甘肃省2009-2013年肺结核发病的时空聚集性研究

Spatial-temporal specific incidence of pulmonary tuberculosis in Gansu, 2009-2013

目的 分析2009-2013年甘肃省肺结核报告发病率的时空及发病聚集区分布特征.方法 采用空间统计学方法,利用2009-2013年甘肃省肺结核报告发病率数据,以区（县）水平计算其空间分布的全局、局部自相关系数,并分析时空分布特征.结果 2009-2013年甘肃省肺结核报告发病率存在空间相关性（P＜0.001）;局部G统计量分析显示热点区域主要分布于河西地区、临夏州、定西部分县区（渭源县、漳县、岷县、安定区）,冷点区域主要分布于兰州市、定西地区部分县区（陇西县、通渭县）、天水市、平凉市及庆阳市部分县区;时空分析结果显示,2009-2013年甘肃省肺结核报告发病率存在时空聚集性,高发病率最大可能聚集区分布于河西地区,聚集时间为2009-2010年（LLR=3 031.10,RR=2.27,P＜0.001）,低发病率最大可能聚集区分布于兰州市,聚集时间为2011-2013年（LLR=1 545.52,RR=0.37,P＜0.001）.结论 2009-2013年甘肃省肺结核报告发病率存在空间和时空聚集区域,河西地区是甘肃省肺结核防控的重点地区.

Objective To understand the spatial-temporal specific incidence of pulmonary tuberculosis （TB） in Gansu.Methods The county-based incidence of pulmonary TB in Gansu from 2009 to 2013 was used to calculate Moran＆#39; s I and G statistics,and analyze the spatial-temporal distribution of areas with different pulmonary TB incidences.Results The spatial correlation in incidence of pulmonary TB was found in Gansu from 2009 to 2013 （P〈0.001）,and the hot spot areas were mainly in Hexi area,Linxia,part of Dingxi,while the cold spot areas were in Lanzhou,part of Dingxi,Tianshui,Pingliang and Qingyang.Spatial-temporal analysis showed that the clustering of high pulmonary TB incidence areas were most likely in the Hexi area during 2009-2010 （LLR=3 031.10,RR=2.27,P〈0.001）,and the clustering of low pulmonary TB incidence areas were most likely in Lanzhou during 2011-2013 （LLR=1 545.52,RR=0.37,P〈0.001）.Conclusion The analysis on spatial and spatial-temporal specific incidences of pulmonary TB in Gansu from 2009 to 2013 indicated that Hexi area is the key area in pulmonary TB prevention and control in Gansu.