关键词: 结核,肺, 患病率, 流行病学研究, 时空聚类分析, 数据说明,统计, 小地区分析

Abstract:

Objective To analyze the epidemiological condition and spatiotemporal characteristics of the smear-positive pulmonary tuberculosis (PTB) in Guangdong province from 2013 to 2017.Methods The information of the smear-positive PTB patients was collected by “China Disease Prevention and Control Information System and Tuberculosis Management Information System” in Guangdong province from 2013 to 2017, and accumulating 126848 cases were registered. In the same period, the resident population data of counties (districts) in Guangdong Province were from the annual statistical yearbooks of Guangdong Province. The vector map of Guangdong Province was used as the spatial structure database, and then the geographic information database was associated with the registration data of smear-positive PTB patients and population data. Spatial aggregation of the smear-positive PTB patients was explored by global and local spatial auto-correlation analysis.Results The average annual registration rate of smear-positive PTB patients was 24.1/100000 in Guangdong Province from 2013 to 2017. At the county (district) level, the smear-positive PTB showed spatial auto-correlation on the whole every year (Moran’s I value, 0.14-0.35), with the highest aggregation in 2017 (Moran’s I=0.35, Z=6.64, P=0.001). Local spatial auto-correlation analysis showed that the high-high clusters of smear-positive PTB patients were scattered throughout the province in 2013 and 2014, and the high-high clusters were mainly distributed in the Pearl River Delta (PRD) region during 2015-2017. Temporal and spatial scan analysis demonstrated that the primary cluster of which the center was Xiangzhou District of Zhuhai city covered 35 counties (districts) from April 2016 to December 2017 (log likelihood ratio (LLR)=358.47, relative risk (RR)=1.22, P<0.01). The two secondary clusters of which the center was Suixi county of Zhanjiang city covered 12 counties (districts) from June 2013 to May 2014 (LLR=338.33, RR=1.42, P<0.01), and of which the center was Jiexi county of Jieyang city covered 6 counties (districts) from January 2013 to April 2014 (LLR=211.34, RR=1.47, P<0.01).Conclusion The registration rate of smear positive PTB in Guangdong province shows spatial clustering distribution on the whole. In hot spots with dense population and floating population, such as the PRD, the risk of PTB transmission is high. Therefore, the treatment and management of PTB patients in these regions should be strengthened, which can prevent PTB spread to surrounding areas.

Key words: Tuberculosis,pulmonary, Prevalence, Epidemiologic studies, Space-time clustering, Data interpretation,statistical, Small-area analysis