长沙市2009年甲型H1N1流感时空过程分析及影响因素研究

肖洪; 田怀玉; 赵暕; 张锡兴; 朱佩娟; 刘如春; 陈田木

Abstract

肖洪,田怀玉,赵暕,张锡兴,朱佩娟,刘如春,陈田木.长沙市2009年甲型H1N1流感时空过程分析及影响因素研究[J].Chinese journal of Epidemiology,2011,32(6):587-592

长沙市2009年甲型H1N1流感时空过程分析及影响因素研究

Spatio-temporal process and the influencing factors on influenza A (H1N1) pandemic in Changsha

Received:November 10, 2010

DOI：

KeyWord: 甲型H1N1流感空间数据分析影响因素

English Key Word: Influenza A (H1N1) pandemic Spatial data analysis Influencing factors

FundProject:国家自然科学基金(40971038);湖南师范大学校级重点学科地图学与地理信息系统;湖南省科技计划项目(2010SK3007);湖南省重点学科建设项目(2008001)

Author Name	Affiliation	E-mail
XIAO Hong	College of Resources and Environment Science, Hunan Normal University, Changsha 410081, China	xiaohong.hnnu@gmail.com
TIAN Huai-yu	College of Resources and Environment Science, Hunan Normal University, Changsha 410081, China
ZHAO Jian	Peking University Health Science Center
ZHANG Xi-xing	Changsha City Center for Disease Control and Prevention
ZHU Pei-juan	College of Resources and Environment Science, Hunan Normal University, Changsha 410081, China
LIU Ru-chun	Changsha City Center for Disease Control and Prevention
CHEN Tian-mu	Changsha City Center for Disease Control and Prevention

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Abstract:

目的分析2009年长沙市甲型H1N1流感大流行期间时空传播过程及扩散过程中的影响因素.方法以长沙市甲型H1N1流感疫情数据,结合长沙市地理信息系统(GIS),利用热点分析、时空聚类分析、空间过程分析和Spearman相关性分析等数据分析方法,对疫情进行深入分析.结果疫情热点区域多出现在市辖区与县城等经济较发达的地区,疫情时空一级聚类区位于浏阳市中部(RR=22.70,P<0.01),二级聚类区位于市辖区岳麓区(RR=6.49,P<0.01)、雨花区(RR=81.63,P<0.01)、长沙县中部星沙镇周边(RR=2.90,P<0.01)、雨敞坪镇(RR=19.31,P<0.01)、城郊乡(RR=73.14,P<0.01)、宁乡县西部龙田镇周边(RR=14.43,P<0.01)以及望城县中部乌山镇周边(RR=13.84,P<0.01),随着时间推移在空间上呈现向东(经济发达地区)扩散的趋势;人口数量、学生数、空间相邻性和经济活动对疫情传播过程产生重要影响;甲型H1N1流感起始期人口密度是主要影响因素(r=0.477,P<0.05),疫情初期与快速发展期学生数量是重要的指标(r=0.831,P<0.01;r=0.518,P<0.01),在疫情顶峰期经济活动对疫情扩散起主要作用(r=-0.676,P<0.01).结论在流感不同的发展阶段,疫情的高危人群与高发区域均有明显的变化,因此应根据疫情的不同阶段对防控措施进行调整.

English Abstract:

Objective To analyze the spatio-temporal process on 2009 influenza A (HlNl) pandemic in Changsha and the influencing factors during the diffusion process. Methods Data were from the following 5 sources, influenza A (HlNl) pandemic gathered in 2009, Geographic Information System (GIS) of Changsha, the broad range of theorems and techniques of hot spot analysis, spatio-temporal process analysis and Spearman correlation analysis. Results Hot spot areas appeared to be more in the economically developed areas, such as cities and townships. The cluster of spatial-temporal distribution of influenza A (HlNl) pandemic was most likely appearing in Liuyang city (RR=22.70,P<0.01). The secondary cluster would include districts as Yuelu (RR=6A9,P< 0.01), Yuhua (RR=81.63, P<0.01). Xingsha township appeared as the center in the Changsha county (RR=2.90, P<0.01) while townships as Yutangping (RR=19.31, P<0.01), Chengjiao (RR=73.14,P<0.01) and Longtian appeared as the center in the west of Ningxiang county (RR= 14.43,P<0.01) and Wushan as the center in the Wangcheng county (RR= 13.84,P<0.01). As time went on, the epidemic moved towards the eastern and more developed regions. Regarding factor analysis, population, the amount of students, geographic relationship and business activities etc. appeared to be the key elements influencing the transmission of influenza A (H1N1) pandemic. At the beginning of the epidemic, population density served as the main factor (r=0.477, P<0.05) but during the initial and fast growing stages, it was replaced by the size of students to serve as the important indicator (r=0.831, P<0.01; r=0.518, P<0.01). However, during the peak of the epidemics, the business activities played an important role (r=-0.676, P<0.01). Conclusion Groups under high risk and districts with high incidence rates were shifting, along with the temporal process of influenza A(H1N1) pandemic, suggesting that the protection measures need to be adjusted, according to the significance of influencing factors at different stages.

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