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目的分析广东省2006―2015年恙虫病流行病学特征并探索其时空分布特征,为制定有效的防治策略和控制措施提供科学依据。方法通过中国疾病预防控制信息系统收集广东省2006―2015年恙虫病疫情资料,利用地理信息系统技术,采用空间自相关分析和时空扫描统计量联合分析的方法对恙虫病发病情况进行时空聚集性分析。结果 2006―2015年广东省累计报告恙虫病病例20 178例,死亡24例,年均报告发病率为2.02/10万,发病率呈逐年升高趋势(P<0.01)。发病高峰呈双峰分布,6―7月达到最高峰,9―10月形成次高峰。全局空间自相关分析结果显示,恙虫病在县区级尺度上呈空间正相关(Moran’s I指数为0.256,P<0.01)。局部空间自相关分析结果显示,德庆县、怀集县、阳山县、广宁县等21个县(区)为“热点”区域(Gi Z值为1.69~5.77,均P<0.01),形成恙虫病的高发区域,全省仅丰顺县为“冷点”区域(Gi Z值为-1.72,P>0.05),为恙虫病的低发区域。时空聚集性分析结果显示,2006―2015年广东省恙虫病流行分4个聚类区,其中1类聚类区(LLR=8 640.82,RR=7.10,P<0.01)是以清远市、连州市为中心点、半径为243.31 km的区域,包含广宁县、云安区、怀集县等46个县(区),波及广东省35.66%(46/129)的县(区)。结论 2006―2015年广东省恙虫病发病率存在逐年升高趋势,且存在显著的时空聚集性,应在高发地区、高发季节对重点人群采取有效的防控措施,降低恙虫病发病水平。
Objective To analyze the epidemiological characteristics of tsutsugamushi disease in Guangdong Province from 2006 to 2015 and explore the spatial and temporal distribution characteristics of tsutsugamushi disease in order to provide a scientific basis for effective prevention and control strategies and control measures. Methods Epidemiological data of tsutsugamushi disease in Guangdong province from 2006 to 2015 were collected by Chinese CDC system. Spatial and temporal clustering analysis of tsutsugamushi disease was carried out using GIS and spatial autocorrelation analysis. . Results A total of 20 178 tsutsugamushi cases and 24 deaths were reported in Guangdong Province from 2006 to 2015, with an annual average incidence of 2.02 / lakh and a rising trend year by year (P <0.01). Peak incidence showed a bimodal distribution, peaked in June-July and peaked in September-October. The global spatial autocorrelation analysis showed that tsutsugamushi disease was spatially and positively correlated at the county scale (Moran’s I index: 0.256, P <0.01). Local spatial autocorrelation analysis showed that 21 counties (districts) of Deqing County, Huaiji County, Yangshan County and Quang Ninh County were “hotspots” (Gi Z values were 1.69-5.77, all P <0.01) , Forming a high incidence of tsutsugamushi disease in the province only Fengshun county “cold spot ” area (Gi Z value of -1.72, P> 0.05), low-risk area for scrub typhus. The results of spatiotemporal aggregations showed that there were 4 clustering regions in Guangdong Province during the period of 2006-2015, of which 1 class clustering region (LLR = 8 640.82, RR = 7.10, P <0.01) The city is the central point with a radius of 243.31 km, including 46 counties (districts) including Guangning County, Yun’an District and Huaiji County, covering 35.66% (46/129) counties (districts) in Guangdong Province. Conclusion The incidence of scrub typhus in Guangdong Province has been increasing year by year from 2006 to 2015, and there is significant spatial and temporal aggregation. Effective prevention and control measures should be taken for key populations in high incidence areas and high incidence seasons to reduce the incidence of scrub typhus.