2018—2019年嘉兴市社区人群急性胃肠炎疾病负担评估

目的 了解社区人群急性胃肠炎流行特征和经济负担,为评估人群食源性疾病的患病情况及单病种疾病负担提供更准确的基础数据。方法 采用分层多阶段随机抽样方法抽取秀洲区和桐乡市共10个街道(乡镇)的20个居委会(行政村)作为调查点,于2018年7月至2019年6月,每月入户问卷调查急性胃肠炎发病情况和经济负担等。结果 现场实际调查2 400户2 400人,发现急性胃肠炎病例62人次,月发病率2.58%(95%CI: 1.95%～3.22%),城镇和农村、不同年龄性别发病差异无统计学意义。根据人口性别、年龄构成调整后的月发病率为2.92%(95%CI: 2.25%～3.60%),推算年发病率为0.38次/人年(95%CI:0.36～0.40)。7～9月为高发季节,医院就诊率12.77%,72.34%的病例与不洁饮食相关,62.50%的29岁及以下年龄病例,83.33%的学龄前儿童,以及学生和办事员病例,均在食用外购食品后发病。病例次均经济负担399.62元,其中次均直接医疗费用294.61元,次均直接非医疗费用39.83元,次均间接费用65.18元,估算全市急性胃肠炎型总经济负担为7.19亿元,其中食源性急性胃肠炎总经济负担为5.20亿元。结论 嘉兴市急性胃肠炎疾病负担较重,建议加强重点人群健康教育,引导建立健康饮食行为,并持续开展相关监测。

Burden assessment of acute gastroenteritis among community population in Jiaxing from 2018 to 2019

Objective To understand the epidemic characteristic and economic burden of acute gastroenteritis among community population, and to provide more accurate basic data for evaluating the prevalence of foodborne disease and single disease burden. To understand the epidemic characteristic and economic burden of acute gastroenteritis among community population, and to provide more accurate basic data for evaluating the prevalence of foodborne disease and single disease burden. Methods Using the stratified multi-stage random sampling method, 20 neighborhood committees (administrative villages) in 10 residential districts (township) of Xiuzhou and Tongxiang County were selected as the survey points. The indoor questionnaire investigation was carried out from July 2018 to June 2019 to survey the incidence rate and economic burden of acute gastroenteritis. Using the stratified multi-stage random sampling method, 20 neighborhood committees (administrative villages) in 10 residential districts (township) of Xiuzhou and Tongxiang County were selected as the survey points. The indoor questionnaire investigation was carried out from July 2018 to June 2019 to survey the incidence rate and economic burden of acute gastroenteritis.Results A total of 2 400 cases were surveyed, 62 person times of acute gastroenteritis were found, and monthly incidence rate was 2.58%(95%CI:1.95%-3.22%). There was no statistical significance in incidence rate between urban and rural areas, and no statistical significance in different gender and ages. Modified by the gender and age composition, monthly incidence rate was 2.92%(95%CI: 2.25%-3.60%), estimated annual incidence rate was 0.38 times(95%CI:0.36~0.40) preson-year. The high incidence season was from July to September. Of all the cases identified, 12.77% reported seeking medical service, and 72.34% of the cases were related with the contaminated food. 62.50% of the cases under 29 years old, 83.33% of the preschool children, and cases of students and clerks suffered from diseases after eating purchased food. The average economic burden of cases was 399.62 Yuan/per time, including 294.61 Yuan of average direct medical cost, 39.83 Yuan of average direct non-medical cost and 65.18 Yuan of indirect cost. The total estimated economic burden of acute gastroenteritis in Jiaxing was 719 million, including 520 million from foodborne disease. A total of 2 400 cases were surveyed, 62 person times of acute gastroenteritis were found, and monthly incidence rate was 2.58%(95%CI:1.95%-3.22%). There was no statistical significance in incidence rate between urban and rural areas, and no statistical significance in different gender and ages. Modified by the gender and age composition, monthly incidence rate was 2.92%(95%CI: 2.25%-3.60%), estimated annual incidence rate was 0.38 times(95%CI:0.36-0.40)preson-year. The high incidence season was from July to September. Of all the cases identified, 12.77% reported seeking medical service, and 72.34% of the cases were related with the contaminated food. 62.50% of the cases under 29 years old, 83.33% of the preschool children, and cases of students and clerks, suffered from diseases after eating purchased food. The average economic burden of cases was 399.62 Yuan/per time, including 294.61 Yuan of average direct medical cost per time, 39.83 Yuan of average direct non-medical cost per time and 65.18 Yuan of indirect cost per time. The total estimated economic burden of acute gastroenteritis in Jiaxing was 719 million, including 520 million total economic burden of foodborne disease. Conclusion The disease burden of acute gastroenteritis in Jiaxing was relatively heavy. It is suggested to strengthen health education for key population, guide the establishment of health dietary behavior, and continue to carry out relative surveillance. The disease burden of acute gastroenteritis in Jiaxing is relatively heavy. It is suggested to strengthen health education for key population, guide the establishment of health dietary behavior, and continue to carry out relative surveillance.