2015年四川省甲型肝炎空间流行病学特征分析

Spatial Analysis on Hepatitis A in Sichuan Province in 2015

目的运用空间统计学的方法描述并探讨2015年四川省甲型病毒型肝炎(甲肝)发病的空间分布特征,为制定预防控制措施提供科学依据。方法通过《中国疾病预防控制信息系统》采集2015年四川省分县(区、市)人口数和甲肝发病数,使用Arc GIS软件制作地图,建立甲肝发病地理信息数据库。采用空间统计软件分析四川省甲肝发病的空间相关性和聚集性特征。结果 2015年四川省共报告甲肝发病数2 387例,报告发病率为2.93/10万,无死亡。甲肝报告发病为非随机分布,存在空间自相关性(P=0.001)。局部自相关发现区域内存在"高-高"(分布于甘孜州和凉山州两个民族地区17个县)、"低-低"(分布于成都市、绵阳市等地区的25个县区)和"低-高"(分布于金川县、炉霍县等6个县)关联模式(P<0.05)。时空扫描结果显示,甲肝发病有3个高发聚集区域,最大的聚集区覆盖16个县,聚集时间为5~10月(LLR=433.74,RR=7.91,P<0.01);次级聚集区覆盖17个县,聚集时间为6~11月(LLR=113.39,RR=7.15,P<0.01);第三个聚集区覆盖6个县,聚集时间为3~6月(LLR=27.48,RR=2.5,P<0.01)。结论 2015四川省甲肝报告发病存在空间自相关性,时空扫描结果提示我省经济发达地区存在甲肝病毒感染发病和暴发的风险,建议加强疾病监测和数据挖掘利用;鼓励成年人接种甲肝疫苗,减少发病以及易感人群逐渐积累而导致甲肝疫情的暴发。

Objective To explore spatial distribution characteristics of hepatitis A in Sichuan province in 2015, and provide evidence for hepatitis A prevention and control. Methods The population and incidence of hepatitis A in Siehuan were obtained from national disease reporting information system, and ArcGIS software was used to make the spatial distribution map for geographic information database building. Spatial statistic software was used to analysis the spatial autocorrelation and clustering of hepatitis A incidence, and the result appeared in Earth Google. Results There were 2 387 ease and no death were reported totally of hepatitis A in Sichuan province in 2015, and the reported incidence rate was 2.93/10 -5. Reported hepatitis A incidence of Sichuan in 2015 had spatial autocorrelation statistically （P = 0. 001 ）. Local spatial autocorrelation analysis identified high- high pattern area （including 17 counties in Ganzi Tibetan autonomous prefecture and Liangshan Yi autonomous prefecture） , low - low pattern area （ including 25 counties of Chengdu, Mianyang city etc. ）, and low - high pattern area （ 6 counties including Jinchuan, Luhuo county etc. ） （P 〈 0. 05 ）. SatScan statistics results indicated that there were 3 high - risk gathering areas. The mostly clustering area of high hepatitis A incidence covers 16 counties, and the clustering time is May to October （LLR = 433.74, RR = 7.91, P 〈 0. 01 ）. The secondary clustering area covers 17 counties, and the clustering time is June to November （LLR = 113.39, RR = 7. 15, P 〈 0. 01 ）. The last clustering area covers 6 counties, and the clustering time is March to June （LLR =27.48, RR =2. 5, P 〈0. 01 ）. Conclusion Reported hepatitis A incidence of Sichuan in 2015 exists spatial autoeorrelation. SatScan statistics results indicated that there exists the risk of HAV infection and outbreak in the developed area in our province. Therefore, we suggest that we should strengthen disease surveillance and data mining, and encourage adults vaccinating hepatitis A to reduce the risk of infected and outbreak of hepatitis A.