2010-2020年山东省临沂市水痘流行特征与时空聚集性分析

Epidemiological characteristics and spatiotemporal clustering analysis of varicella in Linyi City,Shandong Province from 2010 to 2020

目的分析2010-2020年山东省临沂市水痘发病的流行趋势、空间流行特征及时空分布特征,探索山东省临沂市12县区水痘发病高危区域,为卫生行政部门制定合理的防控措施提供理论依据。方法通过中国疾病预防控制信息系统收集2010-2020年山东省临沂市12县区水痘报告病例数据,采用描述性流行病学方法进行基本情况分析。应用空间自相关和时空扫描分析等方法研究山东省临沂市水痘发病时空分布特征。结果2010-2020年山东省临沂市水痘年平均发病率为8.82/10万。发病率与时间分布无明显的线性关系,不同年度、县区发病率比较,差异均有统计学意义(P<0.05);发病率存在明显的地域分布差异,呈现随着远离中心区域而降低的趋势;男性水痘发病率(10.15/10万)高于女性(7.44/10万),差异有统计学意义(P<0.05);各年龄均有病例,5~<10岁发病率最高(36.32/10万),各年龄发病率比较,差异有统计学意义(P<0.05),随着年龄增加,发病率呈明显下降趋势。2010-2020年山东省临沂市水痘发病率存在明显的空间正相关性;兰山区、河东区、罗庄区为高-高聚集区域,沂水县、沂南县、郯城县为低-低聚集区域,兰山区、河东区、罗庄区为高发热点区域,沂水县、沂南县、郯城县为冷点区域,其余区域无明显意义。高-高聚集区域同时也是高发热点区域,低-低聚集区域同时也是冷点区域,存在区域对应性。空间预测结果与水痘发病区域分布结果基本一致。时空聚集性分析检测到2010-2020年一类聚集区域发生在山东省临沂市中部地区,主要为兰山区、罗庄区、河东区3个县区,聚集时间为2018-2020年。结论山东省临沂市水痘发病存在明显的空间聚集性及时间聚集性,通过开展疫情监测、落实健康教育、引导高风险人员及时接种水痘疫苗等综合性防控措施,加强发病聚集区域疫情防控人员和防控资源配置,可有效降低发病率。

Objective To analyze the prevalence trend,spatial epidemic characteristics and temporal and spatial distribution characteristics of varicella in Linyi City,Shandong Province,from 2010 to 2020,and to explore the high-risk areas of varicella in 12 counties of Linyi City,Shandong Province,so as to provide theoretical basis for health administration departments to formulate reasonable prevention and control measures.Methods The data of varicella cases in 12 counties of Linyi City,Shandong Province from 2010 to 2020 were collected through the Chinese Disease Prevention and Control Information System,and the basic situation was analyzed by descriptive epidemiology.Spatial autocorrelation and temporal scanning were used to study the temporal and spatial distribution of varicella in Linyi City,Shandong Province.Results The annual average incidence of varicella was 8.82/100000 in Linyi City,Shandong Province from 2010 to 2020.There was no obvious linear relationship between the incidence and the time distribution,and there was a statistically significant difference in incidence rate in different years and counties(P<0.05).There were obvious regional differences in incidence,and the incidence tended to decrease with distance from the central area.The incidence rate of varicella in men(10.15/100000)was higher than that in women(7.44/100000),with a statistically significant difference(P<0.05).There were cases in all ages,with the highest incidence of 5-<10 years old(36.32/100000),and the difference was statistically significant(P<0.05).With the increase of age,the incidence showed a significant decreasing trend.There was a significant spatial positive correlation between the incidence of varicella in Linyi city,Shandong Province from 2010 to 2020.Lanshan District,Hedong District,and Luozhuang District were high to high clustering areas,while Yishui County,Yinan County,and Tancheng County were low to low clustering areas.Lanshan District,Hedong District and Luozhuang District were high incidence hot spots,while Yishui County,Yinan County and Tancheng County were cold spots,and the other areas had no obvious significance.The high-high clustering area was also a high incidence hot spot area,while the low-low clustering area was also the cold spot area with regional correspondence.The spatial prediction results were basically consistent with the regional distribution of varicella disease.The spatiotemporal clustering analysis detected that a type of clustering area occurred in the central region of Linyi City,Shandong Province from 2010 to 2020,mainly consisting of three counties and districts:Lanshan District,Luozhuang District,and Hedong District.The clustering period was from 2018 to 2020.Conclusion The incidence of varicella in Linyi City,Shangdong Province has obvious spatial and temporal clustering.The incidence rate can be effectively reduced by carrying out epidemic surveillance,implementing health education,guiding high-risk personnel to vaccinate varicella vaccine in time and other comprehensive prevention and control measures,and strengthening the allocation of epidemic prevention and control personnel and prevention and control resources in the areas where the incidence of varicella is concentrated.