Spatial analysis on smear-positive pulmonary tuberculosis in Zhejiang province between year 2015 and 2017

doi:10.3969/j.issn.1000-6621.2018.10.012

Abstract

Abstract:

Objective To analyze the spatial distribution pattern of smear-positive pulmonary tuberculosis patients registered in Zhejiang province, and determine the gathered areas, providing theoretical basis for further study of the risk factors of tuberculosis and prevention and control strategies. Methods The registration data of smear-positive pulmonary tuberculosis in 89 counties in Zhejiang province from 2015 to 2017 was collected and was merged with a vector map to build spatial databases by ArcGIS (version 10.0). Global Moran’s I and local Moran’s I were calculated by GeoDa (version 1.6.0) software respectively, as well as spatial-temporal analysis were studied by SaTScan (version 9.3)software to detect the spatial autocorrelation and cluster range of the distribution of smear-positive pulmonary tuberculosis in Zhejiang province. Results From 2015 to 2017, a total of 30292 cases of smear-positive pulmonary tuberculosis were registered in Zhejiang province, and the mean annual registered incidence rate of each region was 20.69/100000 (range: 4.73 to 45.61/100000). The distribution of smear-positive pulmonary tuberculosis of each region in Zhejiang province showed global spatial autocorrelation (Moran’s I=0.429,Z=5.834,P=0.001). While at the local scale, 25 regions (P<0.05) with positive local spatial correlation (high-high pattern and low-low pattern) and negative local spatial correlation (low-high pattern and high-low pattern) were sort out for analysis, in which 12 regions showed high-high pattern and 11 regions showed low-low pattern, accounting for 92.0% (23/25), indicating the main result of local spatial autocorrelation analysis was positive. Spatial-temporal analysis using SaTScan software detected four cluster areas including 18 regions, and each cluster area showed statistical significance (P<0.001) with log likelihood ratio (LLR) of 211.54,57.66,51.70,44.47, respectively. Conclusion There are apparent spatial autocorrelation and relative strong spatial heterogeneity existed in the distribution of smear-positive pulmonary tuberculosis in Zhejiang province.

Key words: Tuberculosis, pulmonary, Disease notification, Poisson distribution, Epidemiologic studies, Spatial-temporal analysis

Jian-mei WANG,Yu ZHANG,Nan QIN,Yue WANG,Lin ZHOU,Wei-bing WANG. Spatial analysis on smear-positive pulmonary tuberculosis in Zhejiang province between year 2015 and 2017[J]. Chinese Journal of Antituberculosis, 2018, 40(10): 1089-1094. doi: 10.3969/j.issn.1000-6621.2018.10.012

Figures/Tables 10

References 22

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地级市	2015年			2016年			2017年
地级市	人口数 (万)	涂阳患者例数	登记发病率 (/10万)	人口数 (万)	涂阳患者例数	登记发病率 (/10万)	人口数 (万)	涂阳患者例数	登记发病率 (/10万)
杭州市	715.8	1 581	22.09	723.6	1 351	18.67	736.0	1 389	18.87
湖州市	263.8	606	22.97	263.7	556	21.08	264.8	510	19.26
嘉兴市	348.1	783	22.49	349.5	801	22.92	352.1	702	19.94
金华市	475.1	1 570	33.05	478.1	1 460	30.54	481.2	1 430	29.72
丽水市	265.7	401	15.09	266.4	450	16.89	268.0	461	17.20
宁波市	583.8	1 317	22.56	586.6	1 284	21.89	591.0	1 345	22.76
衢州市	255.7	598	23.39	256.4	568	22.15	257.5	591	22.95
绍兴市	443.0	928	20.95	443.1	919	20.74	444.5	922	20.74
台州市	597.1	1 033	17.30	597.5	945	15.82	600.2	1 064	17.73
温州市	813.7	1 658	20.38	811.2	1 393	17.17	818.2	1 394	17.04
舟山市	97.5	119	12.21	97.4	93	9.55	97.3	70	7.19
合计	4 859.2	10 594	21.80	4 873.3	9 820	20.15	4 910.8	9 878	20.11

年份	涂阳肺结核登记情况
年份	Moran’s I指数	Z值	P值
2015	0.387	5.299	<0.001
2016	0.376	5.063	<0.001
2017	0.412	5.532	<0.001
年均	0.429	5.834	<0.001

聚集模式	浙江省各县(市、区)
高-高聚集模式	武义县、金东区、兰溪市、开化县、义乌市、浦江县、建德市、淳安县、桐庐县、镇海区、临安市、嘉善县
低-低聚集模式	泰顺县、文成县、天台县、滨江区、上城区、下城区、西湖区、江干区、拱墅区、普陀区、景宁畲族县
低-高聚集模式	衢江区、诸暨市
高-低聚集模式	无

聚集区域	县(市、区)	时间 (年)	登记患者例数	预计患者例数	RR值	LLR值	P值
第一	婺城区、龙游县、金东区、兰溪市、义乌市、浦江县、建德市、淳安县、桐庐县	2015	1 626	942	1.77	211.54	<0.001
第二	鹿城区、瓯海区	2015	427	243	1.77	57.66	<0.001
第三	海曙区、鄞州区、北仑区、江北区、镇海区	2017	725	486	1.50	51.70	<0.001
第四	秀洲区、南湖区	2016	321	181	1.78	44.47	<0.001