2011年北京市丰台区手足口病流行特征与时空聚集性分析

Space-time cluster analysis of hand, foot and mouth disease in Fengtai district of Beijing in 2011

目的描述2011年北京市丰台区手足口病流行病学特征，寻找手足VI病在丰台区可能存在的时空聚集区。方法利用中国疾病预防控制信息系统上报的2011年手足口病监测数据及丰台区2011年人口统计数据，描述丰台区手足1：3病流行病学特征，并基于离散型泊松分布模型，利用SaTSean8．0软件进行时空扫描分析，从时间和空间二维角度寻找手足口病在丰台区的高发时空聚集区。通过利用AreGIS10．0软件呈现手足口病时空聚集区域。结果2011年，丰台区报告的手足口病病例数为4249例，发病率为201．18／10^5，发病高峰呈双峰分布。花乡地区手足口病的发病率较高。散居儿童与托幼儿童发病基本持平，男性的发病率高于女性。所有病例中，5岁以下儿童所占的比例为90．56％。时空扫描结果显示，最可能聚集时间分布在6月、7月、11月的某时段，一类聚集区位于丰台区中南部，二类聚集区位于丰台区中西部及东部，均为外来人口聚集区域，且部分是出于拆迁环境改造区域，卫生环境较差，通过与实际聚集区域比对，扫描聚集区均与实际发生聚集疫情的发生时间和具体区域相符合。结论时空扫描分析方法可以非常好地应用于丰台区手足口病的高发重点区域分析，可为以后开展针对性的预防控制措施，提供科学参考依据。

Objective To describe the epidemiological characteristics of the hand-foot-mouth disease （HFMD） in 2011 in Fengtai district of Beijing, and to explore the space-time characteristics of HFMD to detect the potential space-time clusters. Methods Epidemiological data of HFMD cases reported in 2011 was obtained from the national disease prevention and control system.. Demographic data were obtained from Fengtai district annual reports 2011. These data were analyzed to describe the epidemiological charac- teristics of HFMD in Fengtai district, and to detect the potential spatial-temperal clusters using SaTScan 8.0 software. These clusters were then demonstrated using the software ArcGIS 10. 0. Results 4244 cases of HFMD were reported in Fengtai District in 2011, with the incidence rate of 201.18/105. The daily inci- dence rate of HFMD showed a bimodal distribution. The prevalence of HFMD in Hua-xiang and the Marco Polo Bridge was higher than other sub-districts. The incidence of the scattered children is similar to that of the kindergarten＇ s children . Male is more likely to be infected with HFMD. 90. 56% of the HFMD cases were under the age of five years. The space-time scan results shows ： gathered time distribuied in a period of June, July and November, Grade-I gathering areas located in Central and southern region of Fengtai District, Grade-II gathering areas located in western and eastern region. These gathering areas were outside population living centers and there were poor sanitary conditions. Compared with the actual clustering areas, the scan resuits were consistent with the actual gathering areas. Conclusions The spatial-temperal scan analysis method showed a good performance in the detection of the spatial-temperal clusters.