2011—2019年山东省肾综合征出血热时空分布及影响因素

Spatio⁃temporal distribution and influencing factors of hantavirus hemorrhagic fever with renal syndrome in Shandong Province,2011—2019

目的分析2011—2019年山东省肾综合征出血热(HFRS)的流行特征、时空分布及影响因素,为当地HFRS防治提供科学依据。方法收集2011—2019年山东省HFRS发病资料并进行流行特征描述,运用空间自相关、时空扫描方法探究HFRS的时空分布特征,进一步利用地理探测器分析各环境因子及其交互作用对HFRS的影响。结果2011—2019年间山东省报告HFRS共11310例,年均发病率1.24/10万,报告死亡人数142例,病死率为1.26%;男女发病性别比为2.6∶1,重点人群为30~70岁之间的农民;发病具有季节性与时空聚集性,有春峰(4~6月)和秋冬峰(10~12月),空间分布呈东南高、西北低的特点;气温、降水、海拔等因素影响HFRS的发病,q值分别为0.349、0.251、0.203;因子间的两两交互作用能够增加发病风险,其中气温与坡度的交互作用对HFRS发病的影响最大(q=0.627)。结论山东省HFRS发病具有时空聚集性,受各种社会、自然因素的影响,且因子之间的交互作用能增强对HFRS的影响。其中海拔高、降水多、植被覆盖广的中部山区及东南沿海地区发病风险较高,需要重点关注。

Objective To analyze the epidemiological characteristics,spatial⁃temporal distribution and influencing fac⁃tors of hemorrhagic fever with renal syndrome(HFRS)in Shandong Province from 2011 to 2019,so as to provide a scientific basis for the prevention and control of this disease.Methods The data of HFRS were collected and the epide⁃miological characteristics were described.The spatial⁃temporal distribution characteristics were analyzed with spatial au⁃tocorrelation and space⁃time scanning.Geodetector were used to analyze the influence of environmental factors and the interactions on HFRS.Results A total of 11,310 HFRS cases were reported,with an average annual incidence of 1.24/100,000;142 deaths were reported,with a fatality rate of 1.26%.The male⁃to⁃female ratio was 2.6∶1.The key population was farmers aged 30 to 70 years.The incidence showed seasonal and spatial⁃temporal clustering,with spring peak(April-June)and autumn⁃winter peak(October-December).The spatial distribution was higher in the southeast and lower in the northwest.Temperature,precipitation,altitude,and other factors could affect the incidence of HFRS(q=0.349,0.251,0.203).The pairwise interactions between factors could enhance the risk of HFRS.The interaction between temperature and slope was the strongest(q=0.627).Conclusion The incidence of HFRS shows spatial⁃tem⁃poral clustering in Shandong Province,which is influenced by various social and natural factors.The interaction between factors can enhance the impact on HFRS.The central mountainous area with high altitude,abundant precipitation and wide vegetation coverage,and the southeast coastal area have higher risk of HFRS and need pay more attention to the prevention and control of this disease.