山东省克山病发病空间分布特征分析

Spatial distribution characteristics of Keshan disease in Shandong Province

目的探讨山东省克山病发病空间分布特征,为克山病防治提供参考依据。方法自山东省地方病防治研究所收集1960-2018年山东省克山病发病数据,构建空间数据库,分别采用ArcGIS 10.2和GeoDa 1.14软件进行全局及局部空间自相关分析(指标为Moran’’sI指数),并绘制局部空间关联指标(LISA)聚集图,分析山东省克山病空间分布的自相关性及聚集范围。结果1960-2018年山东省克山病共发病4172人,乡镇(街道、社区,以下简称乡镇)年发病率范围为0~51.4/万。全局空间自相关分析显示,1962-1964、1969-1985、1989、1995、1998-2001、2004-2016年乡镇水平全局Moran’’sI指数范围为0.020~0.429(P均<0.05),山东省克山病发病整体呈现空间自相关性。LISA聚集图显示,1960、1962-1964、1969-1985、1989、1998-2000、2002-2016年均存在克山病发病高-高(H-H)聚集,其主要分布在3个区域,包括鲁西南的邹城市、平邑县、泗水县,鲁东南的五莲县、莒县,鲁中及鲁中南的青州市、临朐县和沂水县。结论山东省克山病发病具有明显的空间自相关性,H-H聚集主要集中在鲁西南、鲁东南、鲁中及鲁中南的部分乡镇。

Objective To investigate the spatial distribution characteristics of Keshan disease in Shandong Province,and to provide evidence for prevention and control of Keshan disease.MethodsThe incidence data of Keshan disease in Shandong Province from 1960 to 2018 were collected from Shandong Provincial Institute for Endemic Disease Control and Prevention,and a spatial database was built.Global and local spatial autocorrelation(Moran's Ⅰ)were analyzed by ArcGIS 10.2 and GeoDa 1.14 softwares,respectively.Local indicators on spatial association(LISA)aggregation graph was drawn.This allowed us to investigate the spatial autocorrelation and cluster range of the distribution of Keshan disease in Shandong Province.Results A total of 4172 cases of Keshan disease were reported in Shandong Province with an annual incidence rate of O to 51.4/10000 of the population at the township-level from 1960 to 2018.Global spatial autocorrelation analysis on the incidence of Keshan disease at the township-level showed that global Moran's Ⅰ values ranged from 0.020 to 0.429 in 1962-1964,1969-1985,1989,1995,1998-2001 and 2004-2016(P<0.05),thus indicating significant spatial autocorrelation overall.LISA analysis further revealed that high-high clusters of Keshan disease existed in 1960,1962-1964,1969-1985,1989,1998-2000 and 2002-2016.These clusters were predominantly distributed in three areas:Zoucheng City,Pingyi County and Sishui County in the southwest of Shandong Province;Wulian County and Ju County in the southeast of Shandong Province;and Qingzhou City,Linqu County and Yishui County in the central and middlesouth of Shandong Province.ConclusionsKeshan disease exhibits significant spatial autocorrelation in Shandong Province.High-high clusters are mainly located in certain townships in the southwest,southeast,central and middle-south of Shandong Province.