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中国防痨杂志 ›› 2022, Vol. 44 ›› Issue (5): 478-483.doi: 10.19982/j.issn.1000-6621.20210700

• 论著 • 上一篇    下一篇

2011—2020年湖南省学生结核病时空特征分析

龚德华, 唐益, 谭文倩, 王巧智()   

  1. 湖南省结核病防治所,长沙 410013
  • 收稿日期:2021-12-08 出版日期:2022-05-10 发布日期:2022-05-04
  • 通信作者: 王巧智 E-mail:373448885@qq.com

Spatial-temporal analysis of tuberculosis among students in Hu’nan Province, during 2011—2020

GONG De-hua, TANG Yi, TAN Wen-qian, WANG Qiao-zhi()   

  1. Institute of Tuberculosis Prevention and Treatment of Hu’nan Province, Changsha 410013, China
  • Received:2021-12-08 Online:2022-05-10 Published:2022-05-04
  • Contact: WANG Qiao-zhi E-mail:373448885@qq.com

摘要:

目的: 分析2011—2020年湖南省学生结核病空间聚集特征,为学校结核病防控提供参考依据。方法: 登记学生结核病病例相关信息数据来源于《中国疾病预防控制信息系统》的子系统《结核病管理信息系统》,在此系统下载2011年1月1日至2020年12月31日登记的学生结核病患者病案信息,共17397条,同期学生人口数据来源于《湖南统计年鉴》。采用ArcGIS 10.7软件进行空间自相关分析及局部自相关分析,采用SaTScan 9.5软件进行时空聚集性分析,时空分析结果采用ArcGIS 10.7软件实现可视化。结果: 2011—2020年湖南省学生结核病登记发病率呈现下降-上升-下降趋势,年平均登记发病率为14.04/10万(17397/12388.26万),2011—2020年登记发病率分别为13.67/10万(1581/1156.18万)、12.00/10万(1375/1145.44万)、11.92/10万(1374/1152.59万)、10.74/10万(1269/1181.33万)、10.16/10万(1238/1218.12万)、9.22/10万(1154/1251.26万)、12.23/10万(1566/1280.87万)、21.97/10万(2864/1303.71万)、18.97/10万(2532/1334.48万)、17.91/10万(2444/1364.28万)。全局自相关分析结果显示,2011—2020年湖南省学生结核病登记发病率存在空间聚集性[莫兰指数(Moran I)=0.316,P<0.05],2013年(Moran I=0.379,P=0.045)、2015年(Moran I=0.353,P=0.041)、2019年(Moran I=0.472,P=0.007)和2020年(Moran I=0.434,P=0.014)学生结核病登记发病率存在空间聚集性。局部空间自相关分析结果显示,2011—2020年学生结核病登记发病率局部空间自相关呈现3种聚集模式:高-高、低-低、低-高,高值聚集区(高-高聚集)主要集中在张家界市。时空扫描结果显示,学生结核病登记发病率存在时空聚集性,共扫描发现2个时空聚集区域,一级聚集区域分布于湖南省西北部,包括张家界市、湘西州和常德市区域,聚集时间为2017—2020年,LLR=622.22,RR=2.53,P<0.001。二级聚集区覆盖5个市,分别是郴州市、衡阳市、永州市、邵阳市和株洲市。结论: 2011—2020年湖南省学生结核病登记发病率在市州尺度水平上存在时空聚集,“高-高”聚集区域主要在湖南省西北部,以张家界市为中心,辐射周边湘西州和常德市。

关键词: 结核, 学生, 时空聚类分析

Abstract:

Objective: To analyze the spatial clustering characteristics of tuberculosis among students in Hu’nan Province from 2011 to 2020, and to provide a reference for the prevention and control of tuberculosis in schools. Methods: Medical record data of student tuberculosis patients registered from January 1, 2011 to December 31, 2020 was download from the “Tuberculosis Management Information System” which was an subsystem of the “Chinese Disease Prevention and Control Information System”. There were 17397 cases of student tuberculosis patients, and the student population data during the same period was obtained from the “Hunan Statistical Yearbook”. ArcGIS 10.7 was used for global and local spatial autocorrelation analysis, and SaTScan 9.5 was used for spatiotemporal aggregation analysis, and results were visualized with ArcGIS 10.7. Results: From 2011 to 2020, the registered incidence rate of tuberculosis among students in Hu’nan Province showed a downward-up-down trend. The average annual registered incidence rate was 14.04/100000 (17397/123882600). From 2011 to 2020, the registered incidence rate were 13.67/100000 (1581/11561800), 12.00/100000 (1375/11454400), and 11.92/100000 (1374/11525900), 10.74/100000 (1269/11813300), 10.16/100000 (1238/12181200), 9.22/100000 (1154/12512600), 12.23/100000 (1566/12808700), 21.97/100000 (2864/13037100), 18.97/100000 (2532/13344,800), 17.91/100000 (2444/13642800) respectively. From 2011 to 2020, the results of the global autocorrelation analysis of the registration incidence of tuberculosis among students in Hu’nan Province showed that there was spatial clustering for total (Moran I=0.316, P<0.05), and spatial clustering in 2013 (Moran I=0.379, P=0.045),2015 (Moran I=0.353,P=0.041),2019 (Moran I=0.472, P=0.007) and 2020 (Moran I=0.434, P=0.014). The results of the local spatial autocorrelation analysis showed three aggregation modes (high-high, low-low, low-high), and the high-value clustering area (high-high clustering) mainly concentrated in Zhangjiajie City. The results of spatio-temporal scanning proved spatio-temporal clustering existed with 2 spatio-temporal clustering areas. The first-level clustering area was the northwestern region of Hu’nan Province, including Zhangjiajie, Xiangxi and Changde City. The clustering time was during 2017—2020, LLR=622.22, RR=2.53, P<0.001. The secondary clustering area included 5 cities, namely Chenzhou, Hengyang, Yongzhou, Shaoyang and Zhuzhou. Conclusion: From 2011 to 2020, the registered incidence of tuberculosis among students was clustered in time and space at the city or state level. The “high-high” clustering area was mainly in the northwest of Hu’nan Province, with Zhangjiajie City as the center, and radiating to the surrounding cities (Xiangxi and Changde).

Key words: Tuberculosis, Students, Space-time clustering

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