甘肃省2016-2018年法定报告性传播疾病空间分布特征及聚集性分析

Spatial distribution and clustering of notifiable sexually transmitted diseases in Gansu province from 2016 to 2018

目的分析2016-2018年甘肃省三种性病报告发病/感染率的空间分布特征及聚集性,为疫情防控策略的制订及调整提供参考依据。方法应用ArcGIS10.5软件绘制2016-2018年三种性病报告发病/感染率地理分布图,采用GeoDa1.60软件进行全局和局部自相关分析,通过SaTScan 9.1软件进行时空扫描分析。结果 2016-2018年梅毒、艾滋病呈明显空间聚集性分布。梅毒热点区域分布在甘南州的4个县(市);冷点区域主要分布在甘肃东南部的11个县(区)。艾滋病热点区域分布在兰州市的6个县(区)及其周边的2个县;冷点区域主要分布甘肃西部、南部的13个县(区)。时空扫描分析结果显示,三种性病均呈较明显的时空聚集性。梅毒主要聚集区有1个,位于甘南州的3个县,时间为2018年;次要聚集区有6个,分布在甘肃中东部的13个县(区),时间为2017-2018年;艾滋病主要聚集区有1个,位于兰州市的3个区,时间为2018年;次要聚集区有2个,分布在甘肃东部的2个区,时间为2016-2017年;淋病主要聚集区为甘南州碌曲县,时间为2018年;次要聚集区有4个,分布在甘肃中西部的6个县(区),时间为2017-2018年。结论 2016-2018年甘肃省三种法定报告性传播疾病报告发病/感染率呈现上升趋势,且存在明显的时空聚集性。应根据疫情的空间分布特征调整、制订区域化防控策略。

Objective To provide evidence for making and adjusting the strategies of epidemic prevention and control through analysis of the spatial distribution and clustering of STDs in Gansu province from 2016 to 2018.Methods ArcGIS 10.5 software was used for visualizing the geographic distribution of reported incidence from 2016 to2018, global and local autocorrelation analysis was conducted by using GeoDa1.60 software, and spatio-temporal scanning analysis was carried out through the SaTScan9.1. Results Obvious spatial aggregation distribution were found though spatiotemporal analysis of syphilis and AIDS. Syphilis hotspots were clustering in 4 counties of the Tibetan autonomous prefecture of Gannan and coldspot areas were mainly located in 11 counties in the southeast of Gansu. Moreover, the hotspot areas of AIDS clustering in 6 counties of Lanzhou and other 2 counties around it, while the coldspots were located in 13 counties in the southwest of Gansu. Spatio-temporal scanning analysis showed that the three STDs revealed significant spatiotemporal aggregation. The spatiotemporal scanning of syphilis revealed one first-level cluster area in 3 counties of Gannan in 2018, and 6 second-level cluster areas in 13 counties in the mid-east of Gansu during 2017-2018.There was one first-level cluster area of AIDS in 3 districts of Lanzhou in 2018 and 2 second-level cluster areas in the east of Gansu between 2016 and 2017. The main gonorrhea cluster area Luqu county in 2018 and 4 second-level cluster areas were distributed in 6 counties of the mid-east of Gansu during 2017-2018. Conclusion All of the incidence rate of syphilis, AIDS and gonorrhea were increasing from 2016 to 2018, and show distinctive spatiotemporal aggregation. We should adjust our prevention and control strategies according to different epidemic spatial distribution characteristics.