福建省2011—2016年人间布鲁氏菌病流行病学分析和时空聚集探测

Analysis on epidemiology and spatial-temporal clustering of human brucellosis in Fujianprovince, 2011-2016

目的 分析2011-2016年福建省人间布鲁氏菌病（布病）流行病学和时空特征，为制定预防控制策略提供依据。方法 采用R 3.3.1、ArcGIS 10.3.1、GeoDa 1.8.8、SaTScan 9.4.3等软件对福建省2011-2016年布病监测数据进行流行病学分析。结果 2011-2016年福建省共报告布病319例，年均发病率为0.14/10万，年度间发病率呈上升趋势（F=11.838，P=0.026）。男女性发病率比为2.50：1。农民和牧民占比为57.37%。漳州市和南平市发病率居前，分别为0.40/10万和0.32/10万。发病区（县）数呈增加趋势（F=13.447，P=0.021），由2011年的12个增加到2016年的28个。福建省2011-2016年布病发病全局Moran＇s I为正值（0.045），提示有高值或者低值聚集区的存在。局部空间自相关分析得出，高-高（热点）聚集区域分布在漳浦、龙海、龙文等地，高-低聚集区域分布在南安和蕉城等地。时空扫描显示，高发病率区存在3个聚集区，最大可能聚集区以漳浦县为中心，覆盖了云霄、平和、龙海等6个区（县），聚集时间为2013年1月1日至2015年12月31日（RR=7.96，LLR=92.62，P〈0.001）。结论 福建省布病疫情趋于严峻，并向非疫区和一般人群蔓延；重点区域的布病防控工作应进一步加强。

Objective To analyze the epidemiological characteristics and spatial distribution of human brucellosis in Fujian province during 2011-2016, and provide evidence for the prevention and control of the disease. Methods The surveillance data of human brucellosis in Fujian during 2011-2016 was analyzed with software R 3.3.1, ArcGIS 10.3.1, GeoDa 1.8.8 and SaTScan 9.4.3. Results During 2011-2016, a total of 319 human brucellosis cases were reported, the incidence increased year by year （F=11.838, P=0.026） with the annual incidence of 0.14/100 000. The male to female rate ratio of the incidence was 2.50：1. Farmers and herdsmen accounted for 57.37%. The incidence was 0.40/100 000 in Zhangzhou and 0.32/100 000 in Nanping, which were higher than other areas. The number of affected counties （district） increased from 12 in 2011 to 28 in 2016, showing a significant increase （F=13.447, P=0.021）. The Moran＇s I of brucellosis in Fujian between January 2011 and December 2016 was 0.045, indicating the presence of a high value or low value clustering areas. Local spatial autocorrelation analysis showed that, high-high clustering area （hot spots） were distributed in Zhangpu, Longhai, Longwen, etc, while high-low clustering areas were distributed in Nan＇an and Jiaocheng, etc. Temporal scanning showed that there were three clustering areas in areas with high incidence, the most possible clustering, occurring during January 1, 2013-December 31,2015, covered 6 counties, including Yunxiao, Pinghe, Longhai, etc, and Zhangpu was the center, （RR=7.96, LLR=92.62, P〈0.001）. Conclusions The epidemic of human brucellosis in Fujian is becoming serious, and has spread to general population and non-epidemic areas. It is necessary to strengthen the prevention and control of human brucellosis in areas at high risk.