| Objective:In order to understand the epidemiological characteristics and incidence pattern of HFMD in Zigong,explore the relationship between incidence rate and various factors,construct a time series prediction model for HFMD in Zigong and evaluate the fitting and prediction effects of the model,understand the awareness of HFMD and willingness of EV71 vaccination among key populations such as parents of children in Zigong,and provide a scientific basis for rational allocation of medical and health resources and targeted and focused implementation of HFMD prevention and control.And provide a scientific basis for rational allocation of health care resources and targeted and focused prevention and control of HFMD.Methods:The epidemiological description of HFMD epidemic in Zigong City was collected and organized using incidence rate,composition ratio and other indicators.ArcGIS10.2 software was used to indicate different incidence rates with different colors,and the annual incidence rate distribution of each district and county in Zigong City from 2016 to 2021 was plotted respectively;cardinality test and time series analysis were applied comprehensively to analyze and process the data.The literature was consulted,experts were consulted,and self-administered questionnaires were used to survey key populations such as doctors,teachers and parents in Zigong to understand the knowledge of HFMD,vaccination intention and influencing factors of key populations.To carry out dynamic surveillance of HFMD in key environments such as large medical institutions,kindergartens and vaccination sites in Zigong City.The statistical software used included SPSS22.0,SAS9.1 and R4.2.2.Results:(1)From 2016 to 2021,a total of 10660 cases of HFMD were reported in Zigong,with an average annual incidence of 62.86/100,000.Three cases of severe cases were reported,with a severe rate of 0.03%.Except for 2018,which was inconsistent with the epidemic peaks of previous years,the rest of the years showed two peaks in summer and autumn and winter.The areas with high incidence were mainly concentrated in the artesian well area,the difference between male and female incidence was not statistically significant(χ~2=30,P>0.05).The age group with higher incidence was mainly concentrated in the age group of 1-3 years old.The proportion of reported cases in medical institutions above the second level was much higher than that in primary medical drums,accounting for 93.5%.The positive rate of etiological monitoring was 78.3%,of which 163 EV71 were detected,accounting for 11.46%.Cox A16 was detected in 414 cases,accounting for 29.11%.CoxA4 was detected in 6 samples,accounting for 0.42%.Cox A6 was detected in 181 cases,accounting for 12.73%.Cox A10 detected 52 copies,accounting for 3.66.A total of 606 cases of other enterovirus were detected,accounting for 42.62%.The positive rate was 15.61%for invisible surveillance of healthy children and 5.13%for environmental surveillance outside the key sites,and the peak of positive environmental samples showed a certain seasonality.(2)Survey on knowledge about hand,foot and mouth disease:a total of 5900 questionnaires were distributed and 5837 valid questionnaires were collected,with a recovery efficiency of 98.93%.There were 7 questions on HFMD and vaccine knowledge,and the total number of questions answered by the participants was 40859,with an overall knowledge rate of 59.96%.The questionnaire survey showed that parents with younger children,living in towns and cities,and giving their children child health care as required were more willing to vaccinate their children with EV71 vaccine,while teachers and medical personnel and ethnic minorities were less willing to do so.(3)Two time series prediction models(SARIMA and BATS)were used to analyze and predict the incidence of hand-foot-mouth disease.The results showed that BATS and SARIMA could better fit the incidence of hand-foot-mouth disease in Zigong,and BATS prediction was more suitable than SARIMA.Conclusion:In recent years,the epidemic situation of hand-foot-mouth disease in Zigong is relatively severe.On the premise of monitoring reports based on clinical cases,regular etiological monitoring of key populations and external environment in key places such as kindergartens/schools,digital vaccination clinics and medical institutions is carried out to better obtain the protracted characteristics of intestinal pathogenic serotypes in a certain area,so as to make up for the shortcomings in the current monitoring mode.At the same time,according to the influence of other factors on the reporting and monitoring of infectious diseases,different time series models are adopted to predict the epidemic trend of hand-foot-mouth disease in the jurisdiction,so as to better provide reference for the prevention and control of hand-foot-mouth disease.It can also strengthen the health education of key populations before the epidemic peak for epidemic prevention and control,effectively reduce the incidence and severe rate,and reduce the burden of disease. |
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