基于空间自相关和时空扫描统计量的重庆市荣昌区HIV/AIDS病人聚类研究

Autocorrelation and spatiotemporal clusters of HIV/AIDS patients in Rongchang District,Chongqing

目的了解2014—2019年重庆市荣昌区艾滋病病毒(human immunodeficiency virus,HIV)感染者和艾滋病(acquired immune deficiency syndrome,AIDS)病人(简称HIV/AIDS)的时空分布和聚类特征,为相关部门明确艾滋病防控重点及合理配置医疗卫生资源提供参考依据。方法在全国艾滋病综合防治信息系统选择2014—2019年现住址为重庆市荣昌区的HIV/AIDS新发病例信息,导入GeoDa 0.95i软件进行空间经验贝叶斯平滑和空间自相关分析,导入Satscan 9.3软件进行时空扫描分析;采用地理信息系统(GIS)实现结果的可视化展示。结果2014—2019年,荣昌区累计报告HIV/AIDS新发病例1476例,各年报告的≥50岁病例数占全部病例的58.74%~68.92%,,并呈逐年上升趋势(χ趋势2=4.524,P=0.033)。各年HIV/AIDS报告率空间分布均存在正向自相关性(Moran’s I>0,P<0.05)。局域空间自相关和时空扫描统计量综合分析显示城区(昌元街道、昌州街道)和邻近的峰高街道、万灵镇、直升镇等乡镇(街道)为荣昌区AIDS流行地区。结论荣昌区HIV/AIDS新发病例在地理空间分布上存在聚集性,各级政府应重点加强城区和邻近城乡结合部热点区域流动人口HIV的监测以及中老年人群和低档暗娼人群艾滋病的干预力度,同时进一步规范各级医疗机构艾滋病随访管理工作,防止热点区域的扩大和HIV/AIDS的蔓延。

Objective To analyze the spatiotemporal distribution and clusters characteristics of human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)patients in Rongchang District of Chongqing from 2014 to 2019,we provide reference for relevant departments to clarify the focus of AIDS prevention and control and rationally allocate medical and health resources.MethodsNewly identified HIV/AIDS in Rongchang Area from 2014 to 2019 were selected from the National HIV/AIDS Comprehensive Information System.We inputted data into GeoDa 0.95i software for carry out spatial empirical bayesian smoothing and autocorrelation analysis,and into Satscan 9.3 software for statistical analysis of spatial scanning,and finally geographic information system was used for visualization.ResultsA total of 1476 new cases of HIV/AIDS were reported in Rongchang District during 2014-2019.The proportion of cases over the aged≥50 years reported in each year ranged from 58.74%to 68.92%,and increased year by year(χtrend2=4.524,P=0.033).There was a positive spatial autocorrelation in the spatial distribution of the HIV/AIDS reporting rate for each year(Moran’s I>0,P<0.05).The areas with the most serious HIV/AIDS epidemics,including urban areas(Changyuan Street,Changzhou Street)and the neighboring Fenggao Street,Wanling Town,Zhisheng Town and other towns(streets)in the east were Rongchang AIDS-endemic areas,were identified with both the local Moran’s I index and spatiotemporal scan statistics.Conclusion were identified in HIV/AIDS cases in Rongchang District.For the further prevention and control of the hot-spot regions expanding,the government must strengthen monitoring of the migrating population in hotspots,and strengthen AIDS interventions for middle-aged and elderly people and low-fee sex workers,while further standardize the follow-up management of AIDS in medical institutions at all levels.