【摘要】 目的 分析贵州省流行性脑脊髓膜炎(流脑)流行特征和脑膜炎奈瑟菌(Neisseria meningitidis, Nm)血清群变迁趋势。方法 收集贵州省1952-2024年流脑报告病例流行病学和Nm血清群监测信息，分析流脑报告发病率和Nm血清群构成；采用中断时间序列分析评价脑膜炎球菌疫苗纳入贵州省免疫规划(Expanded Program on Immunization, EPI)前后发病率变化。结果 贵州省1952-2024年共报告流脑175 575例，年均报告发病率(/10万，下同)为8.345,各年报告发病率在0.003(2016年和2017年)～220.410(1967年)之间。在2000-2024年报告病例中，0～4岁、5～9岁、10～14岁、15～19岁、≥20岁年均报告发病率分别为0.847、0.798、0.529、0.200、0.036。中断时间序列分析显示，脑膜炎球菌疫苗纳入EPI前期(1994-2005年)、纳入EPI时期(2007-2024年)流脑发病率均呈下降趋势[β(95%CI):-0.101(-0.138～-0.063)、-0.014(-0.028～-0.002)]。在2007-2024年报告病例中，Nm血清群检测阳性57例，其中A群19例(2008-2013年)、B群21例(2016年、2018-2024年)、C群13例(2007-2008年、2013年、2019年、2021-2022年、2024年)、Y群4例(2023-2024年)。结论 贵州省1952-2024年流脑发病总体呈下降趋势，发病以<15岁儿童为主，优势Nm血清群从A群变迁为B群、C群和Y群，脑膜炎球菌疫苗纳入EPI后使流脑发病率进一步下降。建议持续开展Nm血清群监测，加强适龄儿童脑膜炎球菌疫苗常规免疫工作。更多还原

【Abstract】 Objective To determine epidemiological characteristics of meningococcal meningitis(MM) and changes of Neisseria meningitidis(Nm) serogroups in Guizhou province.Methods We obtained epidemiological and serogroup data on MM cases reported during 1952-2024 in Guizhou to determine MM incidence and serogroup distribution. We used interrupted time series analysis to evaluate changes in MM incidence before and after introducing meningococcal vaccine into Guizhou′s Expanded Program on Immunization(EPI).Results During 1952-2024, there were 175 575 MM cases reported in Guizhou, for an average annual incidence of 8.345 per 100 000 population. Incidences per 100 000 by year ranged from 0.003 in 2016 and 2017 to 220.410 in 1967. In 2000-2024, average annual incidences for 0-4-, 5-9-, 10-14-, 15-19-, and ≥20-year-olds were 0.847, 0.798, 0.529, 0.200, and 0.036 per 100 000, respectively. Interrupted time series analysis showed that MM incidences in the pre-EPI period(1994-2005) and the EPI period(2007-2024) both declined [β(95% CI):-0.101(-0.138 to-0.063) and-0.014(-0.028 to-0.002)]. Fifty-seven MM cases reported during 2007-2024 were positive to an Nm serogroup, including 19 serogroup A cases(in 2008-2013), 21 serogroup B cases(in 2016 and 2018-2024), 13 serogroup C cases(in 2007-2008, 2013, 2019, 2021-2022, and 2024), and 4 serogroup Y cases(in 2023-2024).Conclusions MM incidence decreased during 1952-2024 in Guizhou; most cases were in children under 15 years of age. The predominant Nm serogroup shifted from serogroup A to serogroups B, C, and Y. MM incidence decreased further after introduction of meningococcal vaccine into EPI. We suggest continuous monitoring of Nm serogroups and strengthening routine meningococcal vaccination for age-eligible children.更多还原