2008—2018年中国手足口病时空分异特征

Spatial-temporal Heterogeneity of Hand, Foot and Mouth Disease in China from 2008 to 2018

手足口病是一种在婴幼儿中多发的常见传染病,对儿童的身体健康具有重要影响。为揭示我国手足口病的时空分异特征,为手足口病的防控提供科学依据,本文选取自2008年手足口病被列为丙类传染病以来至2018年中国手足口病发病率为研究数据,运用全局莫兰指数、Getis-Ord Gi*、新兴时空热点分析和标准差椭圆等空间统计方法对中国手足口病的整体和局部时空分布模式、特征和趋势进行了分析。结果显示:(1) 2008—2018年我国手足口病发病率呈现显著的空间聚集性,且聚集的强度显著增高;(2)我国手足口病发病的热点区域主要集中在东南沿海地区,且较明显向内陆以及北部沿海地区扩张,而冷点区域主要集中在西北内陆以及东北地区;(3)我国手足口病的新兴时空热点模式以振荡的热点为主,新增热点主要出现在云南、重庆和四川,而冷点分布区域相对稳定,且冷点大部分以加强的、持续的模式出现;(4)手足口病高发病率区域在2008—2018年期间主要向西南方向移动,但在2008—2009年、2013—2014年以及2017—2018年存在向北部移动的趋势,同时2018年手足口病在东—西方向上的分布范围显著增大。总体来说,我国手足口病在南方地区高发。

Hand, Foot and Mouth Disease(HFMD) is a common infectious disease in infants and children and has an important impact on their health. In order to reveal the spatiotemporal heterogeneity of HFMD in China and provide a scientific basis for the prevention and control of HFMD, we select HFMD from 2008(when HFMD was listed as category C infectious disease) to 2018 as the study period and apply spatial statistical methods including Moran’s I, Getis-Ord Gi*, emerging hot spots analysis, and standard deviational ellipse to analyze the general and local spatiotemporal variation and trend of HFMD in China. Results show that:(1) from2008 to 2018, HFMD exhibits a spatial clustering pattern and the intensity of the clustering increases significantly over time;(2) the hot spots of HFMD mainly concentrate in the southeast coast and gradually expand towards inland and northern coastal areas. The cold spots mainly concentrate in the northwest inland and the northeast;(3) the emerging hot spots in China's Mainland mainly occur in Yunnan, Chongqing, and Sichuan provinces, while the emerging cold spots mostly locate in the same regions with the persistent cold spots. Stable hot spots mainly locate in Hainan province in southern China;and(4) high incidence rate of HFMD mainly occurs in the southwest during 2008 and 2018 and gradually occur in the north during 2008-2009, 2013-2014, and2017-2018. In general, HFMD remains primarily in the south of China. This pattern remains relatively stable throughout the years of observation, indicating that public intervention should be strengthen in the south of China. However, the underlying mechanism of the spatiotemporal distribution of HFMD in China still needs further investigation. Combination of multiple scientific disciplines such as geography, spatial statistics, virology, molecular biology, and public health provides multi-perspectives that can aid the research on the underlying mechanism of HFMD transmission.