The epidemiological trends of 40 national notifiable infectious diseases in China: An analysis of national surveillance data from 2013 to 2022

Objective: It aims to provide a preliminary analysis of the epidemiological characteristics and trends of 40 notifiable infectious diseases in the mainland of China over the past ten years, serving as a valuable reference for public health policies and interventions related to infectious diseases. Methods: Using data from the monthly analysis reports of the National Infectious Disease Surveillance System, we obtained information on reportable infectious diseases in China from 2013 to 2022. The data were analyzed using Excel 2010 software, and a joinpoint regression model was employed to examine trends in incidence and case-fatality ratios during this period. Results: From 2013 to 2022, a total of 76 874 318 cases of notifiable infectious diseases were reported in the mainland of China, resulting in an average yearly incidence of 551.26/100000 persons, with an average annual percentage change (AAPC) was 0.23% (95% CI : -3.81 to 4.37). The infectious diseases with the highest yearly incidence include hand, foot and mouth disease, hepatitis B, infectious diarrhea, tuberculosis, and influenza. There were 207216 deaths with an average annual case-fatality rate of 2.70/1000, with an AAPC of 5.53% (95% CI : 2.16 to 9.30). The diseases with the highest mortality rates were acquired immune deficiency syndrome (AIDS), tuberculosis, rabies, infectious diarrhea, and COVID-19. The incidence of notifiable infectious diseases was predominantly attributed to category C diseases, accounting for 54.50% of total cases, while intestinal infectious diseases were the most prevalent, comprising 40.64% of the total morbidity. The monthly incidence trend of 40 notifiable infectious diseases in China’s mainland exhibited a "W" distribution, whereas the monthly case-fatality ratio trend displayed an "M" distribution. Conclusions: It is crucial to continuously reinforce the prevention and control of key infectious diseases, including AIDS, tuberculosis, and viral hepatitis, as well as highly prevalent diseases such as hand, foot and mouth disease, influenza, and infectious diarrhea. Additionally, enhancing surveillance and response to emerging infectious diseases is essential to safeguarding public health and safety.