2017-2021年凉山州肺结核时空特征分析

Analysis of spatio-temporal characteristics of pulmonary tuberculosis in Liangshan Prefecture from 2017 to 2021

目的 分析2017-2021年凉山州肺结核发病的流行趋势及时空分布特征。方法 导出《中国疾病预防控制信息系统》子系统《结核病管理信息系统》中2017-2021年凉山州的发病数据,采用Excel 2010软件进行前期数据处理;利用SSPS 17.0、Arcgis 10.8和SaTScan 9.6软件进行报告发病趋势分析和时空扫描,探索时空聚集性,以P<0.05为差异有统计学意义。结果 2017-2021年凉山州肺结核报告发病率均在100/10万以上,报告发病的男性远多于女性,发病年龄的高峰为15~29岁的青壮年人群,职业分布以农民工发病最多,其次为学生,每年的2月、11月报告发病有所降低,发病的高峰基本在3-7月,差异有较明显的季节性。全局空间自相关结果显示,2017-2021年Moran指数I值分别为0.58、0.51、0.60、0.49和0.43,均有统计学意义(P均<0.05),报告发病率呈聚集性分布。局部空间自相关分析结果显示,2017-2021年分别有4、3、2、1和4个县处于“高-高”区域。2020-2021年存在两个时空聚集区,其中一级聚集区以美姑县为聚集中心(LLR=1 479,RR=2.03,P<0.001)。结论 凉山州近年来疫情居高不下,发病存在一定的时空聚集性,高发病率地区主要集中在东部和中部地区,应针对发病风险人群及疫情高发地区,强化主动筛查,分类分时的采取措施进行防治。

Objective To analyze the epidemiological trend and spatio-temporal characteristics of pulmonary tuberculosis(PTB)in Liangshan Prefecture from 2017 to 2021.Methods The incidence data of Liangshan Prefecture from 2017 to 2021 in the subsystem Tuberculosis Management Information System of Chinese Disease Control and Prevention Information System were derived.Excel 2010 software was used for preliminary data processing.SSPS 17.0,Arcgis 10.8 and SaTScan 9.6 softwares were used to analyze the reported incidence trend,scan the time and space,and explore the time and space aggregation.The difference was statistically significant with P<0.05.Results From 2017 to 2021,the reported incidence rate of pulmonary tuberculosis in Liangshan Prefecture wasmore than 100/10^(5),and the number of reported cases of males was bigger than that of females.The peak age of the onset was young adults between 15 and 29 years old.In terms of occupational distribution,migrant workers were the most affected,followed by students.The reported incidence decreased in February and November of every year,and the peak of the incidence was basically from March to July,with obvious seasonality.The global spatial autocorrelation results showed that the Moran index I values from 2017 to 2021 were 0.58,0.51,0.60,0.49 and 0.43,respectively,with statistically significant(All P<0.05).The reported incidence showed a clustered distribution.The results of local spatial autocorrelation analysis showed that 4,3,2,1 and 4 counties were in the"high-high"area from 2017 to 2021,respectively.From 2020 to 2021,there were two spatiotemporal gathering areas,of which the first-level aggregation area was centered in Meigu County(log-likelihood ratio LLR=1479,risk ratio RR=2.03,P<0.000).Conclusions The epidemic situation in Liangshan Prefecture had remained high in recent years,and the incidence had a certain spatial and temporal clustering.The areas with high incidence rate were mainly concentrated in the eastern and central regions.It is necessary to strengthen active screening and take classified and time-sharing measures to prevent and control the disease for the population at risk and areas with high incidence.