浙江省2016—2020年梅毒流行时空特征分析

Spatiotemporal distribution characteristics of syphilis in Zhejiang province,2016—2020

目的分析浙江省2016—2020年梅毒疫情时空分布特征,探测聚集区域,为梅毒精准防控提供理论依据。方法从中国疾病预防控制信息系统传染病监测系统个案管理模块导出浙江省2016—2020年网络直报的梅毒病例,利用Arcgis10.2软件作为数据管理和呈现平台,建立浙江省2016—2020年梅毒空间分析数据库,对梅毒疫情进行空间自相关分析,采用SaTScan 9.6软件进行时空扫描分析。结果浙江省2016—2020年共报告梅毒158420例,各县区年均报告发病率49.07/10万(20.52/10万~124.29/10万),空间分布总体表现为西部较高、中部较低的态势。全局自相关分析结果显示,各年梅毒报告发病率Moran′s I指数均>0,Z值均>1.96,P值均<0.001,提示梅毒疫情呈聚集性分布。局部自相关分析显示,浙江省存在2个空间相近的高-高聚集区域(杭州市桐庐县和淳安县,丽水市景宁县)和1个低-低聚集区域(金华市金东区、东阳市、永康市)。局部G统计量热点分析结果显示,浙江省梅毒疫情存在6个正热点区域和8个负热点区域。SaTScan时空扫描探测到3个聚集区域,主要集中在东部沿海的台州市、舟山市以及西南部山区部分县区。结论浙江省梅毒报告发病率存在一定的空间聚集性特征,今后应加强西南部山区及东部海岛等交通欠发达和偏远地区的梅毒防控工作。

Objective To analyze spatiotemporal distribution characteristics of syphilis in Zhejiang province from 2016 to 2020,to explore cluster areas of syphilis cases,and to provide a theoretical basis for accurate prevention and control of syphilis.Methods Data on reported syphilis cases in Zhejiang province from 2016 to 2020 were collected from the notifiable infectious disease surveillance system in China Disease Control and Prevention Information System.The ArcGIS10.2 software was used as a data management and presentation platform to establish a database for spatial analysis of syphilis in Zhejiang province from 2016 to 2020,and spatial autocorrelation analysis of reported syphilis incidence was conducted.The SaTScan 9.6 software was used for spatiotemporal scanning analysis.Results A total of 158420 cases of syphilis were reported in Zhejiang province from 2016 to 2020,and the average annual reported incidence rate was 49.07 per 100000 in all counties and districts(range:20.52 per 100000-124.29 per 100000).The overall spatial distribution pattern of syphilis cases in Zhejiang province was characterized by higher reported syphilis incidence in the West area and lower incidence in the middle area.Global autocorrelation analysis showed that all the global Moran′s I indices from 2016 to 2020 were over 0,Z values were over 1.96,and P values were below 0.001,suggesting the spatial clustering of reported syphilis cases.Local autocorrelation analysis showed that there were 2 high-high clustering areas(Tonglu and Chun′an counties in Hangzhou city,Jingning county in Lishui city),and 1 low-low clustering area(Jindong district,Dongyang and Yongkang county-level cities in Jinhua city).Local hot-spot analysis with G statistic showed that there were 6 positive hot-spot areas and 8 negative hot-spot areas of syphilis cases in Zhejiang province.SaTScan spatiotemporal scanning analysis revealed 3 clustering areas,mainly distributed in Taizhou and Zhoushan cities along the eastern coast,and some counties and districts in the southwestern mountainous areas.Conclusions The reported incidence rate of syphilis in Zhejiang province is characterized by spatial clustering.In the future,prevention and control of syphilis should be strengthened in southwestern mountainous areas,eastern islands,and other remote areas as well as areas with poor transportation.