2012-2017年甘肃省甘南藏族自治州乙型肝炎时空聚集性分析

Spatial-temporal distribution of hepatitis B in Gannan Tibetan autonomous prefecture of Gansu, 2012–2017

目的分析甘肃省甘南藏族自治州(甘南州)2012-2017年乙型肝炎(乙肝)发病的时空聚集性分布规律,为当地乙肝的预防控制提供理论依据。方法利用2012-2017年甘南州乙肝报告发病率数据,计算其空间分布的全局、局部自相关系数,分析其空间聚集特征。结果 2012-2017年甘南州乙肝发病率存在空间相关性(P<0.05);局部自相关分析显示,"热点"区域主要分布于夏河县、碌曲县、玛曲县、卓尼县和合作市的部分乡镇;"冷点"区域主要分布于舟曲县、迭部县、卓尼县、临潭县和合作市的部分乡镇。时空分析结果显示乙肝发病存在时空聚集性,最大可能聚集区覆盖夏河县和碌曲县的部分乡镇,聚集时间为2012-2014年(RR=3.50,LLR=219.24,P<0.001)和2016年(RR=6.91,LLR=198.61,P<0.001);次级可能聚集区覆盖临潭县和卓尼县的部分乡镇,聚集时间为2012-2013年(RR=1.79,LLR=70.41,P<0.001)。结论甘南州乙肝发病率存在空间和时空聚集区域,应根据发病空间分布特点,制定相应的防控措施。

Objective To analyze the spatial-temporal distribution of hepatitis B in Gannan Tibetan autonomous prefecture of Gansu province and provide evidence for the prevention and control of hepatitis B.Methods The incidence data of hepatitis B in Gannan from 2012 to 2017 was used to calculate the global Moran’s I and local G statistics and analyze its spatial-temporal distribution characteristics.Results The incidence of hepatitis B showed spatial autocorrelation(P<0.05)from 2012 to 2017,and local autocorrelation analysis indicated that the hot spots areas identified were mainly in some townships of Xiahe,Luqu,Maqu,Zhuoni and Hezuo,while the cold spots areas were mainly in some townships of Zhouqu,Diebu,Zhuoni,Lintan and Hezuo.Spatial-temporal analysis showed that the most likely clustering areas of incidence of hepatitis B were in some townships of Xiahe during 2012–2014(RR=3.50,LLR=219.24,P<0.001) and some townships in Luqu in 2016(RR=6.91,LLR=198.61,P<0.001),followed by some townships of Lintan and Zhuoni during 2012–2013(RR=1.79,LLR=70.41,P<0.001).Conclusion The incidence of hepatitis B showed spatial and spatial-temporal clustering in Gannan from 2012 to 2017.Targeted prevention and control measures should be taken according to the spatial distribution of the disease.