Flexible 空间与 Kulldorff 圆形扫描统计量在甲型肝炎空间聚集性探测中的比较研究

Compare the application of flexible spatial statistics and kulldorff scanning window statistics to spatial aggregation of hepatitis A

目的：比较Flexible空间与Kulldorff圆形扫描统计量在甲型肝炎聚集性探测及其早期预警中的应用价值。方法通过中国疾病预防控制信息系统收集云南省2012年129个县（区）1335例甲型肝炎患者的发病数据。以月份提取时间长度，分别采用Flexible空间扫描统计量和Kulldorff圆形扫描统计量对甲型肝炎发病情况进行空间聚集性分析，并对两种分析结果进行比较。结果Flexible不规则形状扫描统计量空间聚集性分析结果显示，在2012年云南省全省共有15个甲型肝炎空间聚集性区域，其中2012年7月，包括个旧市、蒙自县、文山县在内的区域的聚集性最强[对数似然比（ LLR）＝52．66，P＝0．001]。Kulldorff圆形扫描统计量的分析结果显示，共有20个甲型肝炎空间聚集性区域，其中2012年7月，个旧市、河口县、马关县、蒙自县、屏边县、文山县的聚集性最强（ LLR＝47．82，P＝0．001）。 Flexible不规则形状扫描统计量探测出的发病聚集性区域均与实际监测结果一致，而Kulldorff圆形扫描统计量在5、6月探测出实际发病例数为0的地区有聚集性的发生。聚集性最多覆盖的区域数为5和15时的探测结果显示：与聚集性最大覆盖的区域数为5时比较，最大覆盖的区域数为15时，Flexible不规则扫描统计量探测结果增加了沧源县、耿马县、澜沧县、临翔区和云县；Kulldorff圆形扫描统计量探测结果增加了沧源县、耿马县、临翔区、龙陵县、施甸县、双江县、永德县、云县和镇康县。结论 Flexible 不规则扫描统计量可以逐月探测出甲型肝炎的空间聚集性， Flexible空间扫描统计量探测的准确性优于Kulldorff圆形窗口扫描统计量。

Objective To compare the application valuable of flexible spatial scan statistics and kulldorff scanning window in the cluster detection and early warning of hepatitis A.Methods The case numbers and incidence data of hepatitis A in 2012 for all the counties（ cities, districts） in Yunnan province were collected from China Information System for Disease Control and Prevention and the total number was 1 335.By extracting the time length by month, the flexible spatial scan statistics was tested by retrospective analyses of hepatitis A data in Yunnan in 2012 and compared the results with the Kulldorff circular scan statistic analyses.Results The results of flexible scanning window showed that there were fifteen hepatitis A spatial clusters in Yunnan province in 2012 and in July, these areas including Gejiu county, Mengzi county and Wenshan county had the strongest clusters（the log likelihood ratio（LLR） =52.66,P=0.001）. The results of Kulldorff scanning window showed that there were twenty hepatitis A spatial clusters and these areas including Gejiu county, Hekou county, Maguan county, Mengzi county, Pingbian county, Wenshan county had the strongest clusters （LLR=47.82,P=0.001）.The results of the flexible scanning window were the same as the actual monitoring results.But the results of Kulldorff scanning window showed that in May and June some areas without incidence had the clusters.Conclusion Flexible scanning window can detect the monthly clusters of the Hepatitis A.Flexible scanning window had a higher accuracy than Kulldorff irregular circular scanning window. Flexible spatial scan statistics had the value in the use of spatial aggregation detecting on hepatitis A.