浙江省2010-2019年甲型肝炎流行特征和时空聚集性分析

Epidemiological characteristics and spatiotemporal clustering of hepatitis A in Zhejiang Province from 2010 to 2019

目的分析浙江省2010—2019年甲型病毒性肝炎(甲肝)的流行与时空分布特征。方法通过中国疾病预防控制信息系统传染病监测系统报告的2010—2019年浙江省甲肝病例,基于三间分布描述甲肝流行性特征。采用ArcGIs 10.7软件进行空间自相关分析,基于SaTScan 9.6软件进行时空扫描分析,采用SPSS 25.0软件进行数据分析。结果浙江省2010—2019年累计报告甲肝病例5465例,年均报告发病率1.00/10万,周期性和季节性发病不明显。男性发病率高于女性(P=0.023),发病率最高的年龄组为50~59岁。空间自相关分析显示:2010—2017年间浙江省甲肝发病存在空间相关性,其中2010年相关性最弱(Moran′s I=0.103,Z=1.769,P=0.049),2016年相关性最强(Moran′s I=0.328,Z=4.979,P=0.001)。时空扫描统计结果显示,2010—2019年浙江省甲肝发病存在空间聚集性,共识别到3个聚集区,其中一级聚集区以宁波市象山县为中心,覆盖了包括宁海县、鄞州区等在内的10个县(市、区),聚集时间为2012年1月1日至6月30日。结论2010—2019年浙江省甲肝发病水平呈现平稳波动的趋势,季节性规律不明显,50~59岁人群组为发病重点人群。甲肝疫情存在空间聚集性,应基于时空聚集规律和当地发病情况做好针对性甲肝防控工作。

Objective To analyze the epidemiological characteristics and spatiotemporal clustering of hepatitis A in Zhejiang Province from 2010 to 2019.Methods The data of hepatitis A incidence in Zhejiang Province from 2010 to 2019 were collected from the infectious disease surveillance system of China Information System for Disease Control and Prevention.ArcGIS 10.7 software was used for spatial autocorrelation analysis.SaTScan 9.6 software was used for spatiotemporal scanning analysis.SPSS 25.0 software was used for additional analysis.Results Zhejiang Province has reported 5465 cases of hepatitis A in 2010-2019 years,with an average annual incidence rate of 1.00/100000,and periodicity and seasonality are not obvious.The incidence of male was higher than that of female(P=0.023),and the highest incidence rate was 50-59 years old.Spatial autocorrelation analysis showed that there was a positive spatial correlation between the incidence of hepatitis A in Zhejiang Province from 2010 to 2017,with the weakest correlation in 2010(Moran′s I=0.103,Z=1.769,P=0.049),and the strongest correlation in 2016(Moran′s I=0.328,Z=4.979,P=0.001).Spatiotemporal scanning analysis showed that there was spatial aggregation of hepatitis A in Zhejiang Province from 2010 to 2019,with a total of three aggregation areas identified.Among them,the mostly aggregation area was concentrated in Xiangshan county of Ningbo city,which covered 10 counties(cities and districts),including Ninghai county and Yinzhou district,and appeared from January 1 to June 30,2012.Conclusion The incidence level of hepatitis A in Zhejiang Province shows a stable fluctuation trend from 2010 to 2019,and the seasonal regularity is not obvious.The population group aged 50-59 years old is the key population.There is spatial aggregation in the epidemic situation of hepatitis A.Targeted prevention and control measures of hepatitis A should be done based on the law of spatiotemporal aggregation and local incidence.