前瞻性时空重排扫描统计量法在深圳市流行性腮腺炎聚集性疫情早期预警中的应用

Application of prospective spatiotemporal rearrangement scan statistic to early warning of mumps clustering epidemic in Shenzhen city

目的分析前瞻性时空重排扫描统计量法应用于深圳市流行性腮腺炎疫情早期预警的效果,为传染病监测预警系统的完善提供科学依据。方法以深圳市为研究范围,以街道行政区域为研究尺度,使用SaTScan软件前瞻性时空重排扫描模型对深圳市2012年1月1日-12月31日流行性腮腺炎发病情况进行逐日模拟预警。根据国家疾病监测信息报告管理系统(大疫情系统)上报的病例个案信息、深圳市疾病控制信息管理系统(深圳系统)上报的聚集性疫情事件,核实模拟预警信息的真实性,计算模型的灵敏度、错误预警率、暴发探测时间、预警提前时间等指标。比较时空重排扫描模型和国家传染病自动预警系统(China Infectious Disease Automated-alert and Response System,CIDARS)时间序列模型、时空序列模型预警效果的差异。结果深圳系统2012年共上报29宗流行性腮腺炎聚集性事件,共计纳入深圳市2011年12月3日-2012年12月31日的流行性腮腺炎分析病例9756例,累计分析366次,其中P≤0.05的预警信号数为88条,被确认为阳性信号的有16次,模型的灵敏度为55.17%(16/29),错误预警率为81.82%(72/88)。暴发探测时间在0~22 d之间,平均6.25 d,中位数为4 d。预警提前时间在-12~41 d之间,平均9.75 d,中位数为5.5 d。CIDARS中2012年深圳市流行性腮腺炎时间序列预警信号发出319次,被判断阳性的2次,灵敏度为6.90%(2/29),错误预警率为99.37%(315/317),时空序列预警信号发出208次,被判断阳性3次,灵敏度为10.34%(3/29),错误预警率为98.56%(205/208)。时空重排扫描模型信号数比大疫情系统时间序列模型和时空序列模型预警分别下降72.41%和57.69%。时空重排扫描模型灵敏度显著高于大疫情系统中时间序列模型(P<0.001)和时空序列模型(P<0.001)。时空重排扫描模型的错误预警率显著低于CIDARS时间序列(P<0.001)和时空序列模型的错误预警率(P<0.001)。结论前瞻性时空重排扫描模型在深圳市流行性腮腺炎疫情中具有较好的早期预警效果。

Objective To analyze the effect of prospective spatiotemporal rearrangement scan statistic on the early warning of mumps epidemic in Shenzhen city,and to provide a scientific basis for improving infectious disease surveillance and warning system.Methods Taking Shenzhen city and the street administrative areas as the research scale,the prospective spatiotemporal rearrangement scan model of the SaTScan software was used to conduct daily simulated early warning on the incidence of mumps in Shenzhen city from January 1 to December 31 in 2012.According to the case information reported by the National Disease Surveillance Information Report Management System(hereinafter referred to as the pandemic system)and clustering epidemic events reported by Shenzhen Disease Control Information Management System(hereinafter referred to as the Shenzhen system),the authenticity of simulated early warning information was verified,and the sensitivity,error warning rate,outbreak detection time and advance warning time of the model were calculated.We compared the differences in warning effects of the spatiotemporal rearrangement scan model as well as the time series model and the space-time sequence model of China Infectious Disease Automated-alert and Response System(CIDARS).Results A total of 29 mumps aggregation events were reported by the Shenzhen system in2012.A total of 9,756 mumps analysis cases and 366 times of cumulative analysis from December 3,2011 to December 31,2012 in Shenzhen city were enrolled in this study,of which the number of warning signals with P<0.05 was 88,and 16 times were identified as positive.The sensitivity of the model was 55.17%(16/29),and the error warning rate was 81.82%(72/88).The outbreak detection time ranged from 0 to 22 days,with an average of 6.25 days and a median of 4 days.The advance warning time ranged from-12 to 41 days,with an average of 9.75 days and a median of 5.5 days.The time series warning signals were sent out for 319 times,and the positive ones were judged for 2 times,with a sensitivity of 6.90%(2/29)and an error warning rate of99.37%(315/317).The spatial and temporal sequence warning signals were sent out for 208 times and judged to be positive for 3 times,with a sensitivity of 10.34%(3/29)and an error warning rate of 98.56%(205/208).The number of warning signals in the spatiotemporal rearrangement scan model was 72.41%and 57.69%lower than that in the time series model and the space-time sequence model of the pandemic system,respectively.The sensitivity of the spatiotemporal rearrangement scan model was significantly higher than those of the time series model(P<0.001)and the space-time sequence model(P<0.001)of the pandemic system.The error warning rate of the spatiotemporal rearrangement scan model was significantly lower than those of the time series model(P<0.001)and the space-time sequence model of CIDARS(P<0.001).Conclusions The prospective spatiotemporal rearrangement scan model has a better early warning effect in mumps epidemic in Shenzhen city.