聊城市手足口病多次感染病例时空分布特征

Time and spatial distribution characters on multiple infections of hand, foot and mouth disease in Li- aocheng City

目的运用空间自相关分析探究手足VI病多次感染病例空间分布的热点区域，探索地理分布特征，揭示聊城市手足口病多次感染流行规律，为手足口病的防治提供科学依据。方法使用Excel2003、Access2003软件建立数据库，筛选2008—2011年《中国疾病监测信息报告管理系统》中聊城市手足口病多次感染的病例。将ArcGIS9．3软件作为数据管理和分析平台，研究手足口病多次感染病例的空间分布规律及特点，并利用空间统计模块进行全局空间自相关分析和局部热点分析，综合反应疾病空间分布特征。结果2008年-2011年聊城市手足口病多次感染发生率为17．8％v，其空间分布多集中在平均发病率较高、人口流动性较大的地区；不同肠道病毒类型和同一肠道病毒均可引起多7欠感染，97％患者为不同病毒感染；多次感染发病人数在时问分布上与总发病人数基本一致，男性多于女性，3岁以下占89．6％，以散居儿童为主，3岁以上以托幼机构儿童为主；全局空间自相关Mo-ran’s I=0．28，11=4．91，P〈0．01；广义G统计量G=0．005，u（G）=5．45，P〈0．01，利用局部G统计量得出疾病分布聚集性，热点区域主要集中在茌平县和东昌府区。结论聊城市手足口病多次感染病例存在空间聚集性，强化热点区域的防控措施，对降低当地多次感染发生率具有重要意义。

Objective Using spatial autocorrelation analysis to explore the hot spot areas in the spatial distribution of hand, foot and mouth disease multiple infection, explore the characteristics of geo- graphic epidemics and reveal the epidemic law of multiple infection of hand, foot and mouth disease in L： iaopcheng city, so as to provide scientific basis for the prevention and treatment of hand, foot and mouth dis- ease. Methods Excel 2003 and Access 2003 software management database were used to screen multiple infection eases of hand ,foot and mouth disease in the China management system of disease surveillance re- ports from 2008 to 20i 1. ArcGIS9.3 software was used as data management and analysis platform to study the spatial distribution rules and characteristics of foot and mouth disease multiple infection cases, and spa- tial statistics module was used for overall spatial autocorrelation analysis and local hot spot analysis, and comprehensively respond to the spatial distribution of disease characteristics. Results The incidence rate of hand, foot and mouth disease multiple infection was 17.8 %o in Liaocheng city,2008 - 2011, and the spa- tial distribution was mostly concentrated in the areas with higher average incidence and larger population mi- gration; different types of enteroviruses and the same enterovirus could cause multiple infections, and 97% were different types of virus infection; the incidence of multiple infection in the temporal distribution was consistent with the total incidence, more in males than in females, those under 3 years of age accounted for 89. 6% , mainly scattered-living children, those above 3 years old were mainly children in childcare institu- tions ; overall spatial autocorrelation Moran＇s I = 0. 28, u = 4.91, P 〈 0.01 generalized G statistic G = 0. 005, u （G） = 5.45 ,P 〈0. 01, the use of local statistics derived the distribution of diseases aggregation, the hot areas were mainly concentrated in Chiping county and Dongchangfu district. Conclusion s The spa- tial distribution of HFMD in Liaocheng city was not random but cluster, strengthening the control measures in hot spots is very importance .