| 朱爱富,于彬彬,杨丽华,杨富萍,许定聪,杨玲,明雄攀,王鹏.2006-2024年云南省人间布鲁氏菌病流行特征分析[J].中华流行病学杂志,2026,47(3):520-527 |
| 2006-2024年云南省人间布鲁氏菌病流行特征分析 |
| Epidemiological characteristics of human brucellosis in Yunnan Province, 2006-2024 |
| 收稿日期:2025-07-30 出版日期:2026-03-19 |
| DOI：10.3760/cma.j.cn112338-20250730-00537 |
| 中文关键词: 人间布鲁氏菌病|流行特征|时空聚集性 |
| 英文关键词: Human brucellosis|Epidemiological characteristics|Spatiotemporal clustering |
| 基金项目:云南省医学领军人才培养项目（L-2019001） |
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| 中文摘要: |
| 目的 分析云南省16个市（自治州）2006-2024年人间布鲁氏菌病（布病）流行趋势及时空分布特征，为云南省布病防控工作提供参考依据。方法 资料来源于中国疾病预防控制信息系统传染病监测信息系统，收集云南省16个市（自治州）2006-2024年布病报告病例数据。应用Excel 2021软件整理数据，应用R 4.5.0软件、Origin 2024软件进行数据可视化，应用Joinpoint 5.4.0 软件计算布病发病率的年变化百分比和平均年变化百分比（AAPC）并进行时间趋势分析，应用ArcGIS 10.8软件进行空间自相关分析，应用SaTScan 10.3.2软件进行时空扫描分析。结果 2006-2024年云南省共报告布病7 350例，报告发病率由0.002/10万上升至4.563/10万。Joinpoint回归分析结果显示，总体上2006-2024年报告发病率的上升趋势有统计学意义（AAPC=49.01%，P<0.001）。全局Moran's I值范围为0.25~0.40，有统计学意义的年份分别为2008、2011、2017-2018、2021-2024年，存在明显的正空间自相关（均P<0.05），说明报告布病发病率存在空间聚集性。全局G系数范围为0.15~0.22，有统计学意义的年份分别为2008-2009、2011、2017-2024年，说明报告发病率在空间上呈高值聚集性，2021-2024年的Moran's I值和G系数均>0.00，说明报告发病率呈高值聚集性的正空间自相关。局部自相关分析结果显示，高-高聚集区从2017年的昆明市、红河哈尼族彝族自治州、曲靖市和玉溪市逐年收缩至2022-2024年的昆明市、曲靖市和昭通市。热点地区从2008-2020年先后出现6个市（自治州）聚焦到2021-2024年2个市（昆明市和曲靖市）。时空扫描分析结果显示，5个时空聚集区有统计学意义（均P<0.05），覆盖9个市（自治州），一类聚集区为滇东北地区的昭通市、曲靖市、昆明市。结论 2006-2024年云南省布病疫情总体呈持续上升趋势，热点地区和时空聚集区主要分布在滇东北地区，昆明市与曲靖市是布病防控的重点地区，昭通市、保山市、文山壮族苗族自治州的增幅较大，也应密切关注。应采取精准施策实现布病疫情的有效控制。 |
| 英文摘要: |
| Objective To analyze the epidemic trend and spatiotemporal distribution characteristics of human brucellosis (brucellosis) in 16 cities (autonomous prefectures) of Yunnan Province from 2006 to 2024, and to provide a reference basis for the prevention and control of brucellosis in Yunnan Province. Methods The data were derived from the Infectious Disease Surveillance Information System of the Chinese Disease Prevention and Control Information System, collecting the reported cases of brucellosis in 16 cities (autonomous prefectures) of Yunnan Province from 2006 to 2024. Data were collated in Excel 2021, and data visualization was conducted using R 4.5.0 and Origin 2024 software. The annual percent change and average annual percent change (AAPC) of brucellosis incidence were calculated using Joinpoint 5.4.0 software for time-trend analysis. Spatial autocorrelation analysis was conducted using ArcGIS 10.8 software, and spatiotemporal scanning analysis was carried out using SaTScan 10.3.2 software. Results From 2006 to 2024, a total of 7 350 cases of brucellosis were reported in Yunnan Province, and the reported incidence rate increased from 0.002 per 100 000 to 4.563 per 100 000. The Joinpoint regression analysis results showed that the upward trend of reported incidence rates from 2006 to 2024 was statistically significant (AAPC=49.01%, P<0.001). The global Moran's I value ranged from 0.25 to 0.40. The years with statistical significance were 2008, 2011, 2017-2018, and 2021-2024, respectively. There was significant positive spatial autocorrelation (all P<0.05), indicating spatial aggregation in the reported incidence of brucellosis. The global G coefficient ranges from 0.15 to 0.22. The years with statistical significance are 2008-2009, 2011, and 2017-2024, respectively, indicating that the reported incidence rate shows a high degree of spatial aggregation. The Moran's I value and the G coefficient from 2021 to 2024 were both >0.00. It indicates that the reported incidence rate showed a high level of aggregated positive spatial autocorrelation. The results of local autocorrelation analysis show that the high-high aggregation areas have gradually shrunk from cities (autonomous prefectures) including Kunming, Honghe, Qujing, and Yuxi in 2017 to Kunming, Qujing, and Zhaotong from 2022 to 2024. The hotspots were concentrated from six cities (autonomous prefectures) in 2008 to 2020 to two cities (Kunming and Qujing) in 2021 to 2024. The results of spatio-temporal scanning analysis showed that the five spatio-temporal clustering areas were statistically significant (all P<0.05), and covered nine cities (autonomous prefectures). The first-class clustering areas were Zhaotong, Qujing and Kunming in the northeastern part of Yunnan Province. Conclusions From 2006 to 2024, the brucellosis epidemic in Yunnan Province showed a continuous upward trend. The hotspots and spatiotemporal concentration areas are mainly distributed in the northeastern part of Yunnan Province. Kunming and Qujing are the key areas for brucellosis prevention and control. The increase in cities (autonomous prefectures) including Zhaotong, Baoshan and Wenshan is relatively large and should also be closely monitored. Precise measures should be adopted to control the brucellosis epidemic. |
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