Abstract：
Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne emerging infectious disease with an increasingly global concern. Sex difference in infectious diseases is an important public health problem. A comparative study on sex differences in SFTS incidence and fatality was conducted using all laboratory-confirmed cases in mainland China during 2010-2018. Females had significantly higher average annual incidence rate (AAIR) with a risk ratio (RR) of 1.17 (95% confidence interval [CI] 1.11-1.22; p ˂ 0.0001), but significantly lower-case fatality rate (CFR) with an odd ratio of 0.73 (95% CI 0.61-0.87; p = 0.001). The significant differences in AAIR and CFR were observed in age groups of 40-69 and 60-69 years, respectively (both p < 0.05). There was a rising incidence and declining CFR along with epidemic years. After adjusting for age, temporal and spatial distribution, agricultural setting and onset-to-diagnosis interval, the female-to-male difference in either AAIR or CFR remained significant. The underlying biological mechanisms of the sex-based differences that the females are more prone to get the disease, but less likely for a fatal outcome deserve further investigations.
摘要：
严重发热伴血小板减少综合征（SFTS）是一种蜱传的新兴传染病，日益受到全球关注。传染病的性别差异是一个重要的公共卫生问题。使用2010-2018年中国大陆所有实验室确诊病例，对SFTS发病率和病死率的性别差异进行了比较研究。女性的平均年发病率（AAIR）明显较高，风险比（RR）为1.17（95％置信区间[CI]1.11-1.22；p<0.0001），但病死率（CFR）显着降低，奇数比为0.73（95％CI0.61-0.87；p=0.001）。在40-69岁和60-69岁的年龄组中观察到AAIR和CFR的显着差异，分别(均p<0.05)。随着流行年份的增加，发病率上升，CFR下降。在调整了年龄之后,时空分布，农业环境和发病到诊断间隔，在AAIR或CFR中,女性与男性的差异仍然显著.基于性别差异的潜在生物学机制是女性更容易患病，但对于致命结果的可能性较小，值得进一步调查。
