/2019年度手足口病流行情况。结果2019年第13 — 26周处于春夏季流行季节流行期；2018年第36周至2019年第2周处于秋冬季流行期。春夏季MEM模型最优参数δ=2.6，灵敏度、特异度和约登指数依次为0.883、0.908和0.791；秋冬季MEM模型最优参数δ=2.4，灵敏度、特异度和约登指数依次为0.805、0.862和0.667。重庆市大部分县（市、区）手足口病流行水平一致。结论将手足口病流行双峰拆分为2个单峰分别建立的MEM模型能准确识别手足口病流行期，可以用于重庆市手足口病的预警。

关键词:

English

Establishment of early warning model of hand, foot and mouth disease based on moving epidemic method in Chongqing

Tian Liu ^{1,2

,} ,
Qin Li ^{3

,

,} ,
Li Qi ³ ,
Bosong Li ³ ,
Yu Xia ³ ,
Lin Yang ³ ,
Han Zhao ³

1.
Jingzhou Prefectural Center for Disease Control and Prevention, Jingzhou 434000, Hubei, China
2.
Chinese Field Epidemiology Training Program, Beijing 100050, China
3.
Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400042, China

Corresponding author: Qin Li, 503568313@qq.com

Received Date: 2020-03-18
Available Online: 2020-11-30

Abstract: ObjectiveTo evaluate the feasibility of establishing an early warning model of hand, foot and mouth disease (HFMD) based moving epidemic method (MEM) in Chongqing.MethodsThe incidence data of HFMD in Chongqing from the 1^st week of 2013 to the 26^th week of 2019 were collected from Chinese Infectious Disease Information System. Two peaks of HFMD were found by plotting the epidemic curve of the average incidence of HFMD. The spring-summer MEM model and the autumn-winter MEM model were then established respectively, and the parameters δ of models were screened. The fitting effect of two models were evaluated by using sensitivity, specificity and Yoden index. The models were used to predict the incidence of HFMD in Chongqing in 2018/2019.ResultsThe results showed that the epidemic period in spring and summer lasted from the 13^th week 36^th weeks in 2019, and the epidemic period in autumn and winter lasted from the 36^th week in 2018 to the 2^nd week in 2019. The optimal parameter of MEM model during spring-summer was 2.6, the sensitivity, specificity and Yoden index were 0.883, 0.908 and 0.791, respectively. The optimal parameter of MEM model during autumn-winter was 2.4, and the sensitivity, specificity and Yoden index were 0.805, 0.862 and 0.667. Most counties and districts of Chongqing had similar incidence level of HFMD.ConclusionEstablishing MEM models by dividing two incidence peaks of HFMD into single one respectively can accurately identify the epidemic period of HFMD, and the models can be used for the early warning of HFMD in Chongqing.

Key words:

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图 1 2013－2018年重庆市手足口病发病率经平滑处理后周分布

Figure 1. Weekly distribution of hand, foot and mouth disease incidence by moving average in Chongqing, 2013–2018

下载: 全尺寸图片幻灯片

图 2 2018年第36周至2019年第26周重庆市手足口病监测预警情况

Figure 2. Surveillance and early warning of hand，foot and mouth disease in Chongqing from week 36, 2018 to weeks 26, 2019

下载: 全尺寸图片幻灯片

图 3 2018年第36周至2019年第26周重庆市各县（市、区）手足口病疫情最高值和流行强度分布

Figure 3. Distributions of hand, foot and mouth disease incidence peaks and intensities by county in Chongqing from week 36, 2018 to week 26, 2019

下载: 全尺寸图片幻灯片

表 1 2013年第36周至2018年第35周重庆市手足口病春夏季和秋冬季MEM模型最优参数$\delta $筛选

Table 1. Optimal parameters of MEM model for hand, foot and mouth disease in Chongqing from week 36, 2013 to week 35, 2018

参数备选值	第8－35周			第36周至次年第7周
参数备选值	灵敏度	特异度	约登指数	灵敏度	特异度	约登指数
2.0	0.962	0.593	0.556	0.897	0.666	0.564
2.1	0.941	0.666	0.607	0.886	0.669	0.555
2.2	0.941	0.666	0.607	0.847	0.693	0.541
2.3	0.935	0.674	0.609	0.823	0.766	0.589
2.4	0.910	0.724	0.634	0.809	0.788	0.597
2.5	0.910	0.724	0.634	0.730	0.833	0.563
2.6	0.881	0.752	0.633	0.730	0.833	0.563
2.7	0.871	0.756	0.627	0.730	0.833	0.563
2.8	0.807	0.804	0.611	0.718	0.833	0.551
2.9	0.807	0.804	0.611	0.688	0.850	0.538
3.0	0.701	0.844	0.545	0.688	0.850	0.538
注：MEM. 移动流行区间法

下载: 导出CSV

表 2 2013年第36周至2018年第35周重庆市手足口病春夏季和秋冬季MEM模型拟合效果

Table 2. MEM model fitting of hand, foot and mouth disease in Chongqing from week 36, 2013 to week 35, 2018

年度	第8－35周			第36周至次年第7周
年度	灵敏度	特异度	约登指数	灵敏度	特异度	约登指数
2013/2014	−	−	−	0.714	1.000	0.714
2014/2015	0.829	1.000	0.829	0.971	0.670	0.641
2015/2016	0.880	1.000	0.880	0.710	1.000	0.710
2016/2017	0.948	1.000	0.948	1.000	0.679	0.679
2017/2018	0.772	1.000	0.772	0.647	1.000	0.647
2018/2019	1.000	0.616	0.616	−	−	−
合计	0.883	0.908	0.791	0.805	0.862	0.667
注：MEM. 移动流行区间法