基于时空核估计方法识别2018年新疆维吾尔自治区手足口病发病的高风险时空区域

Identification of high-risk spatio-temporal areas for the incidence of hand, foot and mouth disease in Xinjiang in 2018 based on a spatio-temporal kernel estimation method

目的描述2018年1月-2018年12月新疆维吾尔自治区(简称新疆)手足口病(hand, foot and mouth disease, HFMD)发病风险的时空变化,识别新疆HFMD的高风险时空区域,为今后HFMD的防治提供参考依据。方法收集2018年1月-2018年12月新疆100个市县(市辖区)HFMD的发病数据,描述数据三间分布的特征;使用本文所提出的时空核估计(spatio-temporal kernel estimation, STKE)方法探测高风险时空区域,并与传统时空扫描分析方法的结果进行对比。结果 2018年1月-2018年12月新疆100个市县(市辖区)HFMD年发病率为45.01/10万,病例男女性别比例为1.49∶1;0~5岁儿童为主要的发病人群,占全部病例的80.16%;病例主要来源于幼托儿童和散居儿童,分别占总病例数的45.76%和43.94%。基于STKE方法识别出的高风险时空区域主要包含了两个高峰时段(5-7月、9-11月)及一个变化的高风险空间区域(新疆东北部),时空扫描结果验证了该方法的可行性。结论新疆HFMD的发生存在时间、空间及人群差异,建议加大对HFMD高峰时段及高发地区的防控力度,增强家庭、幼托机构等对0~5岁婴幼儿的预防措施,以降低HFMD发病风险。

Objective The study aimed to describe spatial and temporal changes in the incidence risk of hand, foot and mouth disease(HFMD) in Xinjiang Province from January to December 2018, to identify high-risk spatio-temporal areas for HFMD, and to provide a reference for the prevention and control of HFMD in the future. Methods Data on the incidence of HFMD in 100 Cities and Counties(municipal Districts) in Xinjiang Province from January to December 2018 were collected to describe the characteristics of the three-way distribution of the data;the spatio-temporal kernel estimation method proposed in this paper was used to detect high-risk spatio-temporal regions, and the results were compared with those of the traditional spatio-temporal scanning analysis method. Results From January to December 2018, the annual incidence rate of HFMD in 100 Cities and Counties(municipal Districts) in Xinjiang Province was 45.01/100 000, with a male-to-female sex ratio of 1.49∶1;children aged 0-5 years were the main incidence group, accounting for 80.16% of all cases;cases mainly originated from children in early childhood care and children living in the diaspora, accounting for 45.76% and 43.94% of the total number of cases, respectively. The high-risk spatio-temporal regions identified based on the spatio-temporal kernel estimation method mainly contained two peak periods(May to July and September to November), and a changing significant high-risk spatial region(northeast of Xinjiang Province), and the spatio-temporal scan results verified the feasibility of the method. Conclusions There are significant temporal, spatial and population differences in the occurrence of HFMD in Xinjiang Province. It is suggested to strengthen the prevention and control of HFMD in peak hours and high incidence areas, and strengthen the preventive measures of families and kindergartens for infants aged 0-5 years, to reduce the risk of HFMD.