中国媒介生物学及控制杂志 ›› 2019, Vol. 30 ›› Issue (3): 237-243.DOI: 10.11853/j.issn.1003.8280.2019.03.002

• 恙虫病专题报道 • 上一篇    下一篇

江苏省2008-2017年恙虫病流行特征和时空聚集性分析

张育富, 刘大鹏, 褚宏亮   

  1. 江苏省疾病预防控制中心消毒与媒介生物防制所, 江苏 南京 210009
  • 收稿日期:2019-02-12 出版日期:2019-06-20 发布日期:2019-06-20
  • 通讯作者: 褚宏亮,Email:medchu@jscdc.cn
  • 作者简介:张育富,男,硕士,主管医师,主要从事媒介生物防制工作,Email:yufu2007@126.com
  • 基金资助:
    江苏省医学重点学科项目(ZDXKA2016008)

An analysis of epidemiological characteristics and spatiotemporal clustering of scrub typhus in Jiangsu province, China, during 2008-2017

ZHANG Yu-fu, LIU Da-peng, CHU Hong-liang   

  1. Jiangsu Center for Disease Control and Prevention, Nanjing 210009, Jiangsu Province, China
  • Received:2019-02-12 Online:2019-06-20 Published:2019-06-20
  • Supported by:
    Supported by the Jiangsu Provincial Key Medical Discipline of Epidemiology (No. ZDXKA2016008)

摘要: 目的 分析江苏省恙虫病时空流行特征和时空聚集性,为制定防控策略和措施提供参考。方法 利用描述性流行病学方法、空间自相关性分析和时空聚集性分析描述江苏省2008-2017年恙虫病的时空分布特征和确定高风险地区,并通过ArcGIS 10.2软件对结果进行可视化展示。结果 江苏省2008-2017年共报告恙虫病7 950例,年平均发病率为1.01/10万。农民是高危人群,女性发病率高于男性,病例主要集中在45~80岁年龄组。年平均发病率全局Moran’s I指数为0.130(P=0.023),提示有高值或低值聚集区的存在。局部自相关分析结果显示“高-高”聚集区主要有大丰区、东台市和滨海县等,“高-低”聚集区主要有靖江市。单纯时间扫描分析结果显示,江苏省恙虫病发病存在时间聚集性,主要集中在每年10-11月。单纯空间扫描分析结果显示,恙虫病病例存在明显聚集性,2008-2017年空间聚集区呈从中东部向西、向北和向南扩大的趋势,于2014-2016年聚集区辐射半径达到最大且覆盖区(县)数最多。时空扫描发现一个高发病率时空聚集区,时间为2013年10月至2017年12月,中心为盐城市建湖县,辐射半径为166.68 km(RR=14.45,LLR=6 295.90,P<01)。结论江苏省恙虫病病例在时间、空间2个维度均呈聚集性分布,高发病率聚集区不断扩大,应加强全省恙虫病监测和重点区域防控。

关键词: 恙虫病, 时空聚集性, 空间自相关

Abstract: Objective To analyze the epidemiological characteristics and spatiotemporal clustering of scrub typhus in Jiangsu province, China, and to provide a reference for the development of prevention and control strategies and measures of scrub typhus. Methods Descriptive epidemiological method, spatial autocorrelation, and spatiotemporal clustering were used to analyze the spatiotemporal distribution characteristics of scrub typhus and identify high-risk areas in Jiangsu province during 2008-2017. ArcGIS 10.2 software was used to visualize the results. Results A total of 7 950 cases were reported in Jiangsu province during 2008-2017, and the mean annual incidence was 1.01/100 000. Farmers were the high-risk population. Women had a higher incidence rate of scrub typhus than men. The cases were mainly concentrated in the population aged 45-80 years. The global Moran's I index was 0.130 (P=0.023), indicating the presence of a high value or low value clustering area. The local autocorrelation analysis results showed that "High-High" clustering areas were mainly located in Dafeng district, Dongtai city, and Binhai county, and "High-Low" clustering area was mainly located in Jingjiang city. The temporal scan analysis results showed that the distribution of scrub typhus cases in Jiangsu province had obvious temporal clustering and cases occurred primarily from October to November in each year. The spatial scan analysis results showed that the distribution of cases had obvious spatial clustering; the spatial clustering areas during 2008-2017 had an expanding tendency from middle east to west, south, and north, and the radiation radius of the clustering areas and the number of covered districts or counties all reached the maximum during 2014-2016. Spatiotemporal scan analysis found one clustering area with high incidence from October 2013 to December 2017; its center was Jianhu county of Yancheng, and the radiation radius was 166.68 km (risk ratio=14.45, log-likelihood ratio=6 295.90, P<0.01). Conclusion The distribution of scrub typhus cases in Jiangsu province shows clustering in both dimensions of time and space, and the number of clustering areas with high incidence increases gradually. It should be considered to strengthen the monitoring of scrub typhus and the prevention and control of scrub typhus in key areas.

Key words: Scrub typhus, Spatiotemporal clustering, Spatial autocorrelatio

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