【作者】 刘莹；

【导师】 吴伟；

【作者基本信息】 中国医科大学 ， 公共卫生（专业学位）， 2025， 硕士

【摘要】 目的:性传播疾病(Sexually Transmitted Diseases,STDs)是世界上最常见的传染病之一,其发病率和死亡率很高,严重威胁着人类的生命和健康。2020年我国采取了一系列干预措施来控制新型冠状病毒感染(Novel Coronavirus Pneumonia,COVID-19)的传播与流行,使得中国性传播疾病的发生发展也受到了相关影响。本研究利用干预分析模型构建反事实框架,即2020年至2022年COVID-19疫情干预措施不存在与2023年COVID-19疫情干预措施未放开的反事实框架,预测中国法定报告性传播疾病(艾滋病、淋病和梅毒)两个阶段的发病情况,对比实际发病情况,进行定量评估并探讨针对新型冠状病毒感染采取的干预措施对艾滋病、淋病和梅毒流行的影响。方法:本研究首先对中国法定报告性传播疾病的数据进行汇总、整理和描述性流行病学分析,其中2010年1月至2019年12月为干预前时期,2020年1月至2022年12月为干预时期,2023年1月至2023年12月为干预终止时期。利用干预前时期即2010年1月至2019年12月艾滋病、淋病和梅毒报告病例数构建自回归综合移动平均(Autoregressive Integrated Moving Average,ARIMA)模型、分段回归(Segmented Regression,SR)模型和贝叶斯时间序列(Bayesian Structural Time Series,BSTS)模型,然后对干预时期即2020年1月至2022年12月数据进行预测,随后利用2010年1月至2022年12月数据重新建立模型对干预终止时期即2023年1月至12月数据进行预测,并计算出艾滋病、淋病和梅毒月度实际报告发病数与预测报告发病数之间的绝对百分比误差(Absolute Percentage Error,APE)值,从而评估新型冠状病毒感染采取的干预措施对中国法定报告性传播疾病流行趋势的影响。结果:艾滋病、淋病和梅毒的报告病例数呈现逐年上升趋势,并且都表现出明显的季节性和长期趋势,艾滋病病例数在每年1、2月相对较少,淋病病例数在每年7、8月相对较高,梅毒病例数在每7、8月相对较高。但在2020年初均出现了突然下降的特点,月度报告病例数表现为相对较小,APE表现为绝对值相对较大。2020年至2022年总APE值结果显示,在ARIMA模型中,艾滋病APE=-36.81%,淋病APE=-8.05%,梅毒APE=-27.45%;在SR模型中,艾滋病APE=-35.28%,淋病APE=-22.86%,梅毒APE=-16.6%;在BSTS模型中,艾滋病APE=-18.27%,淋病APE=-7.86%,梅毒APE=-11.93%。2023年总APE值结果显示,在ARIMA模型中艾滋病APE=31.59%,淋病APE=40.40%,梅毒APE=29.53%;在SR模型中艾滋病APE=28.27%,淋病APE=38.25%,梅毒APE=39.17%;在BSTS模型中,艾滋病APE=26.19%,淋病APE=38.42%,梅毒APE=37.83%。结论:ARIMA模型、SR模型和BSTS模型均能够很好的评估干预措施的效果,遏制新型冠状病毒感染采取的干预措施对艾滋病、淋病和梅毒发病的减少有显著影响,随着疫情的结束,干预措施逐渐取消,三种疾病的发病也随之上升至正常水平。这对政府和社会为制定和改进性传播疾病感染服务有一定的借鉴意义。更多还原

【Abstract】 Objective:Sexually Transmitted Diseases(STDs)are one of the most common infectious diseases in the world.Their incidence rate and mortality are very high,which seriously threaten human life and health.In 2020,China took a series of intervention measures to control the spread and prevalence of novel coronavirus Pneumonia(COVID-19),which also affected the occurrence and development of sexually transmitted diseases in China.This study used the intervention analysis model to build a counterfactual framework,that is,the COVID-19 epidemic intervention measures did not exist from 2020 to 2022 and the COVID-19 epidemic intervention measures were not liberalized in 2023.It predicted the incidence of sexually transmitted diseases(AIDS,gonorrhea and syphilis)in China in two stages,compared the actual incidence,made a quantitative assessment and discussed the impact of the intervention measures taken against novel coronavirus infection on the prevalence of AIDS,gonorrhea and syphilis.Methods:In this study,we firstly summarized,sorted out and made descriptive epidemiological analysis on the data of legal sexually transmitted diseases in China,with January 2010 to December 2019 as the pre-intervention period,January 2020 to December 2022 as the intervention period,and January 2023 to December 2023 as the intervention termination period.Using the number of reported cases of AIDS,gonorrhea and syphilis during the pre-intervention period,January 2010-December 2019,we constructed the autoregressive integrated moving average(ARIMA),segmented regression(SR)and Bayesian structural time series(BSTS)models.Then we projected data for the January 2020 to December 2022 intervention period and subsequently re-simulated data for the January to December 2023 intervention termination period using January 2010 to December 2022 data,and calculated the Absolute Percentage Error(APE)value between the monthly actual reported incidence of AIDS,gonorrhea and syphilis and the predicted reported incidence,so as to assess the impact of the intervention measures taken by novel coronavirus infection on the epidemic trend of legally sexually transmitted diseases in China.Results:The number of reported cases of AIDS,gonorrhea and syphilis has shown an increasing trend year by year,and all show obvious seasonal and long-term trends.The number of AIDS cases is relatively low in January and February each year,the number of gonorrhea cases is relatively high in July and August each year,and the number of syphilis cases is relatively high in July and August each year.But at the beginning of2020,there was a sudden decline in the number of monthly reported cases,with a relatively small number and APE showing a relatively large absolute value.The total APE values from 2020 to 2022 showed that in the ARIMA model,AIDS APE was-36.81%,gonorrhea APE was-8.05%,and syphilis APE was-27.45%;In the SR model,AIDS APE=-35.28%,gonorrhea APE=-22.86%,syphilis APE=-16.6%;In BSTS model,AIDS APE=-18.27%,gonorrhea APE=-7.86%,syphilis APE=-11.93%.The total APE value in 2023 shows that in ARIMA model,AIDS APE=31.59%,gonorrhea APE=40.40%,syphilis APE=29.53%;In SR model,AIDS APE=28.27%,gonorrhea APE=38.25%,syphilis APE=39.17%;In BSTS model,AIDS APE=26.19%,gonorrhea APE=38.42%,syphilis APE=37.83%.Conclusion:ARIMA model,SR model and BSTS model can evaluate the effect of intervention measures well.The intervention measures taken to curb novel coronavirus infection have a significant impact on the reduction of AIDS,gonorrhea and syphilis.With the end of the epidemic,the intervention measures are gradually canceled,and the incidence of the three diseases has also risen to the normal level.This has certain reference significance for the government and society to develop and improve services for sexually transmitted disease infections.更多还原