山东省2006-2014年秋冬型恙虫病空间流行病学分析

杨慧; 毕振旺; 寇增强; 郑丽; 赵仲堂

Abstract

杨慧,毕振旺,寇增强,郑丽,赵仲堂.山东省2006-2014年秋冬型恙虫病空间流行病学分析[J].Chinese journal of Epidemiology,2016,37(5):682-685

山东省2006-2014年秋冬型恙虫病空间流行病学分析

Spatial analysis of autumn-winter type scrub typhus in Shandong province, 2006-2014

Received:October 29, 2015

DOI：10.3760/cma.j.issn.0254-6450.2016.05.019

KeyWord: 恙虫病秋冬型流行特征空间流行病学

English Key Word: Scrub typhus Autumn-winter type Epidemic characteristics Spatial epidemiology

FundProject:国家自然科学基金(81273133)

Author Name	Affiliation	E-mail
Yang Hui	Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China
Bi Zhenwang	Institute for Bacterial Infectious Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China	bzwjn@163.com
Kou Zengqiang	Institute for Bacterial Infectious Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
Zheng Li	Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China
Zhao Zhongtang	Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China	ztzhao@sdu.edu.cn

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Abstract:

目的探讨2006-2014年山东省秋冬型恙虫病的时空分布特征和流行趋势。方法基于山东省疾病报告信息系统2006-2014年恙虫病监测数据,采用地理信息系统软件(ArcGIS 9.3)、空间计量软件(GeoDa 0.9.5-i)及空间扫描分析软件(SatScan 9.1.1),绘制发病率地区分布图、局域型空间自相关(LISA)聚集图和空间扫描聚集图;通过计算Moran's I、对数似然比(LLR)、RR等指标进行描述与分析。结果山东省2006-2014年共报告恙虫病病例4453例,年平均发病率呈逐年上升趋势,17个地(市)中有13个发现恙虫病病例。年平均发病率全局Moran's I为0.5015(P<0.01)。16处地区发病率的局域Moran's I有统计学意义(P<0.01),"高-高"(H-H)聚集区主要地点为日照市的五莲县、岚山区和莒县,泰安市的新泰市、莱芜市的莱城区和钢城区、淄博市的沂源县和临沂市的蒙阴县。空间扫描发现,2006-2014年空间聚集区的中心呈整体向东移动的趋势,并于2014年在枣庄市发现2个新聚集区。2006-2010年及2012年一级聚集区中心位于山东省中南部山区,2011、2013及2014年位于东部丘陵地区;聚集区辐射半径于2008、2011、2013和2014年呈扩大趋势。时空扫描发现一个时空聚集区,为2014年10月1日至2014年11月30日,中心为日照市东港区,辐射半径为222.34 km。结论 2006-2014年山东省秋冬型恙虫病的流行存在正向空间自相关和明显的空间聚集性,且发病区域不断扩大,高发地区不断增多,高危聚集区向东部移动,并有周期性扩大趋势。

English Abstract:

Objective To discuss the spatial-temporal distribution and epidemic trends of autumn-winter type scrub typhus in Shandong province, and provide scientific evidence for further study for the prevention and control of the disease. Methods The scrub typhus surveillance data during 2006-2014 were collected from Shandong Disease Reporting Information System. The data was analyzed by using software ArcGIS 9.3 (ESRI Inc., Redlands, CA, USA), GeoDa 0.9.5-i and SatScan 9.1.1. The Moran's I, log-likelihood ratio (LLR), relative risk (RR) were calculated and the incidence choropleth maps, local indicators of spatial autocorrelation cluster maps and space scaning cluster maps were drawn. Results A total of 4 453 scrub typhus cases were reported during 2006-2014, and the annual incidence increased with year. Among the 17 prefectures (municipality) in Shandong, 13 were affected by scrub typhus. The global Moran's I index was 0.501 5 (P<0.01). The differences in local Moran's I index among 16 prefectures were significant (P<0.01). The "high-high" clustering areas were mainly Wulian county, Lanshan district and Juxian county of Rizhao, Xintai county of Tai'an, Gangcheng and Laicheng districts of Laiwu, Yiyuan county of Zibo and Mengyin county of Linyi. Spatial scan analysis showed that an eastward moving trend of high-risk clusters and two new high-risk clusters were found in Zaozhuang in 2014. The centers of the most likely clusters were in the south central mountainous areas during 2006-2010 and in 2012, eastern hilly areas in 2011, 2013 and 2014, and the size of the clusters expanded in 2008, 2011, 2013 and 2014. One spatial-temporal cluster was detected from October 1, 2014 to November 30, 2014, the center of the cluster was in Rizhao and the radius was 222.34 kilometers. Conclusion A positive spatial correlation and spatial agglomerations were found in the distribution of autumn-winter type scrub typhus in Shandong. Since 2006, the epidemic area of the disease has expanded and the number of high-risk areas has increased. Moreover, the eastward moving and periodically expanding trends of high-risk clusters were detected.

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