湖南省手足口病发病风险预警分级标准研究及应用

Research and application of early warning and grading standard for the incidence risk of hand,foot and mouth disease in Hunan Province

目的 分析2011-2018年湖南省手足口病(hand, food and mouth disease, HFMD)发病风险指标(发病率、重症比例、EV71阳性率、病死率)与气象因子的相关性,构建预测模型,开展HFMD发病风险预警分级标准研究及应用。方法 采用z-score标准化处理数据,应用层次分析和专家打分法确定HFMD发病风险指标的权重,加权叠加模型得出湖南省HFMD发病风险预警等级值,应用K-means聚类法,将HFMD发病风险预警等级划分为红色、橙色、黄色、蓝色四类,构建湖南HFMD发病风险预警分级标准。结果 发病率、重症比例、EV71阳性率、病死率分别与气象因子构建的多元逐步回归预测模型R2在(0.019~0.119)间,F值在(7.213~37.598)间,发病率、重症比例、EV71阳性率、病死率对HFMD发病风险等级影响的权重分别为0.56、0.26、0.12、0.06,最大特征向量(λmax)=4.118,一致性指标(CI)=0.040,一致性比率(CR)=0.044,CR<0.1,HFMD发病风险预警等级聚类中心为-0.3288、0.3258、1.4141、4.0639,3个阈值为-0.002、0.880、2.750。结论 2011-2017年湖南省HFMD发病风险指标(发病率、重症比例、EV71阳性率、病死率)分别与气象因子构建的多元逐步回归预测模型均通过显著性检验,预测模型有效,HFMD发病风险指标权重有效,基于2017-2018年HFMD发病数据验证湖南省HFMD发病风险预警分级标准,发现预警等级与实际拟合较好,构建的湖南省HFMD发病风险预警分级标准具有较好的使用价值。

Objective To analyze the correlation of hand,foot and mouth disease(HFMD)incidence risk indicators(including the incidence rate,the proportion of severe cases,the positive rate of EV71 and the case fatality rate)with meteorological factors in Hunan Province from 2011 to 2018,to build a prediction model,and to carry out the research and application of early warning and grading standards for the incidence risk of HFMD.Methods The data were processed by z-score standardization.Analytic hierarchy process and expert scoring method were used to determine the weights of HFMD incidence risk indicators,and the weighted superposition model was applied to obtaining the value of early warning level of HFMD incidence risk.Using K-means clustering method,the early warning level of HFMD incidence risk was divided into four categories:red,orange,yellow and blue.The early warning classification standard for HFMD incidence risk in Hunan was constructed.Results As for the multiple stepwise regression prediction model constructed by the incidence rate,the proportion of severe cases,the positive rate of EV71,the case fatality rate and meteorological factors,R 2 was between 0.019 and 0.119,and F value between 7.213 and 37.598.The weights of effects of the incidence rate,the proportion of severe cases,the positive rate of EV71 and the case fatality rate on the grades of HFMD incidence risk were 0.56,0.26,0.12 and 0.06,respectively.The maximum eigenvector(λmax)was 4.118,the consistency index(CI)0.040,the consistency ratio(CR)0.044,and CR<0.1.The cluster centers of early warning grades of HFMD incidence risk were-0.3288,0.3258,1.4141 and 4.0639,respectively.The three thresholds were-0.002,0.880 and 2.750,respectively.Conclusion The multiple stepwise regression prediction model constructed by HFMD incidence risk indicators(including the incidence rate,the proportion of severe cases,the positive rate of EV71 and the case fatality rate)and meteorological factors in Hunan Province in 2011-2017 passed the significance test.The prediction model was valid,and the weights of HFMD incidence risk indicators were effective.The early warning classification standard for HFMD incidence risk in Hunan Province was verified based on the HFMD incidence data in Hunan Province in 2017-2018,and it was found that the predicted early warning level fitted well with the actual situation.The constructed early warning classification standard for HFMD incidence risk in Hunan Province has good application value.