2013—2017年湖北省手足口病时空聚集性分析
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摘要
目的分析2013—2017年湖北省手足口病的流行病学时空特征及聚集性分布,为制定防控策略提供依据。方法将"疾病监测信息报告管理系统"中湖北省2013—2017年手足口病个案导出,利用ArcGIS 10.3软件展示病例空间自相关分析,使用SaT Scan 9.4软件进行区县为空间单位、月为时间单位的时空聚集性分析。结果 2013—2017年湖北省累计报告手足口病436 495例,年均发病率为149.79/10万,年均死亡率为0.01/10万。全省各区县均有手足口病病例报告,全局空间自相关分析结果显示手足口病在湖北省区县尺度上呈空间正相关。局部空间自相关分析结果显示,高发热点区域主要集中在鄂西北地区和鄂东南地区,低发冷点区域主要是鄂中部偏东的少数区县。时空扫描分析探测到一级聚集区(RR=2.51,P=0.001)时间维度为2014年3月至2016年7月,空间维度覆盖鄂西北12个县区,主要分布在襄阳市和十堰市。二级聚集区(RR=3.14,P=0.001)时间维度为2016年4～6月,空间维度覆盖鄂东南44个县区。结论湖北省手足口病的发病存在明显时空聚集性,高发聚集区位于鄂西北和鄂东南地区,高发聚集区的手足口病防控工作应进一步强化。
Objective To analyze the epidemiological characteristics and clustering distribution of reported cases of hand, foot, and mouth disease(HFMD) in Hubei Province from 2013 to 2017, and to provide evidence for formulating prevention and control strategies. Methods The cases of HFMD in Hubei province from 2013 to 2017 were exported from National Notifiable Infectious Disease Reporting System. HFMD spatial autocorrelation analysis was visualized with software ArcGIS 10.3. The spatial-temporal scan statistical analysis was conducted with software SaTScan 9.4, with county as the space unit and month as the time unit. Results A total of 436,495 cases were reported in Hubei province during 2013-2017, with an average incidence rate of 149.79/100 000, and an average mortality rate of 0.01/100 000. There were cases reported in all districts and counties of the province. The global spatial autocorrelation analysis showed that HFMD was spatially positively correlated at the county and district level. Local spatial association analysis indicated that the high-incidence area was mainly concentrated in the northwestern and southeastern parts of Hubei province, and the low-incidence area was mainly a few districts and counties in the eastern part of central Hubei. Spatial-temporal scan statistical analysis for the spatial and temporal distributions of HFMD during this period revealed that the temporal distribution was from March 2014 to July 2016, and there were 12 class I clusters(RR=2.51,P=0.001) in the northwest of Hubei, mainly in Xiangyang and Shiyan. There were 44 class II clusters(RR=3.14, P=0.001) from April 2016 to June, in the southeast of Hubei. Conclusion HFMD incidence displayed obviously spatial and temporal clustering in Hubei province during 2013-2017. The high-incidence area was located in the northwest and southeast Hubei. The prevention and control of hand, foot and mouth disease should be further strengthened in the high incidence area.
Objective To analyze the epidemiological characteristics and clustering distribution of reported cases of hand, foot, and mouth disease(HFMD) in Hubei Province from 2013 to 2017, and to provide evidence for formulating prevention and control strategies. Methods The cases of HFMD in Hubei province from 2013 to 2017 were exported from National Notifiable Infectious Disease Reporting System. HFMD spatial autocorrelation analysis was visualized with software ArcGIS 10.3. The spatial-temporal scan statistical analysis was conducted with software SaTScan 9.4, with county as the space unit and month as the time unit. Results A total of 436,495 cases were reported in Hubei province during 2013-2017, with an average incidence rate of 149.79/100 000, and an average mortality rate of 0.01/100 000. There were cases reported in all districts and counties of the province. The global spatial autocorrelation analysis showed that HFMD was spatially positively correlated at the county and district level. Local spatial association analysis indicated that the high-incidence area was mainly concentrated in the northwestern and southeastern parts of Hubei province, and the low-incidence area was mainly a few districts and counties in the eastern part of central Hubei. Spatial-temporal scan statistical analysis for the spatial and temporal distributions of HFMD during this period revealed that the temporal distribution was from March 2014 to July 2016, and there were 12 class I clusters(RR=2.51,P=0.001) in the northwest of Hubei, mainly in Xiangyang and Shiyan. There were 44 class II clusters(RR=3.14, P=0.001) from April 2016 to June, in the southeast of Hubei. Conclusion HFMD incidence displayed obviously spatial and temporal clustering in Hubei province during 2013-2017. The high-incidence area was located in the northwest and southeast Hubei. The prevention and control of hand, foot and mouth disease should be further strengthened in the high incidence area.
引文
[ 1 ] XING WJ,LIAO QH,et al.Hand,foot and mouth disease in china,2008-12:an epidemiological study [J].Lancet Infect Dis 2014,14:308-18.DOI:10.1016/S1473-3099(13)70342-6.
[ 2 ] Abedi GR,Watson JT,et al.Enterovirus and Parechovirus Surveillance-United States,2014-2016[J].MMWR,2018,67(18):515-518.DOI:10.15585/mmwr.mm6718a2.
[ 3 ] 杨洪,张振,陈龙,等.2008—2015年深圳市手足口病流行病学特征及病原学监测分析[J].国际病毒学杂志,2017,24(6):375-380.
[ 4 ] CHEN Q,ZHANG Q,HU Z.Profiles of Human Enteroviruses Associated with Hand,Foot,and Mouth Disease in Nanjing,China[J].Disaster Med Public Health Prep,2019,1:1-5.DOI:10.1017/dmp.2018.155.
[ 5 ] 陈琦,邢学森,吴杨,等.湖北省2009—2015年手足口病流行病学和病原学分析[J].中华流行病学杂志,2017,38(4):441-445.
[ 6 ] 丁克琴,杨天池,陈奕宁,等.波市手足口病空间聚集性分析[J].预防医学,2017,29(9):909-913.
[ 7 ] 曹磊,刘峰,闫云,等.2010—2015年陕西省手足口病时空聚集性分析[J].公共卫生与预防医学,2017,28(6):56-59.
[ 8 ] 蒋静,徐勇,张皓,等.2008—2015年宜昌市手足口病病例特征分析[J].公共卫生与预防医学,2017,28(4):81-83.
[ 9 ] LK,GAO LD.Hand Foot and Mouth Disease in Hunan province,China,2009-2014:Epidemiology and death risk factors[J].Plos One,2016,11(11):e0167269.DOI:10.1371/journal.pone.0167269.
[10] A Adin,D Lee,T Goicoa,et al.A two-stage approach to estimate spatial and spatio-temporal disease risks in the presence of local discontinuities and clusters[J].Statistical Methods in Medical Research,2018,5(2):111-121.DOI:10.1177/ 0962280218767975.
[11] XU XJ,TANG Z,ZENG LR,et al.Detection of hand-foot-mouth disease and its spatial-temporal Epidemiological characteristics with GIS platform[J].J Biol Regul Homeost Agents,2018,32(2):371-377.DOI:10.3724/SP.J.1047.2016.00719.
[12] 常彩云,许华茹,赵梦娇,等.SARIMA模型在济南市手足口病预警预测中的应用[J].国际病毒学杂志,2017,24(6):397-401.
[13] 李高明,周亮,陈虹汝,等.基于气象因素的手足口病系统状态聚类方法研究[J].中国卫生统计,2017,34(6):866-868,872.
[14] 陈佶,范学志,赵继军.手足口病传染率季节性及其与人口流动的关系[J].复杂系统与复杂性科学,2017,14(3):97-102.
[ 2 ] Abedi GR,Watson JT,et al.Enterovirus and Parechovirus Surveillance-United States,2014-2016[J].MMWR,2018,67(18):515-518.DOI:10.15585/mmwr.mm6718a2.
[ 3 ] 杨洪,张振,陈龙,等.2008—2015年深圳市手足口病流行病学特征及病原学监测分析[J].国际病毒学杂志,2017,24(6):375-380.
[ 4 ] CHEN Q,ZHANG Q,HU Z.Profiles of Human Enteroviruses Associated with Hand,Foot,and Mouth Disease in Nanjing,China[J].Disaster Med Public Health Prep,2019,1:1-5.DOI:10.1017/dmp.2018.155.
[ 5 ] 陈琦,邢学森,吴杨,等.湖北省2009—2015年手足口病流行病学和病原学分析[J].中华流行病学杂志,2017,38(4):441-445.
[ 6 ] 丁克琴,杨天池,陈奕宁,等.波市手足口病空间聚集性分析[J].预防医学,2017,29(9):909-913.
[ 7 ] 曹磊,刘峰,闫云,等.2010—2015年陕西省手足口病时空聚集性分析[J].公共卫生与预防医学,2017,28(6):56-59.
[ 8 ] 蒋静,徐勇,张皓,等.2008—2015年宜昌市手足口病病例特征分析[J].公共卫生与预防医学,2017,28(4):81-83.
[ 9 ] LK,GAO LD.Hand Foot and Mouth Disease in Hunan province,China,2009-2014:Epidemiology and death risk factors[J].Plos One,2016,11(11):e0167269.DOI:10.1371/journal.pone.0167269.
[10] A Adin,D Lee,T Goicoa,et al.A two-stage approach to estimate spatial and spatio-temporal disease risks in the presence of local discontinuities and clusters[J].Statistical Methods in Medical Research,2018,5(2):111-121.DOI:10.1177/ 0962280218767975.
[11] XU XJ,TANG Z,ZENG LR,et al.Detection of hand-foot-mouth disease and its spatial-temporal Epidemiological characteristics with GIS platform[J].J Biol Regul Homeost Agents,2018,32(2):371-377.DOI:10.3724/SP.J.1047.2016.00719.
[12] 常彩云,许华茹,赵梦娇,等.SARIMA模型在济南市手足口病预警预测中的应用[J].国际病毒学杂志,2017,24(6):397-401.
[13] 李高明,周亮,陈虹汝,等.基于气象因素的手足口病系统状态聚类方法研究[J].中国卫生统计,2017,34(6):866-868,872.
[14] 陈佶,范学志,赵继军.手足口病传染率季节性及其与人口流动的关系[J].复杂系统与复杂性科学,2017,14(3):97-102.