中国2004—2019年狂犬病时空分布特征与气象因素驱动效应研究

Study on the spatiotemporal distribution characteristics of rabies and the driving effects of meteorological factors in China from 2004 to 2019

目的了解我国2004—2019年狂犬病的疾病负担现状及其分布特点,深入分析我国国家监测点狂犬病病例的时空分布规律,探究气象因素对狂犬病发病的驱动效应,旨在为防疫策略的制定提供科学支撑。方法收集中国2004—2019年我国狂犬病的时间、地区及人群等病例数据及同期月度气象数据,描述疾病负担现状及流行特征;使用SaTScan 9.0进行时空季节扫描,探究全国各省份聚集效应。通过拟合Quasi-Poisson分布滞后非线性模型,研究月平均相对湿度、月平均相对温度、月累积降水量、日照时长对狂犬病发病的驱动效应。结果2004—2019年中国报告狂犬病共计26605例,广西壮族自治区发病数居全国首位,关于狂犬病疾病负担的年估计百分变化比皆处于下降趋势;季节性高峰集中在6~11月份,对数似然比为516.14;我国狂犬病发病多集中于南部地区,并且有向中部地区扩大蔓延;狂犬病发病在时间尺度上受相对湿度、气温、降水量和日照时长的影响显著,其月平均相对湿度为74.75%、平均气温为8.725℃、平均降水量为59.25 mm、月累计日照时长56.575 h。月平均温度对狂犬病发病率的相对危险度在滞后3个月时达到高峰,相对风险为4.48,月总计日照总时长与狂犬病发病率相对危险度在滞后2个月时达到高峰,相对风险为1.21。结论全国狂犬病全年均有发病且夏秋季高发。狂犬病疾病负担呈下降趋势,但狂犬病病例依旧存在疾病风险,且发病地区较为集中,有较明确的地域性特点,主要分布于中国中部以及南部等地。气温、日照时长等气象因素对疾病发生具有显著驱动作用。

Objective To understand the current status and distribution characteristics of the disease burden of rabies in China from 2004 to 2019,to analyze in depth the spatiotemporal distribution of rabies cases at national monitoring sites in China,and to explore the driving effects of meteorological factors on the occurrence of rabies,so as to provide scientific support for the formulation of epidemic prevention strategies.Methods Case data of rabies in China from 2004 to 2019 were collected,including time,region,and population,as well as concurrent monthly meteorological data,to describe the current status of disease burden and epidemic characteristics.SaTScan 9.0 was used to conduct spatiotemporal seasonal scanning to explore the clustering effect in various provinces.By fitting a Quasi-Poisson distributed lag non-linear model,the study examined the driving effects of monthly average relative humidity,monthly average relative temperature,monthly cumulative precipitation,and sunshine duration on the incidence of rabies.Results From 2004 to 2019,China reported a total of 26605 cases of rabies,with Guangxi Zhuang Autonomous Region ranking first in the number of cases.The annual estimated percentage change in the disease burden of rabies showed a downward trend.The seasonal peak concentrated from June to November,with a log-likelihood ratio of 516.14.The incidence of rabies in China was mainly concentrated in the southern regions and was expanding to the central regions.The incidence of rabies was significantly influenced by relative humidity,temperature,precipitation,and sunshine duration on a temporal scale.The average relative humidity was 74.75%,the average temperature was 8.725℃,the average precipitation was 59.25 mm,and the cumulative sunshine duration was 56.575 h.The relative risk of monthly mean temperature for rabies incidence peaked at a lag of 3 months,with a relative risk of 4.48.The relative risk of total sunshine duration and rabies incidence peaked at a lag of 2 months,with a relative risk of 1.21.Conclusion Rabies occurs throughout the year nationwide,with a higher incidence in summer and autumn.The disease burden of rabies shows a downward trend,but rabies cases still pose a risk of disease,and the areas of occurrence are relatively concentrated,showing clear regional characteristics,mainly distributed in central and southern China.Meteorological factors such as temperature and sunshine duration play a significant role in driving the occurrence of the disease.