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目的分析河南省2006-2010年流行性乙型脑炎(乙脑)时空分布特征,研究地理环境因子对乙脑发病情况的影响。方法对2006-2010年河南省乙脑发病数据分市县进行流行病学及空间自相关分析,利用相关分析及多元线性回归研究气象因子、地表因子、社会经济条件等地理环境因素对乙脑发病的影响。结果河南省5年共报告2 729例,年平均发病率为0.547 4/10万,死亡119例,平均病死率为4.36%。年内7-9月发病集中,占全年发病数的97.08%,年际变化呈“U”形。疾病发病“热点”呈现明显的西南多、东北少的空间分布特征,洛阳、南阳、信阳3市发病热点现象显著。气象因子中,降雨量、降雨日数、>80%湿度天数及>25℃积温与发病率正向作用显著,而>30℃温度的累积天数、最高温度>30℃的累积温度将有效降低乙脑发病;地表因子中,省内水网密度低、耕地面积高的地方易致乙脑发病,两者与发病率在置信度为99%水平均呈显著相关;社会经济类因子中,农民人均收入的提升可有效降低疾病暴发,医疗卫生从业人数增加可降低乙脑暴发的可能性。多元线性回归拟合地理环境因素对疾病发病率影响,预测模型中R2=0.643,调整后R2=0.414,拟合效果良好。结论河南省西南地区属于乙脑防控重点区域,关注地理环境因素的动态变化对乙脑防控有前瞻性作用。
Objective To analyze the temporal and spatial distribution of Japanese encephalitis (JE) in Henan Province from 2006 to 2010 and study the influence of geographical factors on the incidence of Japanese encephalitis. Methods The epidemiological and spatial autocorrelation analysis of JE counties in Henan province from 2006 to 2010 was conducted. The correlation analysis and multivariate linear regression were used to study the influence of geographical factors such as meteorological factors, surface factors and socioeconomic conditions on the incidence of JE Impact. Results A total of 2 729 cases were reported in Henan Province in 5 years. The average annual incidence rate was 0.547 4 / 100,000 and 119 died, with an average mortality rate of 4.36%. During the year from July to September, the incidence was concentrated, accounting for 97.08% of the annual incidence, showing an “U” shape in the interannual variation. The incidence of disease “hot spot ” showed obvious spatial distribution characteristics of southwestern and northeastern provinces, and the incidence of hot spots was significant in 3 cities of Luoyang, Nanyang and Xinyang. Among the meteorological factors, precipitation, rainfall days,> 80% humidity days and accumulated temperature> 25 ℃ had a significant positive effect on the incidence. However, the accumulated temperature> 30 ℃ and the maximum temperature> 30 ℃ would reduce the encephalitis In the surface factors, the density of water network in the province is low and the area of cultivated land is high, the incidence of Japanese encephalitis is easily induced. Both of them have a significant correlation with the incidence of the disease with a confidence level of 99%. Among the social and economic factors, the per capita income of farmers Of the increase can effectively reduce the outbreak of the disease, the increase in the number of medical and health practitioners can reduce the possibility of JE outbreak. Multivariate linear regression fitted the influence of geographical factors on disease incidence. The prediction model R2 = 0.643, after adjustment R2 = 0.414, the fitting effect was good. Conclusion Southwest Henan Province belongs to the key area of prevention and control of Japanese encephalitis. The dynamic changes of geography and environmental factors have a prospective role in the prevention and control of Japanese encephalitis.