2010—2023年中国梅毒流行趋势及时空分布特征

Epidemiological trends and spatio-temporal distribution characteristics of syphilis in China from 2010 to 2023

目的分析中国2010—2023年梅毒的流行趋势与时空分布特征。方法通过中国疾病预防控制信息系统传染病监测系统收集2010—2023年31个省、自治区和直辖市梅毒病例报告数据,利用Joinpoint 5.2.0软件进行流行趋势分析,应用ArcGIS 10.5软件以县区为单位进行空间自相关分析,使用SaTScan 10.2.3软件进行时空扫描分析。结果2010—2023年全国梅毒报告发病率由26.86/10万上升至37.60/10万,年均变化百分比为1.82%(95%CI:0.81%~2.89%),报告发病率上升趋势有统计学意义(P=0.002)。全国各县区梅毒报告发病率呈显著的空间正自相关(Moran′s I=0.47~0.60,均P<0.001),全局G系数检验统计量Z(G)值均?1.96,表明梅毒报告发病率呈高值聚集模式。局部空间自相关分析显示各年热点地区的数量为180~294个,主要分布于新疆、青海、贵州、四川和云南等。时空扫描分析探测到92个时空聚集区,主要分布于2010—2012年的浙江、广西、广东和福建,2013—2017年的新疆以及2019—2023年的四川、贵州、重庆等。结论2010—2023年中国梅毒报告发病率整体呈上升趋势,疫情存在明显的时空聚集,热点地区与时空聚集区分布基本一致,主要分布于西北、东南沿海和西南地区,时空聚集区随着时间推移逐渐从东南沿海和西北地区转变至西南地区。

Objective To investigate the epidemiological trends and spatio-temporal distribution characteristics of syphilis in China from 2010 to 2023.Methods Data on syphilis cases reported from 31 provinces,autonomous regions or municipalities from 2010 to 2023 were collected from the Infectious Diseases Surveillance System of Chinese Disease Prevention and Control Information System.Joinpoint 5.2.0 software was used to analyze the epidemiological trends of syphilis,ArcGIS 10.5 software was used for spatial autocorrelation analysis at the county level,and SaTScan 10.2.3 software was used for space-time scan analysis.Results The national reported incidence rates of syphilis increased from 26.86 per 100000 in 2010 to 37.60 per 100000 in 2023,with an average annual percent change of 1.82%(95%CI:0.81%-2.89%),and the upward trend in the reported incidence rates was statistically significant(P=0.002).There was a positive spatial autocorrelation in the reported incidence rates of syphilis at the county level in China(Moran'sⅠrange:0.47-0.60,all P<0.001),and all of the Getis-Ord general test statistic Z(G)values were>1.96,indicating a high-value clustering pattern in the reported incidence rates of syphilis.The local spatial autocorrelation analysis showed that the annual number of hotspot areas ranged from 180 to 294,which were mainly located in Xinjiang,Qinghai,Guizhou,Sichuan and Yunnan.A total of 92 spatio-temporal clusters were identified by space-time scan analysis,which were mainly distributed in Zhejiang,Guangxi,Guangdong and Fujian from 2010 to 2012,in Xinjiang from 2013 to 2017,and in Sichuan,Guizhou,Chongqing,etc.,from 2019 to 2023.Conclusions From 2010 to 2023,the reported incidence rates of syphilis in China exhibited a fluctuating increase on the whole,with obvious spatio-temporal clustering characteristics.The hotspot areas were basically consistent with the spatio-temporal clusters,and were mainly distributed in the northwestern,southeastern coastal and southwestern areas.Over time,the spatio-temporal clusters gradually changed from the southeast coastal and northwestern areas to the southwestern areas.