2018-2022年浙江省钩端螺旋体病流行特征与时空聚集性分析

Epidemiological characteristics and spatiotemporal clustering analysis of leptospirosis in Zhejiang Province from 2018 to 2022

目的分析2018-2022年浙江省人间钩端螺旋体病(钩体病)的流行特征与时空分布特点,为制定钩体病防控策略提供科学依据。方法钩体病数据来源于中国疾病预防控制信息系统,采用描述性流行病学方法进行分析。应用ArcMap 10.8软件进行空间自相关分析和结果可视化展示,通过SaTScan 10.1.2软件进行时空扫描,分析和描述钩体病时空聚集性特征。结果浙江省2018-2022年共报告人间钩体病病例255例,包含1例死亡病例,年均发病率为0.0843/10万,年均死亡率为0.0003/10万。8月至10月为浙江钩体病高发月份,病例以45~86岁的中年及老年人为主(221例,86.67%),65~69岁年龄组发病人数最多(57例),男女比例为4.67∶1,职业主要为农民(190例,74.51%)。温州市和丽水市的5年累计发病数(201例)占总发病数的78.82%。2018-2022年全局空间自相关分析表明全省钩体病发病率呈现空间正自相关;局部空间自相关分析显示,“高-高”聚集区主要集中在浙江省南部山地丘陵地带的温州市、丽水市和台州市。时空扫描分析在浙江省南部发现3个高发聚集区域。结论浙江省钩体病发病呈现明显的地区聚集性和季节性,高发区域主要位于浙江南部的山地和丘陵地区,病例以中老年男性农民为主,需加强农村居民健康教育,防范潜在流行风险。

The epidemiological and spatiotemporal distribution characteristics of human leptospirosis in Zhejiang Province from 2018 to 2022 were analyzed,to provide a scientific basis for formulating leptospirosis prevention and control strategies.Data on leptospirosis were collected from the China Information System for Disease Control and Prevention,and analyzed with descriptive epidemiological methods.ArcMap 10.8 software was used for spatial autocorrelation analysis and visual display of the results.SaTScan 10.1.2 software was used for spatiotemporal scanning,to analyze and describe the spatiotemporal aggregation characteristics of leptospirosis.A total of 255 human cases of leptospirosis were reported in Zhejiang Province from 2018 to 2022,including one death;the average annual incidence was 0.0843/100000,and the average annual mortality was 0.0003/100000.The highest incidence of leptospirosis in Zhejiang occurred from August to October.Most cases were in middle-aged and older people 45-86 years of age(221 cases,86.67%).The number of cases was highest among people 65-69 years of age(57 cases).The male to female ratio was 4.67∶1.The main occupation was farming(190 cases,74.51%).The cumulative number of cases in Wenzhou and Lishui in 3 years(201 cases)accounted for 78.82%of the total cases.The global spatial autocorrelation analysis from 2018 to 2022 showed that the incidence of leptospirosis in the province presented a positive spatial autocorrelation.Local spatial autocorrelation analysis indicated that the“high-high”gathering areas were concentrated primarily in Wenzhou,Lishui,and Taizhou in the mountainous and hilly areas of southern Zhejiang Province.Spatiotemporal scanning analysis revealed three clusters with high incidence in southern Zhejiang Province.The incidence of leptospirosis in Zhejiang Province showed clear regional clustering and seasonality,and the high incidence area was mainly in the mountainous and hilly areas of southern Zhejiang Province.The cases occurred mainly in middle-aged and older male farmers.Health education among rural residents should be strengthened to prevent potential epidemic risks.