2004-2018年中国戊型病毒性肝炎发病趋势和空间聚集性

Trends in incidence and spatial clustering of hepatitis E in China,2004-2018

目的了解中国戊型病毒性肝炎(戊肝)的发病流行趋势与空间分布特征。方法从中国疾病预防控制信息系统中获取2004-2018年全国戊肝报告发病数据,采用Arcgis10.3软件对戊肝发病率进行空间自相关分析。结果2004-2018年全国共报告戊肝358122例,年均发病率为1.78/10万,发病率从2004年的1.27/10万上升到2018年的2.06/10万(趋势x^2=5714.71,P<0.001),但北京、天津、河北、辽宁、吉林、黑龙江年发病率均呈下降趋势。全局自相关分析显示,全国2004-2018年各年戊肝发病率全局Moran’sI指数在0.14-0.27之间,均存在全局自相关。局部自相关分析显示,戊肝发病的"高-高"聚集区域由东北部沿海逐渐向东部和南部沿海及相邻地区发展。戊肝发病的热点区域从2004年的东北沿海向2018年的南部沿海地区逐渐转移。结论2004-2018年中国戊肝发病呈现显著的空间聚集性分布,需加强发病持续上升省份和沿海热点区域的戊肝联合防控工作。

Objective To analyze the spatial and temporal incidence of hepatitis E virus(HEV)infection in China.Methods We collected HEV incidence data reported to the China Information System for Disease Control and Prevention during 2004-2018,and analyzed spatial distribution and autocorrelation of HEV incidence using ArcGIS version 10.3.Results A total of 358122 HEV cases were reported in China during 2004-2018,for an average annual incidence of 1.78 cases per 100000 population.The annual incidence increased from 1.27 per 100000 in 2004 to2.06 per 100000 in 2018(Trend x^2=5714.71,P<0.001),while the annual incidence declined in Beijing,Tianjin,Hebei,Liaoning,Jilin,and Heilongjiang.Global spatial autocorrelation analysis showed that the global Moran’s I coefficients for HEV incidence during 2014-2018 ranged from 0.14 to 2.27,indicating global autocorrelation.Local spatial autocorrelation analysis showed that high-high clustering areas of HEV gradually moved from northeastern coastal to eastern and southern coastal and adjacent areas.Hot spots for HEV gradually moved from northeast coastal areas in 2004 to southern coastal areas in 2018.Conclusions Annual HEV incidence in China showed significant spatial clustering from 2004 to 2018.We need to strengthen prevention and control in provinces with increasing HEV incidence and in hot-spot coastal areas.