2016-2020年浙江省一期与二期梅毒流行时空特征分析

Spatiotemporal distribution of primary and secondary syphilis in Zhejiang, 2016-2020

目的 分析2016—2020年浙江省一期与二期梅毒时空分布特征,探索疫情聚集区域,为制定梅毒精准防控策略提供依据。方法 从中国疾病预防控制信息系统导出2016—2020年现住址为浙江省的一期梅毒和二期梅毒病例,利用Arcgis10.8软件建立空间分析数据库,对一期与二期梅毒疫情进行空间自相关分析,利用SaTScan 9.7软件进行时空扫描聚类分析。结果 浙江省2016—2020年共报告一期与二期梅毒33 226例,年报告发病率呈下降趋势(趋势χ^(2)=26.136,P<0.001);各县(区)年均报告发病率为11.65/10万(2.62/10万~40.40/10万),空间分布总体表现为东部较高、中部较低的态势;全局自相关分析结果提示一期与二期梅毒疫情呈聚集性分布(各年报告发病率Moran’s I指数均>0,均Z>1.96,均P<0.001),局部自相关分析显示存在1个空间相近的高-高聚集区域(台州市椒江区、黄岩区、三门县、临海市)和4个低-低聚集区域(分别为丽水市青田县、温州市鹿城区、瓯海区、瑞安市;金华市磐安县、东阳市;绍兴市柯桥区;衢州市龙游县)。局部G统计量热点分析结果显示存在6个正热点区域(台州市椒江区、黄岩区、路桥区、天台县、三门县、临海市)和5个负热点区域(温州市鹿城区、瓯海区、瑞安市、衢州市龙游县、绍兴市嵊州市);SatScan时空扫描探测到4个聚集区域,最大可能聚集区和次级可能聚集区主要集中在宁波市、舟山市和台州市等东部沿海地区。结论 浙江省一期与二期梅毒报告发病率存在空间聚集性特征,应加强东部沿海地区的梅毒防控工作。

Objective To analyze the spatiotemporal distribution of primary and secondary syphilis in Zhejiang province from 2016 to 2020, explore the clustering area and provide theoretical basis for the accurate prevention and control of syphilis.Methods The data of primary and secondary syphilis cases in Zhejiang were collected from China Disease Control and Prevention Information System, and software arcgis 10.8 was used to establish a spatial analysis database for spatial autocorrelation analysis. Software SaTScan 9.7 was used for spatiotemporal scanning analysis. Results In Zhejiang, a total of 33 226 cases of primary and secondary syphilis were reported from 2016 to 2020, with the average incidence rate of 11.65/100 000(from 2.62/100 000 to 40.40/100 000), and the annual incidence rates showed a decrease trend(χ^(2)=26.136, P<0.001). In terms of the overall spatial distribution, the incidence was higher in eastern area and lower in central area. The global autocorrelation results showed that the incidence of primary and secondary syphilis showed clustering(Moran’s I index were all >0, Z values were all >1.96, and P values were all <0.001), and the local autocorrelation analysis showed that there was one high-high clustering area in Jiaojiang, Huangyan, Sanmen and Linhai of Taizhou and 4 low-low clustering areas(Qingtian in Lishui, Lucheng, Ouhai and Rui’an in Wenzhou, Pan’an and Dongyang in Jinhua, Keqiao in Shaoxing, Longyou in Quzhou).The results of local G-statistic hotspot analysis showed that there were 6 ‘positive hotspots’(Jiaojiang, Huangyan, Luqiao,Tiantai, Sanmen and Linhai of Taizhou) and 5 ‘negative hotspots’(Lucheng, Ouhai, Rui’an of Wenzhou, Longyou of Quzhou,Shengzhou of Shaoxing) in Zhejiang. Spatiotemporal scanning detected four clustering areas, the most likely clustering and secondary likely clustering were mainly in Taizhou, Ningbo and Zhoushan along the eastern coast. Conclusion The incidence rate of primary and secondary syphilis reported in Zhejiang showed spatial clustering. In the future, syphilis prevention and control in the eastern coastal area of Zhejiang should be strengthened.